H/T to The Lay Scientist for getting my butt in gear to write this post.
Imagine you arent feeling well. You go to the doctor, they run some tests, and it turns out you have a tumor. Well… your physicians arent sure if you have a tumor or not, but they sent some of your blood to a lab, and a non-FDA approved test said you might have a tumor. Maybe. When your blood was sent to other labs, they couldnt find anything.
And even if you do have a tumor, you have no reason to believe that its actually causing a disease– it very well could be benign. They dont know how its effecting you, if at all. Technically, they dont even know where it is.
But good news! They have a drug that works on these kinds of tumors in tissue culture… but no one has tested these drugs on your kind of tumor in small animal models, much less non-human primates, much less valid clinical trials on humans.
And even if you take this drug, there is no way of objectively measuring whether it is working or not. Technically, it could be making the tumor worse, but again, we cant measure ‘better’ or ‘worse’ objectively, so…
Oh, and btw, the drug they have to ‘treat’ you has severe side-effects. A ‘successful’ treatment course will almost certainly ultimately lead to liver and/or kidney failure (assuming you arent hit by a car before then), plus a host of other side effects along the way.
Would you take this drug for your ‘tumor’?
Now read the text above, but replace ‘a tumor’ with ‘XMRV’. Would you confidently take antiretrovirals?
Far too many Chronic Fatigue patients are, and I will try to explain exactly why this is a horrible, horrible idea:
Antiretrovirals in HIV-1 patients is not a simple ‘hey lets try…’ process. Everything is done with a purpose. Every move is strategic and calculated. Here is a basic basic basic overview. Does that look like something MDs ‘play around’ with?
A layman might think ‘Hey, HIV-1 is a retrovirus, and XMRV is a retrovirus, why dont we give people who are ‘infected’ with XMRV antiretrovirals?’ So lets compare/contrast HIV-1 and XMRV to see why this would be a very bad idea:
1. Viral load– How many viruses are floating around in an infected patient? Right after infection, this number is pretty high. But after HIV-1 establishes itself, some people, by virus and host chance/genetics, can keep their viral loads lower than others. Since viral load is associated with disease progression, if someone is not keeping their viral loads low on their own, they should go on antiretrovirals.
Contrast with XMRV– No one has isolated free virus in ‘XMRV infected’ individuals. No one. Even the WPI. Even Judy Mikovits.
Assuming WPI/Mikovits have super powers and they really are the only humans on Planet Earth that can find this virus in CFS patients, none of the tests they perform are quantitative. Their PCR is straight ‘YES’/'NO’. Their super-duper-awesome-new-1970s method of ‘culturing cells’ (whatever the hell they think theyre doing there) is not quantitative. Assuming people are RIFE with XMRV, there is still no quantitative way to measure ‘more’/'less’ XMRV, thus there is no way to measure the effectiveness of antiretrovirals in XMRV ‘positive’ patients.
How would you know whether antiretrovirals are working in XMRV patients?
2. CD4+ T-cell count– CD4+ T-cells arent just essential for fighting off ‘new’ infections. The chickenpox you got when you were seven, the cold you got last winter, you have CD4+ T-cells that ‘remember’ those infections and help you not get infected again. HIV-1 really likes to infect CD4+ T-cells, and the process kills the cells. That steady decline in CD4+ T-cells is a patients progression to AIDS. If a patient is controlling the viral loads, and their CD4+ T-cell numbers are good, they dont really ‘need’ to be on antiretrovirals. If that number drops, the patient needs to go on antiretrovirals ASAP.
Contrast with XMRV– No one has correlated XMRV to a quantifiable pathology. No one. Ive seen a ton of hand waving and just-so stories, but not a lick of science. Though I must admit, Im particularly amused by the ‘natural killer cell‘ story, but thats another post. Whats the ‘defect’ in XMRV ‘positive’ patients that antiretrovirals are correcting? B-cells not working right? Too much of this cytokine or not enough of that one? There is no way of quantifiably assessing whether the antiretrovirals are doing any ‘good’ at all.
How would you know whether antiretrovirals are working in XMRV patients?
3. Drug resistance– Its gotten to the point with HIV-1, that everyone is tested for drug resistance before they are put on anything. Obviously, why would you give someone an antiretroviral their virus was already resistant too, and drug resistance is increasing in prevalence. There are a series of PCR tests that can be done to look for common resistance mutations, and then you know which drugs you dont even have to bother with, cause they wont do any good. Sometimes this doesnt work as planned, as drug resistant variants are always a minority population within the quasispecies, but generally, it works. If someone who was previously responding well to antiretrovirals (see #1, #2) suddenly fails, we can test for drug resistance to know exactly why they failed.
Contrast with XMRV– Testing for drug resistance pre- and post- antiretrovirals is impossible (see #1). For all we know, these people ‘infected with XMRV’ who are haphazardly swallowing antiretrovirals are breeding drug resistant variants that will fuck over you and me.
How would you know whether antiretrovirals are working in XMRV patients?
4. Side effects– One thing physicians always look for in people taking antiretrovirals is side effects. These drugs screw with your body, so you might have cholesterol problems, or insulin problems, or liver problems, or kidney problems… I mean, if you are HIV-1 positive in the US, you arent going to die of ‘AIDS’ anymore. Youre going to die of liver/kidney failure from the drugs. *shrug* Another constant between HIV(+) people taking antiretrovirals is that the drugs make them feel like shit for a while. Until their bodies adjust to the drugs a bit. A common reason for why people are hesitant to take the drugs is because they hear from their friends/message boards “I wasnt sick until I started antiretrovirals”. Thats so common its a cliche HIV Deniers capitalize on. Antiretrovirals make you feel like shit when you first start taking them (not that staying on them is a walk in the park) (not that not taking them is an option either).
Contrast with XMRV– This is a quote from someone in Canada who is taking a random collection of antiretrovirals at some arbitrarily chosen dose because she has been convinced by ‘scientists’ and administrators at the WPI, and their marketing, that the cause of her disease is XMRV, and an irresponsible MD is willing to prescribe them to her:
the wpi has knowledge of 3 people in the US on azt 300 mg for CFS. they noticed improvement in 2 weeks (i am sure they were XMRV+, though)
Weird how AZT appears to have a totally different effect on HIV-1 people than XMRV people, huh? But even assuming its true, I fully encourage everyone to read that entire thread to see how ‘successful’ randomly taking antiretrovirals has been for these people. The OP recently left a comment on ERV about how AWESOME she is doing. It appears that was a lie.
That thread. The threads like it there. This blog.
They are horrifying.
And the fact idiot physicians are happily prescribing these medications…
And the fact it is totally legal, apparently, for Annette Whittemore, Judy ‘The Bartender’ Mikovits, and the Whittemore Peterson institute to terrorize people with XMRV diagnoses (outside of a research setting, with no definitive proof of the virus or that it causes disease*) and support uncontrolled, unguided drug experimentation on these people (not really, though, **WIIIINK!!!**).
Its horrifying.
This is all fucking horrifying.
There is no objective way to measure whether/if antiretrovirals are doing anything to XMRV ‘positive’ individuals.
* Weird how every reagent in our lab has a huge disclaimer on the box and product inserts “NOT FOR CLINICAL OR DIAGNOSTIC USE. FOR RESEARCH PURPOSES ONLY.” So weird.