Talk:HIV/Archive 2

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This archive page covers approximately the dates between 7 June 2005 to 6 June 2006

What was the link between HIV and AIDS based on?

Dr. Luc Montagnier of France created this link between HIV and AIDS, can someone please point me in the direction of the scientific evidence that was used to make this claim?

If you read the abstract of the 1983 paper by Luc Montagnier, you will see that actual claim made on the basis of one patient was a retrovirus that "may be involved in AIDS". This abstract was in fact written by Gallo. At the latter Gallo press release about a "possible" cause of AIDS was incorrectly reported in the press as a "probable" cause of AIDS. When the HIV antibody test was developed several months later it was discovered that about half the diagnosed AIDS patients in the United States did not test positive. As a postive HIV antibody test was then required for an AIDS diagnosis, these patients were reclassified as not having AIDS. Sci guy 13:22, 17 October 2005 (UTC)

I thought it was Gallo. JFW | T@lk 03:57, 7 Jun 2005 (UTC)

That's a *HOTLY* debated point. There have been accusations (with actual evidentiary claims to back them up) that Gallo stole Montagnier's work (if memory serves, Montagnier sent him a sample of the virus and then Gallo published before Montagnier, leading many to suspect he used the sample sent him in an unethical way). For a time, I believe Gallo was investigated for unethical behavior relating to that. →Raul654 04:09, Jun 7, 2005 (UTC)

Raul, I was trolling the anon. JFW | T@lk 04:14, 7 Jun 2005 (UTC)

For a brief history of AIDS:

• start here: NEJM, December 10, 1981
• then, the association with HTLV, in the same issue of 'Science':
  • Gallo
  • Mongagnier
• By 1984, Gallo gets more confident about the virus he calls HTLV-III.
• At the same time, Montagnier chases down LAV.
• Then, at the end of 1984, two articles in 'Nature' report cloning the virus:
  • In November, Gallo.
  • In December Montagnier.

You be the judge. I'm inclined to call it a draw. Polacrilex 04:59, Jun 7, 2005 (UTC)

Thanks, I may just be crazy but I really think there should be a "simple" translation of all this medical jargon. Quite frankly I'm not sure that I want to draw my own conclusion. I would like to think that if I test positive for HIV and have my life runied, that there is a good reason for someone doing so.

--Warrick FitzGerald 02:40, 10 Jun 2005 (UTC)

Now that is a more difficult issue (if I understand your point correctly). Simply proving an association between HIV and AIDS is easier than proving a causal relationship. The best method that science has to do the latter is contained in Koch's postulates, in which four findings must exist between an organism and a disease to establish causality:

• It must be found in patients with the disease, but not in those without (not satisfied by HIV, in which some patients with detectable virus never develop symptoms)
• An individual sample must be isolated from a patient with the disease (satisfied by HIV)
• The organism so isolated should cause the disease when introduced into a healthy animal (hopefully never done in humans, and difficult to do in animals)
• The organism should then be able to be isolated from the now diseased animal (again, difficult to do in animals).

Polacrilex 16:28, Jun 10, 2005 (UTC)

Posted by Michael Gerzon (7/11/05): About Koch's postulates - you don't need them any more. When Koch's invented them (19-th century), there were no other way to check how virus or bacteria cause disease, because there were no molecular biology technics at that time. Nowadays you can see from the experiment, that HIV destroys cells of the immune system. What more do you need to believe that HIV cause immune deficiency (AIDS) ? To use those postulates now is like using a calculator instead of computer to launch someone in space. Surely, you can still use them, but if you have problems in doing so, like in case with HIV, there are other experimental data you can relay on.

Structure of the Article

I have just restructured the article because I found that it focused on the AIDS side of HIV infection, something better done in the AIDS article and it talked about the function of virally encoded proteins before it described them. I also added more information on the basic life cycle, but not too much to be confusing. If the article is to be about HIV, surely the virus characteristics should come first? --Grcampbell 23:22, 10 August 2005 (UTC)

You repeatedly changed "antibodies to HIV are one of the criteria for a diagnosis of AIDS." to "antibodies to HIV are one of the criteria for an HIV diagnosis. "The original statement is intended to identify the importance of HIV in a diagnosis of AIDS and also convneiently link the articles in the introduction. It is not easy for other editors to clearly identify the other changes you have made, which you have not discussed in any detail. Also Wikipedia is not the place to publish your original research or promote your publications. For all these reasons, I am restoring the consensus version by Jredmond and Joy Stovall. I agree it can be improved, but this needs to be done it ways that other editors can understand and support and with appropriate references Sci guy 16:33, 12 August 2005 (UTC)

Yes, I agree, it is much better to have inaccuracies in an article as long as they agree with your pseudo-science. Not. The changes made focus the article on HIV itself, give more detail to the subtype variations, replication cycle and transmission strategy differences throughout the world. It has also removed repititions and factual inaccuracies such as HIV having a shell. It is called an enveloped capsid. Now on to the statement change that you first brought up:

"antibodies to HIV are one of the criteria for a diagnosis of AIDS." to "antibodies to HIV are one of the criteria for an HIV diagnosis

They are a criteria, but are not specific to an AIDS diagnosis, see AIDS defining clinical conditions or the CDC if you like. Also, it is not specific, as the presence of some antibodies to HIV actually prevent the progression to an AIDS diagnosis. This has been documented many times by teams in both Italy and the USA. If you want factual inaccuracies, keep changing the article, if you want Wikipedia to become a reference point with clear and correct data, stop pushing your own POV. And BTW FYI my original research is published in medical journals and have been cited many times over the past 10 years. However, I do not push my original research on this board, merely, correct the factual errors that you seem to like to push for whatever reason only known to yourself. --Grcampbell 19:16, 12 August 2005 (UTC)

You have convinced me. Do you have reference for "some antibodies to HIV actually prevent the progression to an AIDS diagnosis"? You are correct there is no need to refer to HIV antibodies here. The original context in an earlier verison was that in some countries most of the people diagnosed with AIDS were not infected with HIV, but in the USA evidinece of HIV infection was required for an AIDS diagnosis. This was later edited to "one criteria". I am deleting the offending text Sci guy 08:59, 13 August 2005 (UTC)

Listed below are the differences between Sci Guys version replaced by Grcampbell:

"In the United States and Europe, antibodies to HIV are one of the criteria for a diagnosis of AIDS." - Rewritten to: "In the United States and Europe, antibodies to the HIV gp120 and p24 antigens are one of the criteria for an HIV-AIDS diagnosis."

Did you know that antibodies against HIV-1 Tat are seen as a diagnosis of LTS or LTNP status? Probably not.

"More specifically, HIV is a lentivirus, a one of genus of retroviruses that are characterized by long latency periods [1] and lipid-coated outer shells" - Rewritten to: "HIV is a member of the genus lentivirus, part of the family of retroviridae that are characterized by long latency periods [1] and a lipid envelope of host cell origin surrounding a protein/RNA core.

"Inside the virus there are two identical strands of RNA, in the same way that we have two identical copies of each chromosome. The RNA is coated by the CA protein (formed from Gag) and is not easily seen unless the virus particles are broken apart. The reverse transcriptase enzyme, which includes integrase, is also packaged into the virus along with certain other important proteins (some from the virus, some captured from the cell) and a tRNA molecule that initiates the reverse transcription process. Because the virus contains certain proteins it needs to replicate, injection of the pure RNA will not result in a successful infection." - Rewritten to: "HIV-1 is composed of two copies of single-stranded RNA enclosed by a conical nucleocapsid comprised of the viral protein p24, typical of lentiviruses. This is in turn surrounded by a plasma membrane of host-cell origin. The single-stranded RNA is tightly bound to the nucleocapsid proteins, NCp7 and enzymes that are indispensable for the development of the virion such as reverse transcriptase, proteases and integrase. A matrix composed of an association of the viral protein p17 surrounds the capsid ensuring the integrity of the virion particle. The envelope is formed when the capsid buds from the host protein, taking some of the host-cell membrane with it. The envelope includes the glycoproteins gp120 and gp41, which are derived from the gp160 precursor. gp41 is a transmembrane protein that is covalently linked to gp120."

The term CA is not used, the viral RNA doesn't compose a chromosome - two completely different things!, reverse trancriptase isn't the same as integrase.

I rewrote the life cycle of HIV. Why?

- CD4 isn't a coreceptor. - "During the early phases of an HIV infection typically both CCR5 and CXCR4 are bound while late stage infection often involve HIV mutations that only bind to CXCR4." actually, R5 is much more dominant whilst X4 virtually disappears. - I added a lot more detail such as X4 and R5 terminology which is standard current knowledge in the field. Look it up in any virology textbook. I also mentioned the fact that HIV can infect dendritic cells, a developing field.

I added in subtype detail and geographic distribution, something lacking in previous versions.

I added in the pathogenic role of Tat in HIV progression, something that KT Jeang, B Ensoli and Gallo all believe.

I merged signs and symptoms with HIV infection, the title was redundant. I also added more detail and links to HIV Disease Progression rates, the CDC defined terms and the WHO terms in more detail, which were already mentioned in passing but not linked to.

Treatment was changed, as the level of 350/µl is inaccurate, and so was the change by Sci Guy in the last version that I saw, it isn't 200/µl across the board. Another factual error!

The structure was rearranged to focus more on HIV, and not AIDS progression, something which is done in the AIDS article. I want this article to be good, but changes back to factual inaccuracies by pseudoscientists are just plain bad! --Grcampbell 20:12, 12 August 2005 (UTC)

treatment guidelines

I have edited the text to agree with the reference cited, "defer retroviral treatment in patients with no symptoms who have more than 200 T-cells". Actually I prefer the original text, but as the reference supporting it has been removed, I am editing to the reference, apparently preferred by other editors! Sci guy 16:53, 12 August 2005 (UTC)

This is wrong, see revised version, and thus the importance of talking about the WHO system of classification. --Grcampbell 21:04, 12 August 2005 (UTC)

HIV Genome

Here is a kinda hacked together job of the HIV Genome. Critiques anyone? Should I put it in?

File:HIV Genome.JPG

The HIV Genome.

It looks ok --Grcampbell 21:04, 12 August 2005 (UTC)

Isn't it from the UCSC lecture slides? --Grcampbell 21:54, 19 September 2005 (UTC)

Nunh-huh reverts

This statemtns is very far from a clear statement of causality.

"HIV (Human Immunodeficiency Virus) is a retrovirus that infects cells of the human immune system, causing AIDS (Acquired Immunodeficiency Syndrome) at the most advanced stage of infection."

First it suggests that HIV causes AIDS by infecting cells of the human immune system. Secondly, that AIDS is an advanced stage of infection.

HIV causes AIDS would be less controversial Sci guy 08:18, 14 August 2005 (UTC)

Newsflash Sci guy, if you're looking for less controversial material, I suggest you go somewhere other than the article on HIV. HIV is a controversial issue touching whole countries' perspectives to talking over dinner on wednesdays at home. We're not ommitting science because you think it'll be easier for people to handle.

If you want to make it easier to read, then be my guest - just don't do any of that backdoor POV misinformation bull that you've been pulling over at the AIDS article. JoeSmack (talk) 05:37, August 15, 2005 (UTC)

What did I JUST say Sci guy?! You speak from one side of your mouth that it needs to be stated more clearly that HIV causes AIDS, and then you speak from the other by obfuscating the definition in the article! I have to revert you vandalism all the time! Quit it!! JoeSmack (talk) 16:12, August 15, 2005 (UTC)

Hey, JoeSmack, give denialists a chance to voice their opinion. HIV is not Jesus. I'm sure both points of view can coexist. 216.184.121.161

Man, I've been trying, very, very hard. And trust me, they get and use their chance to voice their opinion - a lot. More than a lot of other legit stuff in wikipedia. I can't talk delicately 24/7, ya know? JoeSmack (talk) 20:23, August 27, 2005 (UTC)

Mosquitos

I've heard that HIV cannot be transmitted through mosquitos (and I guess other biting insects). And this appears, based on AIDS rates not spiraling out of control in mosquito-intesive areas, to be true. My question: How does that work? -Litefantastic 23:42, 13 September 2005 (UTC)

Why mosquitos cannot transmit AIDS --WS 00:52, 14 September 2005 (UTC)

AIDS rates are spiraling out of control in mosquito-intesive areas, because diseases endemic in these areas (some of with are transmitted by mosquitos) can produce antibodies that cross react in HIV antibody tests. Sci guy 13:27, 17 October 2005 (UTC)

Article is too long

At 50K this article is about twice the acceptable length. Do we edit or move sections out? Perhaps start by removing all the unreferenced speculation? LAboy 13:42, 29 September 2005 (UTC)

I agree. It is impossible to edit and too slow loading with over 200K of images. I have reverted to the last version approved by JDWolf and removed most of the images Sci guy 15:12, 29 September 2005 (UTC)

I notice that several editors are ignoring the size limits. A long article with large images is simply unworkable. It can neither be viewed nor dedited by most people. Sci guy 01:54, 30 September 2005 (UTC)

At over 200 K this article has become impossible to edit. I am reverting to the previous agreed version of an acceptable size. Also there are too many large images, that slow the loading of the page Sci guy 03:55, 1 October 2005 (UTC)

Sci guy, please stop with the reverts. There are plenty of other ways to handle an article that's become overstuffed with detail. One is to rewrite particularly long paragraphs or sentences for brevity, without removing any facts. You haven't tried that. Another is to look for sections that might be moved out into their own articles, like (just off the top of my head) the list of specific HIV genes. You haven't tried that. You just decided to axe everything Grcampbell added in the last month and a half (I'm assuming that when you say "the last version approved by JDWolf", you mean the version Jfdwolff reverted to on August 16). I know you've had conflicts with other editors over POV, sourcing, and wording, but here you're really showing blatant contempt for the collaborative process. If the article needs to be cut down, let people work on it step by step. ←Hob 07:04, 1 October 2005 (UTC)

Also: "At over 200 K this article has become impossible to edit" - that's baloney. The images, added together, are over 200K; the article text, which is what you edit, is 50K total. And it's always possible to edit one section at a time. The length of the article is over the recommended limit, but it's not an emergency requiring immediate drastic measures as you seem to think. ←Hob 07:33, 1 October 2005 (UTC)

When we've got about 15kb of references, external links, and internal links to other wiki languages, do we want them to have more space and prominence than the actual article? If we cut it down like LAboy (sockpuppet of Sci guy's no doubt) wants, then the article will be shorter than the references! --Grcampbell 23:29, 18 October 2005 (UTC)

proposals for streamlining the article

I agree that the article length is a problem - but I'm happy we've got so much material; the question is what to do with it.

I have a few suggestions; could I get some responses on each one?

New article for genome details - The current section HIV genome organisation and HIV protein function could be summarized, with details moved to HIV genome - which could then be expanded to describe how and when these genes were identified. (This would involve moving some references, too.)

Trimming the Treatment section - Much of what's in Treatment is also in AIDS and/or HAART.

Removing some images - This is a separate issue from the article text length, and I don't think the images actually prevent the article from loading even on a slow connection, but... I'd lose the TIME cover for sure. In the genome section, I don't think the linear diagram of the genome is essential. (Grcampbell, what's the source of that image? It needs to be sourced, it's not enough to just say the author released rights.) And Carl Henderson's phylogenetic tree, to be decipherable, requires a ton of descriptive text that should probably be in its own article rather than on an image page.

Finally: I'm not sure why some of those image files are as big as they are; the images don't look that big. I'll ask Grcampbell some file format questions. ←Hob 08:46, 1 October 2005 (UTC)

The time cover has no added value here, so I think it should be removed. It would be nice for a AIDS press coverage article or something like that. --WS 11:41, 1 October 2005 (UTC)

All great ideas, I have actioned them all Sci guy 14:15, 6 October 2005 (UTC)

Genome details don't need to be removed. Reinstated, as they were moved in such a copy and paste corrupted way wuth no references. This article is about HIV, it requires the details that are being removed. By simply taking out the references and the specific area details on the epidemiology, which could be moved, the article size falls to just 33kb. Now why do we need to corrupt the article for 1kb of detail? --Grcampbell 20:13, 17 October 2005 (UTC)

Please see Wikipedia:Guide to writing better articles#Articles covering subtopics. It's both common and recommended for articles on complex subjects to be refactored into sub-articles (see, for instance, the article on any country or major city) and I think HIV genome is an appropriate instance. The refactoring may have been done clumsily in this case - the references certainly should move along with the content (which would also further reduce the size of the reference section in the main article), and I think the "genetic variability" piece is more suited to the main article - but that can be fixed without undoing the whole thing. Yes, these are interesting and important details, but the fact that "this article is about HIV" doesn't mean the main article has to include everything one could possibly say about it - especially when it's information that's only comprehensible to readers with more specialized knowledge. ←Hob 00:53, 20 October 2005 (UTC)

That's fine, but it was done is such a haphazard way, that it was sounding silly, and the article was all messed up because of it. --Grcampbell 01:09, 20 October 2005 (UTC)

OK, so let's pitch in and fix it. The sub-article is currently an orphan (i.e. nothing else links to it) so it can be knocked into shape before cutting the main article; probably the first thing to do is to identify which references belong to the sub-article. By the way, that image still needs to have its source identified or the image cops will delete it, as they've been doing.

And, Sci Guy: if you do the "revert to version with appropriate length" thing one more time, I will start an RfC. That's not a threat - it's a request for comment from other editors, and it's probably what you should have done rather than take this article length crusade upon yourself. The article length limit is a guideline, and a good one, but not in itself a sufficient justification for undoing significant contributions by other editors. Also, it was unhelpful for you to make massive cuts in other sections at the same time as moving the HIV genome material; edits should be incremental, so others can see what you're doing and tweak it piece by piece, rather than having to accept or revert monumental changes. ←Hob 03:34, 20 October 2005 (UTC)

The article guidelines for length are not even respected for the Featured articles. The current one, French law on secularity and conspicuous religious symbols in schools is 40kb in length, with the references taking up a fraction of this, yesterdays FA was Schizophrenia and is 69kb in length. --Bob 18:55, 25 October 2005 (UTC)

developing a process

It would be helpful if editors could agree on a summary list of what is important today about our current understanding of HIV - and whether this knowledge is based on experimental data, the consensus of expert committees, or suggestions. So many things have been suggested about HIV over the last 20 years, do we need to record every blind alley? Also we need some logical allocation of the 30K across the main issues - and a list of issues that need to be explored in greater detail in other other articles Sci guy 15:09, 18 October 2005 (UTC)

at the moment the article is 35kb, my last edit, with about half that being references and external links. --Grcampbell 16:01, 18 October 2005 (UTC)

list of articles providing more details

Further information: HIV genome

Further information: HIV Disease Progression Rates

Further information: WHO Disease Staging System for HIV Infection and Disease

Further information: CDC Classification System for HIV Infection

Further information: Antiretroviral drug

Further information: AIDS pandemic

References

I understand that the high level of vandalism of this article makes progress slow and difficult.

Once again there has been a progressive loss of references and sources. It is important for readers and editors to be able to clearly see the source of particular facts or opinions. This is especially relevant to the many aspects of this article that rely entirely on the consensus of expert panels, whether CDC, WHO, UNAIDS or NIH. Also I notice that some editors reword the opinions of these expert panels to change the meaning - or revert to earlier statements when a later one is available.

I have restored and corrected the UNAIDS cited information on transmission. Sci guy 13:42, 17 October 2005 (UTC)

I understand that the high level of vandalism of this article makes progress slow and difficult. - Yes, I totally agree. I don't agree with the irresponsible vandalism being carried out by AIDS denialists. --Grcampbell 20:14, 17 October 2005 (UTC)

Sources please

I have removed this section to the discussion page, because it makes many claims, but cites no sources Sci guy 13:54, 17 October 2005 (UTC)

HIV primarily infects vital components of the human immune system such as CD4+ T cells, macrophages and dendritic cells. It also directly and indirectly destroys CD4+ T cells. As CD4+ T cells are required for the proper functioning of the immune system, when enough CD4+ cells have been destroyed by HIV, the immune system barely works, leading to AIDS. HIV also directly attacks certain human organs, such as the kidneys, the heart and the brain leading to acute renal failure, cardiomyopathy, dementia and encephalopathy. Many of the problems faced by people infected with HIV results from the failure of the immune system to protect them from certain opportunistic infections and cancers.

The information in the cited paragraph is basic, uncontroversial fact about HIV. Sources aren't needed for the same reason a source isn't required for the paragraph that says HIV is transmitted through penetrative vaginal/anal/oral sex. If you insist, a link back to the CDC HIV page should be sufficient.

By the way, the References section is in need of work. Since the break up of the page into different section articles, many of the entries no longer apply to the main article. They need to be moved to the appropriate article(s) or removed, as the back links are broken. --Bk0 14:12, 17 October 2005 (UTC)

If these are "basic, uncontroversial fact about HIV", then it would be helpful to cite the research that discovered these facts. The comments about HIV transmission are actually the opinion of UNAIDS and is presented as such precisely because all of these possible methods of transmission have not been demonstrated - and some remain controversial. Sci guy 14:28, 17 October 2005 (UTC)

I know you are an AIDS denialist Sciguy. We all know you don't care about the article, as long as it is sabotaged and corrupted. The facts in that section you removed are well-known and are not made-up. Before you corrupt the article again, can you please try adding in a reference instead of cutting and chopping the article? The only people who believe it to be controversial are Duesberg and his cronies, and the gullible ill-informed people who choose to follow him. --Grcampbell 20:11, 17 October 2005 (UTC)

Calling me an "AIDS denialist" - whatever that is for citing reference to UNAIDS seems strange! Sci guy 01:49, 18 October 2005 (UTC)

Yes, again, you are unable to act properly, and you take a chainsaw to a complete article. I know you are impatient, but if you leave the article alone for a short while, the length will come back to 32kb (without counting references), and then there will be no need to corrupt and change the article to a version with little fact, and much inference. And BTW, FYI, the UNAIDS does not deny or oppose any of what you cut, nor does it state that it is inaccurate. What you are unaware of, and what is published fact, are two different things. Before you think you know everything and start deleting huge chunks because your knowledge base is extremely small, please try doing your own research first. --Bob 19:01, 25 October 2005 (UTC)

Unique genes

The list of major HIV genes is headed with

"HIV has several major genes coding for structural proteins that are found in all retroviruses, and several nonstructural ('accessory') genes that are unique to HIV."

but it is never specified which genes are common and which are unique. Kapow 13:22, 29 October 2005 (UTC)

Good point, but see also the discussion above about moving the bulk of the genome section into HIV genome. Currently that article exists but hasn't been linked to, because there was disagreement over how the cuts were made, but I think the plan is still to make the move - so any edits to the genome material should be mirrored in the sub-article. (And I think the answer to your question is that they're all unique except for parts of gag and pol, but I'm not sure.) ←Hob 13:43, 29 October 2005 (UTC)

major moves: structure and genome

Since discussion has been moving rather slowly but no one seemed to disagree with the notion of splitting off sub-articles, I've made some rather drastic edits to summarize and split off the entire HIV#HIV structure and genome section into HIV structure and genome. The sub-article was formerly HIV genome, but the structure section made numerous references to individual genes, which referred to individual proteins, etc. (see the new talk page for my thoughts on further reorganization). All the citations that were only used in the moved sections are now in the sub-article, and not in the main one.

The summary text I left in the structure/genome section is of course a first draft. I was trying to capture the main points in a way that's readable to the average user without being technically inaccurate.

The length of the main article is now 26K. That's not incredibly long, but still I strongly suggest splitting off at least one more sub-article, just so we can provide a better overview while preserving the excellent level of detail we have. I suggest HIV#Life cycle of HIV, possibly incorporating HIV#HIV tropism. I don't mean eliminating the entire topic from the main article, just summarizing to highlight the central points for a casual reader. ←Hob 00:10, 1 November 2005 (UTC)

I suggest leaving the article as is and stripping off some of the external links. --Bob 00:21, 1 November 2005 (UTC)

Pruning some links would make the article shorter (and many of those links are probably already in AIDS or should be), but that wasn't really my main concern. I was thinking more that the "life cycle" section is quite technically detailed, and it's great for WP to have that kind of information, but it's the kind of thing that is often given its own article so that the main article can provide a slightly simpler overview for less specialized readers. Right now the Introduction section gives a very brief summary of the viral life cycle - I was thinking more of something that emphasizes certain key steps of the process that are relevant to disease progression and treatment (e.g. the fact that activation of T cells speeds up HIV reproduction) but doesn't mention things like conformational changes in proteins. ←Hob 02:41, 1 November 2005 (UTC)

I'm even more determined to split off the "life cycle" section now, and I have some thoughts about how to reorganize its content, but they're hard for me to summarize. So I'm going to start working on a draft at User:Hob/HIV life cycle, and will do my best to keep it up to date with any further edits that happen here. More later. Btw, that last anon edit (66.93.135.20) was me. ←Hob 23:07, 3 November 2005 (UTC)

CCR5 mutation

Removed this sentence from the last section: Recent studies have shown that about 10% of all Europeans are naturally immune to HIV. This is due to the genetic mutation of CCR5, a side effect of the various epidemics and plagues that ravaged Europe during the Middle Ages. We do need to mention the CCR5 mutation, but we shouldn't mention "recent studies" without a source, and the "Middle Ages" statement is just a hypothesis so far (it seems likely that some epidemic was involved, but there's disagreement about whether it was plague, smallpox, or what); more importantly, CCR5 mutations don't make anyone "immune to HIV", they just give resistance to many common strains of the virus. People with CCR5 mutations are still vulnerable to strains that use CXCR4, which are less common but can still arise spontaneously and unfortunately appear to be more virulent. Probably we should summarize the point here, with one good reference, and provide more detail in the CCR5 article. ←Hob 23:34, 3 November 2005 (UTC)

true, but the primo-infecting strain of HIV is almost always R5. Most people homozygous for CCR5 delta 32A are resistant to infection for this reason. There does exist a few exceptions of homozygous CCR5 delta 32 individuals becoming infected, but these people were primarily infected with X4 virus, a rare occurence. A nice review of the origin of the mutation is found at the end of this link: PMID 15715976 --Bob 23:51, 3 November 2005 (UTC)

To be precise the study found 10% of all Europeans are heterozygous for a CCR5 mutation, not making them immune to HIV transmission. However 1% are homozygous for this mutation, making them immune to infection by R5. There are only 8 or so documented cases of transmission of X4 type HIV, statistically insignificant. |--Spaully 22:40, 29 November 2005 (UTC)

another sub-article: pathogenicity?

I'd love to see yet another a new article, Pathogenicity of HIV, focusing on the specific mechanisms by which HIV can damage immune system cells and other tissues. This is currently left a bit unclear in the various HIV and AIDS articles, and there's a lot of fascinating research which hasn't made it into general knowledge - most people still think of AIDS strictly in terms of T cells. Can anyone think of a better title? ←Hob 23:45, 3 November 2005 (UTC)

the actual mechansims are still being studied, and for a title? the one you propose, How HIV destroys the immune system or HIV pathogenesis...? --Bob 23:52, 3 November 2005 (UTC)

Yeah, I know the research is still ongoing, but we can at least describe what's known or strongly suspected. I'd avoid using "immune system" in the title because the article should also include HIV's possible direct effects on other systems and how these may contribute to dementia, diarrhea, etc. ←Hob 00:16, 4 November 2005 (UTC)

I like the title HIV pathogenesis most. --WS 09:14, 4 November 2005 (UTC)

So do I. --Bob 23:44, 17 November 2005 (UTC)

cure?

"one proved case of a person being cured from HIV"

I think that additional virus tests will have to be performed over a period of years in order to confirm a cure. See: Wikinews.
--JWSchmidt 19:34, 13 November 2005 (UTC)

This isn't the first time this has happened. There have been a few cases recorded in Africa, but because it was Africa, nobody belived them... sigh. --Bob 23:45, 17 November 2005 (UTC)

I had read about new antiretroviral medicine from Yahoo News this year (2006). The news said the Scientists will going to perform a medical test to know if the new medicine is safe to the health of human. -- Christian. May 5,2006. 10:42 am.

please use edit summaries

I'd just like to play the designated nag here, and urge everyone who makes more than trivial edits to provide edit summaries. Not everyone has the time or inclination to track every little change; summaries make it possible to see at a glance, in your watchlist, what kind of content is being changed and why. This is especially important in articles where there's a history of content disputes. Detailed discussion/argument over content issues belongs on the talk pages, but summaries are a basic courtesy to your collaborators. ←Hob 22:18, 14 November 2005 (UTC)

Please Clarify 1 in 8000 chance?

I dont understand "1 in 8000 chance of vaginal insertive" does that mean if a male has sex with a random person he has a 1 in 8000 chance of being infected? Or does it mean he has a 1 in 8000 chance of being infected by an infected woman? Can someone clarify? And I think these odds are better than what that they should be (in either case), but thats just my opinion.

It means per sexual act between an uninfected person and an infected one, the probability of transmission is 1/8000. The wording is unclear however as to whether transmission in receptive vaginal intercourse is male->female or vice versa. Those minimum odds are higher than I've heard in the past, I've seen 1/2000 mostly, but it does strike you as odd, even at 1/2000. That's a lot of sex! |-- Spaully 01:49, 13 December 2005 (UTC)

receptive is the person receiving, insertive is the person giving. The risk for receptive is for the person receieving. Not very difficult to understand... --Bob 18:38, 14 December 2005 (UTC)

I'm confused as well. The wording seems to state that the chance of being infected from a HIV-positive partner after vaginal intercourse is somewhere between 1/53 and 1/10000 for women, but exactly 1/8000 for men.

The chance for women seems to be so vague that it's nearly meaningless, and the number for men would mean that if your wife is infected and you have intercourse every day for a year, you still would have less that 10% chance of getting infected (as long as you don't sodomize her), that seems like a very low risk.

There's a reference to a website called thebody.com, but I could not find a specific article on that site about these numbers. --anonymous 16.dec

True, but how many cases of striaght guys getting HIV through sex have you heard of? And by the way according to the stats the odds are exactly 4%.

Anonymous edits

Someone should check the unsourced edits by 24.240.37.184 on 8 January. No idea if they're correct or not, but could easily be vandalism. Greenman 17:29, 8 January 2006 (UTC)

What the anon editor did was to switch the odds for receptive and insertive vaginal sex, in a way that looks plausible at first glance, since it didn't make much sense that the receptive (female) partner would have less risk. However, since the sources have not changed, the numbers should not. Someone needs to look up the original source (Pilcher et al.) and figure out whether the previous version was a mistake or what. And changes of this kind should never be made without some explanation, at least an edit summary; some would consider that grounds for an immediate revert no matter what. ←Hob 18:11, 8 January 2006 (UTC)

I looked up the study and it is 1/53 - 1/10000. But that is only an estimate for acute HIV infection. In an established infection chances would be lower. --WS 19:39, 8 January 2006 (UTC)

News, people

http://news.bbc.co.uk/1/hi/health/4642940.stm Looks like they now have an accurate 3D model of HIV. Researchers rejoice. http://www.scienceblog.com/cms/hiv_prevention_hope_yogurt_bugs_that_make_antiviral_drugs_9864 Well, well, CURE FOR AIDS!

• • i would LOVE to see more info on the orgin of hiv, maybe some possible theories of what happened in the beginning that always had interested me but there never seems to be much talk about that on sites**
    • Check out AIDS origin Raul654 05:15, 26 January 2006 (UTC)

Research focused on subtype B?

The Genetic variability of HIV section ends with this ambiguous and unsourced claim:

Almost 95% of all HIV research currently taking place is focused on subtype B, while a few laboratories focus on other subtypes.

It doesn't say what type of research is focused on subtype B, but reader might assume that it is the search for a vaccine. Such an assumption would imply a bias in favor of the Americas and Europe at the expense of the global epidemic. Does anyone know the focus of that "95% of all HIV research" claim or, better, a souce? The Rod 03:58, 29 January 2006 (UTC)

It stipulates that the majority of HIV research carried out focusses on the HIV-1 subtype B. I don't have the source for this data, but I remember reading about it in a medical journal. I believe it to be KT Jeang who stated that, but I'm not sure. However, a quick review of the literature on HIV research will quite easily back up and prove this claim. --Bob 23:36, 30 January 2006 (UTC)

Life/replication cycle

Given the controversy over the status of viruses as living entites, many virologists prefer to replace 'life cycle' with 'replication cycle.' I think this should be adhered to. —The preceding unsigned comment was added by Williruntus (talk • contribs) .

Transmission risk table

I am curious about how significant other people here think the reference number 16 is (Varghese, B., Maher, J. E., Peterman, T. A., Branson, B. M. and Steketee, R. W. (2002). Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use. Sex. Transm. Dis. 29 (1): 38-43. PMID 11773877.). I could only get to the abstract of the study and don't know where I could find the full text, but from reading the abstract, it seems to me that there should be a note of some kind right at the table. The reason for this is that: a) Concluding a per-act risk from intercourses of stable partners seems to neglect quite a few factors in HIV transmission, like differences in response of different individuals to different virus subtypes (I'm not very firm in medicine, guessing here a bit); b) using the numbers as they are given in the study without further notes suggests that these are more or less scientifically proven, reliable probablities. Doing so on a sensitive page like this one might lead some people to estimate their infection risk wrongly. I propose that a note should be attached that says something like "according to one survey" or "the way these probabilites were deducted might bias actual risk by a significant margin". Opinions? --DanyX 14:47, 18 March 2006 (UTC)

OK, I found a report by the worldbank that voices similar concerns. I added a note to the table. This was my first wikipedia edit, if there is anything wrong with it please fix it and tell me about it. Thanks! --DanyX 22:47, 23 March 2006 (UTC)

Maybe if you actually read the source data, then it would become clearer. --Bob 23:35, 23 March 2006 (UTC)

Sorry, I don't quite get it - do you mean the source data of the references given in the current transmission risk table (Varghese et al, ...)? As I said, I have only found an abstract of the stated articles which did not give any clue as to whether these risks might be underestimates (which I think they are outside of stable partnerships). Which is precisely my point: users who just take a look at the transmission risk table without reading up on the surveys that were used to arrive at these numbers should be given a warning that these numbers may be underestimates, or at least that most of them come from only one source that was conducted with very specific parameters. Scientists are probably (hopefully) used to question "facts" that come from only one source, but in this particular case I think it is important to warn ordinary readers. --DanyX 12:36, 24 March 2006 (UTC)

Again, read the source data, Varghese etc. That particular reference is a review of current data. Just because you can't get hold of it, doesn't mean you have to negate what it says. Read it, then comment. Reading an abstract is not enough.--Bob 17:11, 24 March 2006 (UTC)

Ok, it seems I didn't get my point accross, let me try again:

• Yes, I only read the abstract and I am aware that I therefore cannot judge this survey.
• I cannot read the full text because I do not have access to it, just like most people reading this wikipedia article, I guess.
• I don't want to say that Varghese et al is wrong, nor do I negate what it says (I don't even know what exactly it says). All I am trying to say is that the average reader with no background in medicine, who stumbles accross this article, might take the per-act risk given in this table as a reliable figure for his own per-act risk. At roughly 1:1000 when having sex with an infected (!) partner, they might estimate their chances of infection to be neglible, which might lead them to the conclusion that the use of condoms is not necessary because the risk is so small anyway.
• Please don't get me wrong: I think it's very good, that wikipedia, through people such as yourself, relies on scientific research. It is a great thing that wikipedia is not a dumb propaganda machine. But I think that, especially as wikipedia is becoming a more reliable source of information, wikipedians have to take the POV of the "average" reader into account and remind them that whatever estimates current research provides, is just that: the _current_ state of the research, and that these are estimates drawn from some specific cases.
• One more thing: you may argue that the current table header already states that the numbers given are estimates. While this should be enough to call readers to attention, I doubt it really does. Skimming through related pages throughout the internet, it seems that there are several individual factors that together can result in a shift of the individual risk by one or maybe even two orders of magnitude. This is in my opinion a significant piece of information.
• Let me just summarize once more: all I ask for is that there should be some kind of a warning that brings the fact that individual per-act risk may vary considerably, to attention.

--DanyX 19:16, 24 March 2006 (UTC)

Everybody has access to this article, just go to a library and ask for it. Also, it states clearly in the table that it is an estimate. It also states clearly in the abstract that it is a Per-act relative risk for HIV infection. Just how much clearer does one have to be? Do we assume that the average wikipedia reader is stupid? --Bob 19:40, 24 March 2006 (UTC)

It doesn't have anything to do with readers beeing stupid. People might want a simple answer from this article: "How high is the risk of an HIV infection when performing sex without a condom?". The way the article is currently written, they may skim through it, find the table of estimated risks and take them for granted. I tried to outline some more points above. For me it boils down to the following: All I ask for is a note. This certainly would not hurt scientists like you, at the most it might be a small nuisance. But it might prevent some people from (as a worst case scenario) abandoning safer sex prematurely. This alone justifies a note IMHO. I am very willing to discuss alternative wording from the one I provided, but I think that some kind of a statement warning the user to be careful with these numbers should be included. --DanyX 18:11, 25 March 2006 (UTC)

Hm, no Answer - would anyone still object if I would attach a note to the table that warns users not to trust their lives on these numbers? Or something along these lines? I think noone can object to such a warning, for reasons given above... --DanyX 09:20, 28 March 2006 (UTC)

There is another issue with that more-than-debatable table. To my knowledge (and that is an informed knowledge) no case of transmission of HIV through the oral mucosa was ever reported. There are studies on couples in which one member was HIV+ and who performed, for years, unprotected oral sex. No partner ever got HIV, not to mention that it is the de facto sexual behaviour in areas and epidemiological groups where HIV is not spreading, but present. These and more sources of data are totally conflicting with that table. Being wikipedia the first source of information for the ignorant, this "small error" can have terrible consequences to millions of lives. —The preceding unsigned comment was added by 157.86.64.134 (talk • contribs) .

Can't be that an informed knowledge then, as cases have been reported and the risk is real. Read the references --Bob 19:09, 27 March 2006 (UTC)

Transmission table (style issues)

The table is a mess. I made a concerted effort to clean it up for style, code, and grammar issues. In return, the changes were reverted with the smart-ass comment "cleaned up table". I'm not going to play edit war like a little child, but I believe the issues should be addressed.

1. I cleaned up the source for consistency. There were unnecessary spaces and mixed use of old HTML style tags and CSS styles. There is also this peculiar <div> tag at the beginning. I cleaned up that mess, removing the unnecessary spaces, using only CSS styles, and eliminating that <div> tag.
2. I eliminated manual breaks. Not to mention the use of </br> (which doesn't actually exist) and the unnecessary use of <br />. The manual breaks are unnecessary. The table should be allowed to expand with larger resolutions.
3. I reworded the headings, as they seem to be written by someone with a tenous grasp of the English language. I also made some changes for consistency (the two footnotes are worded in a different manner, the use of "anal intercourse" but "penile-vaginal intercourse"). Then there are the ones that just fly in the face of grammar and usage rules, like "percutaneous needle stick", and my favorite, "needle-sharing injection drug use".
4. This is purely typographical, but nonetheless significant. The asterisk does not need to be formatted as superscript, because it already is in most fonts. Second, the section symbol (§) is not intended to be used as a reference to a footnote, so I replaced it with a dagger, in the same location as the asterisk for consistency.

I don't see why every fucking time I make multiple changes to a table, someone has to fully revert the whole damn thing. I don't exactly do this for my own personal enjoyment, and would appreciate some respect for at least some of my changes.—Kbolino 03:13, 18 April 2006 (UTC)

For your information, the table was published using the classifications of the CDC. It is also in the style that was just passed in a WP:FA. Also, please remember WP:CIVIL or refrain from posting. The div tags are so that the font is smaller, so it doesn't eat the page, and the breaks are there for the same reasons.--Bob 15:08, 18 April 2006 (UTC)

First, my apologies about an uncivil tone. I interpreted the reversion comment as a personal attack, and responded in kind. This is, of course, wholly inappropriate, but I was upset at the time.

Second, An encyclopedia is an aggregation of information from other sources, which means that it does not have to copy things like tables verbatim from one source. When something can be improved for clarity, there is no reason why it shouldn't. Readers can always refer back to the original source to see the original wording and context.

Third, if you want a smaller font size, then add a style rule into the style attribute of the <table> tag, instead of encapsulating the table in another tag altogether.

Fourth, the table doesn't "eat the page" with a hard-coded width (I used 50%, which works out okay; there's no way to say "50% of the page, but no larger than X ems/inches/cm/pixels"). Browsers naturally break text when appropriate, so manual breaks are usually unnecessary.—Kbolino 08:48, 19 April 2006 (UTC)

INVALID TRANSMISSION RATIOS

If I'm reading it correctly... Out of 10,000 acts of intercourse with an HIV positive individual, 5 men and 10 women will get infected? I followed the citation and the stats are completely misinterpreted. This is pretty important since this false information poses a huge risk to those who might see the stats and say "Fuck it, the chance I get HIV from someone is tiny, who needs condoms?" or something... Please look at the stats and provide correct ratios.—The preceding unsigned comment was added by 130.156.1.75 (talk • contribs) .

Perhaps if you read the references that are cited, you may come to understand the table, as published by the CDC. As is, you are the one in error. --Bob 23:04, 26 April 2006 (UTC)

Question, 130.156.1.75 —which citation did you follow? The first citation (#12, I think) is not the basis for all of the remaining data. If you can note specific info from the cited articles (or, for that matter, other reputable sources, please note it here. That said, I second Bob—the numbers may varying (slightly) from reference-to-reference, but the two I just re-checked (#16 and 17) are spot-on. MarcoTolo

Ah yes, the Transmission Risk Table. I voiced my concerns in the posts above a while ago. By now I have, at long last, been able to actually go to the library and look into some of the sources mentioned (specifically Varghese et al.). My findings were as following: a) that it seems the numbers these studies give are pretty much the best estimates available, as such they are a good choice to cite in a wikipedia article. b) The numbers are very likely to be "correct" (as in, as good an approximation as we will have for some time), even tough intuitivly extremely low. c) that said, the study must be seen as not more that it says it is: the attempt to "quantify the Per-Act Risk of HIV based on the choice of Partner, Sex Act and Condom Use". It leaves several quite possibly important factors unregarded (e.g. varying infectivity in stages of HIV infection, concurrent STDs, ...). All of this leads to the same conclusion that I came to before: I do not doubt that these numbers are on average good estimates. I very strongly feel, however, that wikipedia readers should be made aware of these two emphasises. They should take them with a grant of salt. The individual risk for any given person might be 2 orders of magnitude higher, or lower. I certainly did not expect this much variance (I'm not sure this is the correct term, please bear with me as I am not a native english speaker). I think that it would be very sensible to attach a note at the table that tells the readers that individual risks may vary considerably. --DanyX 21:10, 8 May 2006 (UTC)

I will admit - I was surprised at how low they are (particularly the 0.5% for anal-receptive intercourse). But at the same time, I think the table is probably one of the most important bits of information in this article. Raul654 18:35, 14 May 2006 (UTC)

I haven't read the references. But from the sound of it, there are other factors besides those that DanyX gave as an example. E.g. lubricant use, how 'experienced' the partners are etc. These are likely the affect an individual transmission rates quite significantly. In any case, I agree with DanyX (and others) mostly that we need a warning. This is not to say these figures are useless. These figures are likely of great interest to epidemologists and the like and they also help us to understand how much more 'dangerous' various acts actually are (since conservatives like to hound on about such things, it's nice to actually see the figures). The point is, they are not and were never intended to tell people that hey, I only have 1/200 chance of getting if the person is HIV+ it so I shouldn't bother with condoms. Also, I have to say IMHO the rates aren't that low. An 0.5% risk per sex act is quite scary actually. When taken together with the relatively unlikelyhood (in most countries) that your partner will be HIV+, it may not seem quite as scary but the question is, why take the risk. The trouble is, most people have trouble with statistics. They get worried about plane crashes but don't care about driving. They buy the lotto thinking they might win but have unprotected sex because they don't think they'll get HIV.Nil Einne 07:59, 27 May 2006 (UTC)

Natural Reservoir located

http://abcnews.go.com/Health/story?id=2003434&page=1 Someone with a lot more wikie-experience than I may want to add that in someplace. Cheers! 206.156.242.36 18:27, 25 May 2006 (UTC)

This has been done but with the actual paper published in Science by Beatrice Hahn's group. --Bob 23:07, 25 May 2006 (UTC)

You probably should update the introduction section as well since although the top section contains the latest info, the introduction section doesn't really. In fact, it might be wise to go in to more detail in the introduction section or even start an origin section. Hopefully the latest info will help put to rest the polio vaccine story Nil Einne 08:05, 27 May 2006 (UTC)

I've changed this from "AIDS is known to have originated...." to "AIDS is hypothesized to have originated....". Basically, the claim that Keele, et al have definitely demonstrated that SIV/HIV crossover came from this population is highly debatable. Edward Hooper contests this finding in two statements given here: [1] [2]. Edward Hooper, of course, is the main force behind the Oral Polio Vaccine hypothesis, and while I'm not a partisan of that hypothesis, I think that some of the points he raises are valid, most notably, the question of sampling. Quite simply, until there's been adequate sampling of SIV strains in chimp populations in places like Congo (Kinshasa), Congo (Braazaville), Gabon, etc, one cannot definitively say that this Cameroon SIV population is the one that comes closest to HIV-1, strain M (the strain responsible for the world AIDS epidemic). (If Keele or others involved in this study have addressed this issue, I'm unaware of it.) The earliest AIDS epidemic cluster and the earliest preserved serum material containing HIV are from the Kinshasa area, so this also calls the "Cameroon hypothesis" into question.

BTW, my school library does not have a subscription to Science online. If anybody would be kind enough to download a PDF of Keele, et al and email it to me, please contact me via my talk page. Peter G Werner 20:14, 28 May 2006 (UTC)

Delta 32?

Does anyone else think that the Delta 32 genetic defect should be mentioned in this article? The Delta 32 is a mutation that many humans have in their genes which renders their cells immune to the HIV. —The preceding unsigned comment was added by Yoyoceramic (talk • contribs) .

As long as you have a good citation for the claim, yes.

Atlant 13:01, 1 June 2006 (UTC)

HIV Testing

To me, this article is a first resource for people hoping to get an HIV test done. However, there is no content on testing.

There are different technologies available, special considerations about window period that should be addressed. To me, this is an obvious oversight.

This is Wikipedia, so you know what to do: be bold!

Atlant 13:57, 6 June 2006 (UTC)