Prosecution Expert Witness Elizabeth Dax’s Testimony

Dax's original testimony is at aras.ab.ca/articles/legal/Dax%20Transcript.pdf (5.3 MB pdf). Page numbers are 825-932.

• Sample Western Blot and Second Sample Western Blot
• HIV-1 Particle Drawing.
• HIV Landing/Taking Off From Cell.
• Dendritic Cell Fluorescence.
• Pubmed References claimed to document HIV Structure.
• Particle budding to/from cell claimed to be HIV and another EM of budding.
• Particles in culture claimed to be HIV.

The types of tests that have been cited in evidence here [by the Perth group] are really dinosaurs, in lots of ways.

you can certainly isolate the virus. You can work out ways to make it more and m ore pure, but, just because there is some proteins from the [cellular] environment in it, it doesn't mean the virus isn't isolated. It certainly is isolated; you can demonstrate the isolated virus, you can measure it, you can photograph it, you can identify it by immunological methods. You can identify it by molecular methods.

This illustrates a common problem with AIDS ‘experts’ – they have obviously never looked up the word “isolation” in a dictionary. Clearly every listed meaning of this word is to separate something (HIV in this case) from everything else.

I don’t want to complicate things too much but I think it’s naive to talk about ‘virus’, even a single person who is infected with HIV there will be different forms of the virus. The virus is very clever at mutating, it changes its structure a little bit all the time, so that’s another mechanism it uses to escape the immune response.

very few ELISAs are used in Australia any more

[HIV testing is] driven largely by the transfusion services, which must have maximum sensitivity to make sure that no infected person becomes a donor but also, if they are reactive, to err on the side of caution

This is an admission that HIV testing is oriented to prefer false positives rather than false negatives. Excluding some HIV negative is perceived as a much lesser problem than including some HIV positive blood.

Those [HIV] tests are different to other infectious diseases where you have a clinical syndrome that basically acts as your screening test…Here, there is no symptoms in many cases

This reliance on testing of healthy people is one explanation why, over time, the average health of people with “AIDS” has improved. When most cases were diagnosed based on clinical symptoms the starting point was obviously much lower. A healthy person can be diagnosed with “AIDS” when a minor health condition occurs, however, in the era when AIDS was diagnosed clinically, the condition was limited to mostly seriously ill people.

If the [HIV] test is reactive, there’s two possibilities - three actually - it can be a technical problem with the lab, a true reactivity or a false reactivity.…we repeat the test in duplicate…If two of the three tests that have then been performed are reactive, that is then called repeatedly reactive and we are convinced in the lab that that is either a true positive or a false positive - a true antibody or a false…We then go on to supplement[ary] testing…In Australia we use the Western blot…The chances of that pattern [positive western blot band pattern] occurring in somebody who doesn’t have true antibody are almost zero. We have not seen it.

Obviously if the Western Blot gives a false positive reaction there is no way to distinguish this from a true positive (except by rarely performed sequencing). Her final statement is just an indication that they are powerless to detect false positive Western Blot reactions.

A reactive ELISA, a reactive Western blot and that person has gone on to have their viral load measured and there is a significant viral load. Putting those three together, is there any room for error that person is HIV-positive?

Yes, there have been no widespread validations of the viral load test in the general population. There may be a significant percentage of HIV-antibody-negative people with “significant” viral load, in fact there are indications this is true. Again, if viral load is taken as validation of Western Blot, there is no way to validate that viral load is actually measuring HIV. The circular reasoning has a larger radius, but it’s still a circle.
Dax also seems to be implying that if the probability of reactive ELISA being a false positive is quite low, say 10%, that the possibility of a second false positive is only 10% of that (i.e. 1%), and so on, leading to a vanishingly small probability of the entire set of tests being false. But this assumes that all tests are independent events which they aren’t. The probability of a false positive after all the tests might still be 10% (and since we can’t know the true false positive rate of ELISA tests without validation studies, it could actually be a lot higher).

The sample is tested in an immunoassay, and I have said not usually an ELISA these days, we have far more specific and sensitive tests.

Elsewhere Dax notes that 3 ELISA tests, one Western Blot and possibly viral load testing constitutes the Australian standard. But here (and on page 856 and 910) she is denying that ELISA tests are widely used any more.

There may be bands on [a Western Blot] that are not indicative of HIV or may have one band or perhaps two that run in the same position as the HIV proteins…That is called an indeterminate. The laboratory, at that stage, would say in the report ‘If you have any indication that this person has been exposed or suspect that they’re seroconverting, send us another sample”.

This indicates some bias in the testing. A gay man, for example, is more lilkely to get extensively re-tested.

Can you just explain the difference between specific and non-specific proteins in this context?

Yes. Specific being that those are proteins that we can identify as part of the HIV. They have a particular sequence…If you have a new infection or vaccination, you may get some of the sticky stuff [antibodies that cross-react with HIV antigens] around but it doesn’t fall in those nice neat bands.

Western blot tests do not care about the sequence of amino acids in proteins. They react when an antibody/antigen reaction occurs causing the antibodies in the serum to ‘stick’ to the test.
If the Western Blot test has “nice neat bands” then it is assumed that it is a true positive. Therefore true positives always have “nice neat bands”!

If you take a virus from someone who is infected and isolate the p24 - isolate the virus, break it up and find the p24, that will have a unique sequence, yes…if [the protein] were not [from HIV] and there were a protein there, you would have a different [amino acid] sequence.

The problem is that HIV is never truly isolated so any proteins with the weight of 24 kiloDaltons (which is all p24 means) will be interpreted as viral unless protein sequencing is performed, which is rare.

The mixture of proteins that you put on [the western blot] before you put the electrophoresis across, and that is from an HIV, so that is an HIV protein, okay. There is no doubt that that is an HIV protein on Western blots. These days you couldn’t sell a Western blot if it weren’t an HIV protein, okay?

No, it’s not okay. The western blot test manufacturers have not used pure HIV in their preparations so we don’t know whether the proteins really are from HIV. Okay?

Dr. Turner referred to a study he said you were involved in documenting, involving reformed drug addicts (Lang et al below)…[it] reported that a reformed drug addict, HIV positive, on the Western Blot and ELISA lost their HIV antibodies and reverted to negative when they reformed [stop using drugs].

I honestly can’t remember what that paper was about

We can remind Dr. Dax with a quote from the paper at the end of this page.

Well, obviously I haven’t seen Mr. Parenzee’s results, but if he were tested in an immuno-assay which was reactive, and if he were infected with HIV his Western Blot would have shown the band pattern that we expect to call his status as positive and I have no reason to suggest why the IMVS would have called it positive if those band patterns weren’t present. So while I don’t have that in front of me, I can’t, you know - these labs operate under a system of quality management, using tests that are highly evaluated, highly assessed, using strategies that are defined from several different orders and by and large if they have examined the specimen, they have examined them carefully, that is a true result.

Here Dax is refusing to interpret the Western Blot just in case she comes up with the wrong answer (i.e. that Parenzee’s result is indeterminate).

I’m not sure that I mean anything particularly by ‘virus isolation’

What can we say? We agree that Dax doesn’t have a clue what virus isolation means. We can suggest starting with a dictionary to understand what isolation means first.

What evidence in the Montagnier paper, which you have cited , convinced you that Montagnier had proved that HIV is the cause of AIDS?

Well, this is the accepted reference , this is the accepted seminal reference for the isolation of HIV and it refers to the isolation of a virus, ‘the virus’, that is associated with people who had acquired immunodeficiency disease. So I think that that’s an accepted reference as the basic isolation. I could have cited many others but when you produce a scientific paper you try and go back to the fundamental reference and this is the accepted fundamental reference.

What I was really asking you was if you let us know what evidence did Montagnier produce which convinced you, you Dr. Dax, that Montagnier proved HIV as a cause of AIDS?

Well I can’t tell you exactly what’s in that paper that convinced me, it’s an accepted reference, it’s the accepted seminal reference and there’s many other references that could have been quoted subsequently, including the Gallo papers and onward. So, I mean the methodology is standard.

What evidence in the Montagnier paper you cited convinced you that Montagnier had proved the existence of HIV?

Well I think that, as I said, they are using methods, accepted methods for that and it was the most probable reference at that time and it was proven to be right and as I say, we went back and that’s the seminal reference that’s quoted.

One of the main test[s] is the ELISA test?

That’s not true, we don’t use it anymore.

Dax was recalled for more questioning, which is available here. Page numbers are 1147-70.

[Dr. Val] Turner continues: ‘HIV experts claim they could distinguish between true (caused by HIV) and cross-reactions (not caused by HIV) by using second, third and fourth generation antibody tests and arranging these into various test algorithms. By developing such methods they claim HIV tests can be diagnosed with utmost accuracy. I reject such claims because no amount of technological tinkering can obviate the fundamental need to verify all antibody tests, no matter what tests are used and in what arrangements they are conducted, against the virus isolation gold standard’. Can you comment on that?

Well I disagree. I think he just doesn’t understand what we are - what the evidence is. I think Dr. Turner unfortunately, as I said before, has such a blinkered point of view. He thinks that there is only one or two anti-agents. He thinks that there is a single method of screening HIV antibodies. He thinks that there is one single way to compare antibodies with the presence of virus and I reject his point of view. The overwhelming body of evidence is against [Turner’s] point of view, and I think Dr. Turner needs to read with a more open mind. By the way Dr. Turner has already indicated in his testimony that he takes all the normal precautions as [against?] somebody who is HIV positive. I see that. I would challenge Dr. Turner and Mr. Sidopoulos [Ms. Eleopulos] to - if they are so sure that anti-HIV positivity does not constitute a relationship with HIV infectivity, why don’t they put out their arms like Duesberg who was a great proponent of this view? When he was asked to put out his arm he withdrew his points of view.

Dr. Turner is an emergency medical physician and would probably be fired if he didn’t take the standard precautions, whether he believes they are necessary or not. As for Dr. Duesberg, he has most certainly not withdrawn his point of view. Injecting foreign blood, even if it contains no pathogens, is still a dangerous thing to do. Unexpected adverse reactions to screened blood are still quite possible.

“8 HIV-negative male volunteers gave informed consent to participate in this study…Over 4 days of the second week [after obtaining baseline immunologic data], each volunteer participated in 13 [amyl nitrite and placebo] inhalation sessions…the absolute number of blood lymphocytes decreased significantly following the inhalation protocol, then returned to baseline levels…The results showed that exposure to amyl nitrite can induce changes in immune function even after short exposure to moderate doses.” [i.e. 'poppers' can cause the white blood cell declines that are characteristic of AIDS]

Dax EM et al. Effects of Nitrites on the Immune System of Humans. NIDA Research Monograph. 1988; 83: 75-80.

“The initial study group consisted of 1,129 addicts (949 men and 180 women) consecutively admitted to the National Institute of Mental Health’s former Clinical Research Center at Lexington, KY, between May 15, 1971, and May 14, 1972...The WB [Western Blot] results from the earlier study, which had employed a technique enhanced by the use of an avidin-biotin system, were reanalyzed. The Centers for Disease Control issued diagnostic criteria in 1985 recommending that a WB be considered positive if either band p24 or band gp4l was present alone or in combination with other bands. On rereading, blots with isolated p24 bands were considered to be indeterminate. One 1985 WB, with bands at both the 24 and 55 kilodalton regions, was included among the positives, since the interpretation of this pattern had previously been unclear. The 1971-72 serum specimens were not available for retesting... The two former patients whose 1971-72 WB results were most strongly reactive had current ELISA and WB assays that were negative. Their immune function parameters were inconsistent with immune suppression... The results of the ELISA and WB assays performed on the 1971-72 specimens remain an enigma. Some were interpretable as positive, although only weakly reactive. One explanation is that the results observed in 1985 were true positives, that PDAs in the early 1970s had antibodies to an HIV-like agent that was nonpathogenic, and that the WBs subsequently converted from positive to negative. Loss of HIV antibodies in asymptomatic homosexual men has been reported. It is possible that antibodies to a nonpathogenic virus would have disappeared during the 17 to 18 years between admission to Lexington and the 1989 followup. Although this potential cannot be ruled out, it is more likely that the earlier results were false positives. The reasons for false positivity are unclear, but cross reactivity with related retroviruses may be one possibility. The HIV Western blot assay may cross-react with antibodies to HTLV-I in the p24 and p55 antigen regions, but not the gp4l region. These serum specimens were tested for the presence of HTLV-I/HTLV-II antibodies by other investigators, and a 6.3 percent seropositivity rate for the entire cohort was observed. It is not known if these 10 persons were seropositive for this related retrovirus; however, it is unlikely that this type of cross reactivity accounted for the previous results, given the distribution of the bands and the fact that reactivity was not detected during selected 1989 followup WB screening. The earlier false positivity could be the consequence of either the state of the serum specimens or the test kit or assay employed. It has been suggested that artifactual findings may occur as a consequence of frequent thawing and refreezing of serum aliquots, and that frequent refreezing might affect the physical properties and serologic characteristics of the serum protein moieties. The available evidence would suggest that long-term storage and repeated thawing and refreezing does not affect subsequent testing for serum constituents”

Lange WR et al. Followup study of possible HIV seropositivity among abusers of parenteral drugs in 1971-72. Public Health Rep. 1991 Jul-Aug; 106(4): 451-5.

“This study determined the proficiencies of laboratories measuring human immunodeficiency virus type 1 (HIV-1) viral loads and the accuracies of two assays used for HIV-1 viral load measurement in Australia and investigated the variability of the new versions of these assays. Quality assessment program panels containing (i) dilutions of HIV-1 subtype B, (ii) replicates of identical samples of HIV-1 subtype B, and (iii) samples of subtype E and B were tested by laboratories. Total variability (within and between laboratories) was tested with quality control samples. The coefficients of variation (CVs) for the Roche AMPLICOR HIV-1 MONITOR version (v) 1.0 and Chiron Quantiplex bDNA 2.0 assays ranged from 53 to 87% and 22 to 31%, respectively. The widespread occurrence of invalid runs with the AMPLICOR HIV-1 MONITOR 1.0 assay was identified. The CVs of the new versions of the assays were 82 to 86% for the AMPLICOR HIV-1 MONITOR v 1.5 assay and 16 to 23% for the Quantiplex bDNA 3.0 assay. For virus dilution samples, all but 5 of 19 laboratories obtained results within 2 standard deviations of the mean. The Quantiplex bDNA 2.0 assay reported values lower than those reported by the AMPLICOR HIV-1 MONITOR version 1.0 assay for samples containing HIV-1 subtype B, whereas the reverse was true for subtype E. Identification and resolution of the problem of invalid runs markedly improved the quality of HIV-1 viral load testing. The variability observed between laboratories and between assays, even the most recent versions, dictates that monitoring of viral load in an individual should always be by the same laboratory and by the same assay. Results for an individual which differ by less than 0.5 log(10) HIV-1 RNA copy number/ml should not be considered clinically significant.”

Best SJ et al. Quality of human immunodeficiency virus viral load testing in Australia. J Clin Microbiol. 2000 Nov; 38(11): 4015-20.

“in blood screening programs or in low prevalence populations such as in the 'worried well' where the ratio of falsely to truly reactive results is high, the positive predictive value will be low [i.e. a significant minority, or even a majority, of positive test results will be false positives, even when the test is highly accurate]”

Dax EM et al. Advances in laboratory testing for HIV. Pathology. 2004 Dec; 36(6): 551-60.