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http-equiv=Content-Language content=en-us> <!-- <BASE target="_blank"> --><!--[if gte mso 9]><xml> <o:shapedefaults v:ext="edit" spidmax="2050"/> </xml><![endif]--><!--[if gte mso 9]><xml> <o:shapelayout v:ext="edit"> <o:idmap v:ext="edit" data="1"/> </o:shapelayout></xml><![endif]--> </head> <body bgcolor="#EBE6DA" lang=EN-ZA link=blue vlink=purple style='tab-interval: 36.0pt;margin-left:12.0pt;margin-top:12.0pt;margin-right:12.0pt;margin-bottom: 12.0pt'> <div class=Section1> <p class=MsoNormal style='margin-top:12.0pt;margin-right:0cm;margin-bottom: 6.0pt;margin-left:0cm;line-height:150%'><span class=apple-style-span><b><span style='font-family:"Calibri","sans-serif";color:black'>Claus Jensen to the Perth Group on Umber<o:p></o:p></span></b></span></p> <p class=MsoNormal style='margin-top:12.0pt;margin-right:0cm;margin-bottom: 6.0pt;margin-left:0cm;line-height:150%'><span class=apple-style-span><span style='font-family:"Calibri","sans-serif";color:black'>I was wondering if you have seen the latest from Umber.&nbsp;<o:p></o:p></span></span></p> <p class=MsoNormal style='margin-top:12.0pt;margin-right:0cm;margin-bottom: 6.0pt;margin-left:0cm;line-height:150%'><span class=apple-style-span><span style='font-family:"Calibri","sans-serif";color:black'>Some very specific claims are made, which I have underlined.<o:p></o:p></span></span></p> <p class=MsoNormal style='margin-top:12.0pt;margin-right:0cm;margin-bottom: 6.0pt;margin-left:1.0cm;line-height:150%'><strong><i><span style='font-family: "Calibri","sans-serif";color:#333333'>Jean Umber</span></i></strong><span class=apple-style-span><i><span style='font-family:"Calibri","sans-serif"; color:#333333'>&nbsp;</span></i></span><span class=date><i><span style='font-family:"Calibri","sans-serif";color:#E40428'>19 May, 2010</span></i></span><span class=apple-style-span><span style='font-family:"Calibri","sans-serif"; color:#333333'><o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 1.0cm;line-height:150%'><span class=apple-style-span><i><span style='font-family: "Calibri","sans-serif";color:#333333'>I think it is an easy way to explain the lack of death in <st1:country-region u7:st="on"><st1:place u7:st="on">Uganda</st1:place></st1:country-region>:&nbsp;the cut off for the black people is higher as the same for the white people.&nbsp;I explain: <u>the HIV test measures the amount of P24, which is considered as the sign of HIV replication</u>. But, through the study of Aquaro it is now clear that <u>the amount of P24 depends on that of cellular peroxynitrite</u><br> </span></i></span><span class=apple-style-span><span style='font-family:"Calibri","sans-serif"; color:black'><a href="http://www.retrovirology.com/content/pdf/1742-4690-4-76.pdf"><i>http://www.retrovirology.com/content/pdf/1742-4690-4-76.pdf</i></a></span></span><span class=apple-style-span><i><span style='font-family:"Calibri","sans-serif"; color:#333333'><br> <br> Another study (Kalinowski, 2004), show that <u>the amount of peroxynitrite is normally greater in the umbilical vein endothelial cells isolated from blacks than in the same from whites.</u><br> </span></i></span><span class=apple-style-span><span style='font-family:"Calibri","sans-serif"; color:black'><a href="http://circ.ahajournals.org/cgi/reprint/109/21/2511.pdf"><i>http://circ.ahajournals.org/cgi/reprint/109/21/2511.pdf</i></a></span></span><span class=apple-style-span><i><span style='font-family:"Calibri","sans-serif"; color:#333333'><br> <br> <span class=GramE>Thus</span> the amount of P24 is normally greater in black and <u>the cut off of the HIV test should be increased for the blacks.</u></span></i></span><span class=apple-style-span><span style='font-family:"Calibri","sans-serif"; color:black'><o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><span style='font-family: "Calibri","sans-serif";color:#333333'>There&nbsp;are some leaps of logic here but perhaps the gaps can be successfully filled in?<o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><span style='font-family: "Calibri","sans-serif";color:#333333'>First, </span></span><span class=apple-style-span><span style='font-family:"Calibri","sans-serif"; color:black'>by perusing Umber s references I can see that p24 ELISA was used among other things to  assess viral production in vitro:<o:p></o:p></span></span></p> <p class=MsoNormal style='margin-top:12.0pt;margin-right:0cm;margin-bottom: 6.0pt;margin-left:0cm;line-height:150%'><span class=apple-style-span><i><span style='font-family:"Calibri","sans-serif";color:black'>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Virus production was<b> </b></span></i></span><span class=apple-style-span><i><span style='font-family:"Calibri","sans-serif";color:#333333'>assessed by p24 ELISA, western blot, and electron microscopy.</span></i></span><span class=apple-style-span><span style='font-family:"Calibri","sans-serif"; color:black'><o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><span style='font-family: "Calibri","sans-serif";color:#333333'>But I don t know which HIV tests measure the amount of p24, and only that. If anything, I would have thought that the presence/amount of antibodies that react with p24 is what a test can tell us. But can a high concentration of p24-reactive antibodies be directly translated into high amounts of p24 (= viral activity) or vice versa, even on the Orthodoxy s view?<o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><span style='font-family: "Calibri","sans-serif";color:#333333'>Second, assuming that Umber is right in her interesting observation that the amount of p24 is dependent on peroxynitrite, how can we conclude that because the amount of peroxynitrite in certain cells in black people is high, the amount of p24 is high as well? An analogy: Fish are dependent on water, but just because there is water in my kitchen sink it doesn t mean there are fish in there as well.<o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><span style='font-family: "Calibri","sans-serif";color:#333333'>And how can we conclude that blacks <i>naturally</i> have higher levels of peroxynitrite than whites because some test subjects did?<o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><span style='font-family: "Calibri","sans-serif";color:#333333'>Finally, Umber seems to think that <span class=GramE>elevated levels of p24 alone is</span> a marker for AIDS. Is that because&nbsp;<o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><span style='font-family: "Calibri","sans-serif";color:#333333'>1. <span class=GramE>p24</span> is detrimental to health in and of itself?<o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><span style='font-family: "Calibri","sans-serif";color:#333333'>2. <span class=GramE>p24</span> is a reliable marker for elevated levels of peroxynitrite, which is detrimental to health?<o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><span style='font-family: "Calibri","sans-serif";color:#333333'>3. &nbsp;<span class=GramE>p24</span> is a reliable marker for elevated levels of peroxynitrite, which in turn is a marker for other conditions (general oxidation), which is &nbsp;detrimental to health?&nbsp;<o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><span style='font-family: "Calibri","sans-serif";color:#333333'>This still presupposes that blacks are naturally more oxidised than whites - with or without it being detrimental to their health?<o:p></o:p></span></span></p> <p class=MsoNormal style='margin-top:12.0pt;margin-right:0cm;margin-bottom: 6.0pt;margin-left:0cm;line-height:150%'><span class=apple-style-span><span style='font-family:"Calibri","sans-serif";color:black'>Judging from the reference Umber considers it proven that p24 is a marker of oxidative stress (my third suggestion above), and that (American) blacks are supposed to be naturally more highly oxidised than whites.&nbsp;<o:p></o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><span style='font-family: "Calibri","sans-serif";color:#333333'><o:p>&nbsp;</o:p></span></span></p> <p style='margin-top:12.0pt;margin-right:0cm;margin-bottom:6.0pt;margin-left: 0cm;line-height:150%'><span class=apple-style-span><b><span style='font-family: "Calibri","sans-serif";color:black'>Claus Jensen to Anthony Brink on Umber<o:p></o:p></span></b></span></p> <p class=MsoNormal style='margin-top:12.0pt;margin-right:0cm;margin-bottom: 6.0pt;margin-left:0cm;line-height:150%'><span class=apple-style-span><span style='font-family:"Calibri","sans-serif";color:black'>1. Umber says that the HIV tests cut-off levels for Africans should be higher&nbsp;than for Caucasians, since they are more highly oxidised.&nbsp;If not, the tests lose predictive value by catching too many perfectly healthy people. <o:p></o:p></span></span></p> <p class=MsoNormal style='margin-top:12.0pt;margin-right:0cm;margin-bottom: 6.0pt;margin-left:0cm;line-height:150%'><span class=apple-style-span><span style='font-family:"Calibri","sans-serif";color:black'>2. Umber s&nbsp;reference for this says that&nbsp;the higher level of oxidation predisposes black Africans for&nbsp;certain conditions:<o:p></o:p></span></span></p> <p class=MsoNormal style='margin-top:12.0pt;margin-right:0cm;margin-bottom: 6.0pt;margin-left:14.2pt;line-height:150%'><span class=apple-style-span><i><span style='font-family:"Calibri","sans-serif";color:#333333'>Conclusions  Compared with whites, the steady-state NO/O2/ONOO balance in endothelial cells from blacks is kept closer to the redox states characteristic for the endothelium-impaired function disorders. This may explain the differences in racial predisposition to the endothelium dysfunction during ongoing vascular disturbances with the hallmark of enhanced NO inactivation within the endothelium by oxidative stress. </span></i></span><span class=apple-style-span><span style='font-family:"Calibri","sans-serif"; color:#333333'>(<i>Circulation</i> 2004<span class=GramE>;109:2511</span>-2517)<i><o:p></o:p></i></span></span></p> <p class=MsoNormal><span class=apple-style-span><span style='font-family:"Calibri","sans-serif"; color:black'><o:p>&nbsp;</o:p></span></span></p> <p class=MsoNormal style='margin-top:12.0pt;margin-right:0cm;margin-bottom: 6.0pt;margin-left:0cm;line-height:150%'><span class=apple-style-span><span style='font-family:"Calibri","sans-serif";color:black'>3. If higher oxidation of endothelial cells predisposes the African race(s) to endothelial dysfunction,&nbsp;is it not logical&nbsp;to assume that&nbsp;the higher oxidation predisposes for various other things  like  AIDS ? <o:p></o:p></span></span></p> <p class=MsoNormal style='margin-top:12.0pt;margin-right:0cm;margin-bottom: 6.0pt;margin-left:0cm;line-height:150%'><span class=apple-style-span><span style='font-family:"Calibri","sans-serif";color:black'>&nbsp;4.&nbsp;If&nbsp;yes,&nbsp;the HIV tests at their present cut-off level&nbsp;do&nbsp;retain their overall predictive value in mixed study populations, since the higher level of oxidation predisposes blacks to&nbsp;croak easier than whites.&nbsp;&nbsp; <o:p></o:p></span></span></p> <p class=MsoNormal><span class=apple-style-span><span style='font-family:"Calibri","sans-serif"; color:black'><o:p>&nbsp;</o:p></span></span></p> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0cm;margin-bottom:12.0pt; margin-left:0cm'><span class=apple-style-span></span><b><span style='color: black'><span style='orphans: 2;widows: 2;word-spacing:0px'>&nbsp;<o:p></o:p></span></b></span></p> <p class=MsoNormal style='margin-top:6.0pt;margin-right:0cm;margin-bottom:12.0pt; margin-left:0cm'><span class=apple-style-span><b><span style='color:black'>&nbsp;<o:p></o:p></span></b></span></p> </span></div> </span> </body> </html>