| | | | | Martyn French is a clinical professor with the University of Western Australia and clinical director of the department of clinical immunology and biochemical genetics at the Royal Perth Hospital. | ||
| Testimony | Martyn French's testimony can be found here (2.3 MB pdf, pages numbered 779-824). |
| French Testimony (pages 814-5) | There is another, rarer, immunodeficiency syndrome well described, and I have seen it in my practice, of a case called, a disease called idiopathic CD4 T cell lymphopaenia. This is a rare immunodeficiency disorder in which individuals lack CD4 T cells, they are in very low numbers the CD4 T cells, and we don't know why it happens, the cause is still not determined, but all of those patients - and some of those patients can develop opportunistic infections. All of those patients have been studied very, very intensively to determine if they have HIV infection because, of course, initially it was thought that they had some unusual form of HIV and, with every investigation that's been undertaken, no-one can find HIV in them and they have very low CD4 T cell counts. So I think that is evidence that having a very low CD4 T cell count doesn't mean that you will develop HIV infection |
| Judge | Is it evidence that people with HIV infection do not necessarily develop low CD4 T cell counts? Thats the reverse side of the coin. |
| French | Yes. There are people with HIV who never develop low CD4 T cells, and there are people [with] low CD4 T cell [count]s who do not have HIV. |
| Judge | But is that unusual in medical science? |
| French | No. |
| Judge | "In the sense that you will always get instances where there may be a paradox? |
| French | Yes. |
| Judge | Or where there may be a non-explanation for it? |
| Our Question | Is that the same as where there may be no explanation for it? |
| French | Yes, There are a lot of paradoxes in medicine. The disorder that we talked about initially, that I first described in the 1990s, was very much a paradox because what was observed was that patients with HIV, who were given antiretroviral therapy which was suppressing the infection, then became sick and developed a lot of inflammation, and it was thought they were developing infections, and it was paradoxical why they should be developing an infection when you're treating the HIV, but in fact the inflammation we now know is due to the immune system recovering, fighting the infections causing the inflammation, so medicine is full of paradoxes. |
| Recall Testimony | His recall testimony can be found here (1.3 MB pdf file, pages numbered 1171-1198). |
| French (page 1194) | It is advised by the manufacturing companies that viral load tests should not be used as a diagnostic assay, but my belief is that the reason they have done that is there havent been studies done to validate them as diagnostic tests. In practice, however, many people do use a viral load test as a test to help confirm the diagnosis of HIV infection. it is just that manufacturers dont recommend it. |
| His Honour | In other words, if somebody is diagnosed as positive HIV and they have a viral load test, and the viral load is a certain figure and they subsequently have a viral load test, and the viral load has dramatically increased, thats confirmatory to some doctors for the presence of HIV? |
| French | Yes, its in our view, it confirms the presence of HIV infection |
This web page is maintained by David Crowe. Please contact him if you discover any errors, or have any suggestions for improvements.
© Copyright July 19, 2008 by GARLAN.