Talk:HIV

Because of their length, the previous discussions on this page have been archived. Talk:HIV/archive 1

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)

opening sentence

It's all I've looked at again, having been put off by your non-response. It's not a good opening:

'HIV (human immunodeficiency virus) is a retrovirus that infects cells of a human immune system—mainly CD4+ T cells and macrophages, vital components of a host's immune system—and destroys or impairs their function.'

What about: 'HIV (human immunodeficiency virus) is a retrovirus that infects mainly CD4+ T cells and macrophages—vital components of a host's immune system—and destroys or impairs their function.'

That map: hate the new colours ... can you go for less saturated colours? Yuk. Just two plain colours that won't jump out at the reader.

Remove that well-known nest of HIV, the Antarctica, and relocate the key to the resulting space. Insert 'Type' before each letter. We need all percentages to one (or no) decimal place. And just who is the copyright holder? Tony 01:14, 20 September 2005 (UTC)

the copyright holder of that map as is is me, as I created it. You don't seem to like any colour, and since the colours are similar to the UNAIDS map lower down, I'm keeping it as is. And BTW, some people DO have jobs to do and since the watchlist doesn't function for the Peer Review page, I didn't know it was ammended. Also, your edits and suggestions in the text were heeded, kept or amended, if they didn't distort the facts, as some of them did. --Grcampbell 17:12, 20 September 2005 (UTC)

Lose the self-righteousness, dude. I have a huge workload. Tony 00:51, 21 September 2005 (UTC)

The article has undergone a dramatic improvement since the arrival of Grcampbell on the scene. Thanks, Gr, for your good work! - Nunh-huh 00:54, 21 September 2005 (UTC)

It's not his technical expertise and contribution to the article that is at issue: it's his narky attitude towards contributors such as myself. Making comments such as 'oh, and by the way, some people DO have jobs' (I'm on unemployment benefit, am I?) is unacceptable; please read the Wiki code of conduct. Distorting the facts is something that specialist editors will inevitably do. Since you need such people to improve the text—it would be rare to find an expert in HIV and language in the one person—you're expected to fix any unintended distortions that arise from their work without complaint. It's factually incorrect to claim that I 'don't seem to like any colour'—I put forward the suggestion that less saturated colours be used, and I've only commented on the colour scheme once before. It's much better now; thanks for the insult.

The text still needs lots of work, but somehow I don't think I'll bother: too many other contributors are asking for my asistance. Currently, it's quite unacceptable for promotion to FA status. Tony 01:20, 21 September 2005 (UTC)

Sorry you feel that narky attitudes have something to do with FA status. Unfortunately adopting an attitude that is entirely sweetness and light almost led to article takeover by AIDS denialists. As for me, I'm grateful the article has become both more informative and more accurate, which is far more important than being a "featured article". It seems you are commenting on your working relationship; I am just commenting on the article. - Nunh-huh 01:34, 21 September 2005 (UTC)

My comment about FA status is a separate, although related issue. Sweetness and light is never going to cut it: more like polite and serious, even towards near-vandals. Please don't lump me in with the denialists: I was trying to improve the prose. Yes, I am commenting on working relationships. Tony 02:11, 21 September 2005 (UTC)

I wasn't lumping you anywhere. I was just commenting on Grcampbell's good work. - Nunh-huh 03:25, 21 September 2005 (UTC)

Improving the prose is one thing, changing the text so it changes the facts is another. Narky? Look at your opening statement under this heading? Please read the Wiki code of conduct. I have already apologised twice for the non-response. The watchlist doesn't update peer review pages, for whatever reason, so I had no idea that comments were made. Your comments in the article, however, were adressed, heeded or ignored (if they disrupted the flow of text or changed the facts (which some did)). What does FA status mean? well written, comprehensive, factually accurate, neutral, and stable. It certainly isn't stable, thanks to the AIDS denialists, and the fact that I, and others have been trying to improve the articles facts. Is it comprehensive? No. To do that, we would need to increase the article length by about 1000-fold. Is it neutral? No, as it leans towards mainstream scientific thought, leaving the extreme monority denialists out of it (thankfully). Is it factually accurate? As much as can be expected. Is it well written? Well, I am a scientific writer, so my style is very different to the flowery prose that English scholars may use. I am happy that this be corrected, but I would prefer, and I am sure most people here would prefer, that the article be factually accurate (or as close can be (I am not an expert in all fields of HIV, only some)) than perfectly written, but factually inaccurate. Does it therefore fit the FA rules, not at all, but then again, neither do most of the articles that have that status! And thanks Nunh-huh for the compliments, I am happy that someone is appreciative of my contributions. --Grcampbell 15:48, 21 September 2005 (UTC)

Actually, by Wikipedia's definition of neutrality—that viewpoints be represented in proportion to the numbers of those who hold them—I think we qualify as neutral. And you're welcome... I think those who have worked on this before you appreciate how daunting keeping the article factual can be. - Nunh-huh 20:52, 21 September 2005 (UTC)

Now that you've got that off your chest, Grcampbell, may I sympathise with your frustration at the denialists. Why not ignore them? English scholars who use flowery prose won't survive for long nowadays. Scholarly and scientific prose, at their best, are approaching each other in style; that was inevitable. Your article needs to be perfectly written and factually accurate; anything less just won't do, so don't even think of trade-offs; that's where I come in to help, and I'm almost always treated with more respect for my free labour. Tony 23:41, 21 September 2005 (UTC)

Treat others as you would like them to treat you. You have been less than pleasant in your dealings with me. Maybe, if you heeded your own advice, you would be treated with more respect. Until then, good day. --Grcampbell 00:00, 22 September 2005 (UTC)

Oh spare me the sermon and get off your physician's pedestal. 'Good day to you, too, sir.' Phhhhhh Tony 00:10, 22 September 2005 (UTC)

Again, Narky. --Grcampbell 00:19, 22 September 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)

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)

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)

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)