Talk:HIV/AIDS

Mentioning year and source

In this edit "A 2006 media report" was added. We do not need to preface every line with "a 2004 book", "a 2009 systematic review and meta analysis" etc as that would just look silly. Thus have reverted the changes. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:37, 8 September 2013 (UTC)

Have removed the sentence entirely as we already discuss here HIV/AIDS#Denial.2C_conspiracies.2C_and_misconceptions. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:41, 8 September 2013 (UTC)

My insertion of the year of the article is explained on your Talk page, but I support your latest edit.--Soulparadox (talk) 15:47, 8 September 2013 (UTC)

Have found a better ref [1]. Agree that the original ref was not very good as it was a primary rather than a secondary source. Thanks for joining the discussion. Doc James (talk · contribs · email) (if I write on your page reply on mine) 15:54, 8 September 2013 (UTC)

Slate story on HIV/AIDS

There is a story at Slate.com about AIDS and its denialists. The quote I'm interested in (it's in the second paragraph) is as follows: Before the advent of modern HIV treatments, AIDS was a speedy and terrifying killer, turning an otherwise healthy human into an emaciated corpse with horrifying speed.

The current AIDS article contradicts that statement, as follows: Without treatment, this second stage of the natural history of HIV infection can last from about three years to over 20 years (on average, about eight years). While typically there are few or no symptoms at first, near the end of this stage many people experience fever, weight loss, gastrointestinal problems and muscle pains.

I'm at a loss to understand the discrepancy. I think it should it be addressed in the article. I just want to get some comment before I include the Slate comment and reference in the article. Operative67 (talk) 18:41, 14 October 2013 (UTC)

It's important to understand that in the early days of the epidemic, HIV/AIDS was often not diagnosed until it had entered its terminal phase with severe opportunistic infections. Those individuals were, in fact, infected 3-20 years earlier, but the second stage of the illness went unrecognized because little was known about it at the time. From the perspective of the patient/family, the time from diagnosis to death was indeed often very short in the early days. With a better understanding of the epidemiology of HIV/AIDS and better diagnostic tests, people are presently often diagnosed early in the second stage of the illness. For a more technical discussion of this apparent discrepancy, see lead-time bias. MastCell ^Talk 18:52, 14 October 2013 (UTC)

Genetherapy against AIDS

Is genetherapy the solution to cure aids and to save Zambia, implanting the genes of somone who cannot be infected with the disease to a sick people? — Preceding unsigned comment added by 188.20.77.242 (talk) 16:17, 29 October 2013 (UTC)

So it looks like a case of bad reporting by the Slate author, Stern. Surprised no Slate editor caught it. Operative67 (talk) 00:20, 15 October 2013 (UTC)

CCR5

Would this review of CCR5 Monoclonal antibodies at least be enough for the article to mention the connection between CCR5 deletion and HIV immunity? http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760828/

Is it being used in practice? Else would go in the section on research. Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:09, 14 November 2013 (UTC)

HIV timecourse graph

old version

new version

Hey there fellow editors, I have created a new version of the graph to show the time course of an HIV infection in the hope to include it in this article as well as the HIV article. The aim was to make a graph that is as simple and clear as possible to serve its purpose to explain the time course of CD4 cell counts and viral load over the course of a typical untreated HIV infection. The old graph has quite a few issues that have been bothering me and which I tried to address with the new version. Below I am discussing the changes and my reasons behind them.

Scope

First, let's define the purpose of the diagram in this article. As I understand it this is an overview diagram to explain a generalized trends of CD4 cell counts and viral load over the course of time of a typical untreated HIV infection. As such, the diagram should be simple and easy to understand.

The purpose, however, is not to explain what HIV/AIDS is or give specific details about different aspects of an HIV infection. An overview diagram is the very last place to add text content. That's what the caption and the rest of the article are for.

• Comment That's your take on scope. This as an overview of HIV's time course in the context of the HIV RNA and CD4 trajectories. Linking these concepts conceptually is helpful - and reliable sources seem to agree. Clearly, it's not the "very last place to add text" - and I see it as helpful. -- Scray (talk) 00:21, 27 November 2013 (UTC)
  • That is one reliable source, and here's another reliable source (Fig 1) that does not deem the text helpful and leaves it out. So? The point is that, sadly, figures in original publications are hardly a gold standard for good and informative design. And I think we, the editors, are well able to decide for ourselves what belongs in a figure for a Wikipedia article and what doesn't.SPLETTE :] ^{How's my driving?} 12:02, 27 November 2013 (UTC)

Remove of text clutter

Following the scope of the diagram, I have decided to remove unnecessary text clutter in the diagram:

-'Wide dissemination of virus; Seeding of lymphoid organs' - These are arbitrarily picked pieces of details about an HIV infection that belong in either the caption or rather the article where the acute phase of HIV is being discussed. They do not belong in the graph itself. If we were to include these two very specific details in the graph, why not include other, equally important information: formation of latent cells, production of antibodies etc.? The list is endless.

-'Conditional Constitutional Symptoms', 'Opportunistic diseases' - That is what 'Symptoms of AIDS' means. Again, it doesn't need to be specified here. It should be explained in detail in the article text where the symptoms of AIDS are explained. Moreover, this diagram is very general in nature. Thus, it doesn't make any sense to pinpoint 'ConditionalConstitutional Symptoms' & 'Opportunistic diseases' to particular points in time at 7.5 years and 10 years. This may mislead the viewer to believe that for example conditionalconstitutional symptoms will not occur before 7.5 years of an HIV infection.

• Comment "clutter" is subjective. The current figure reflect widespread usage of figures like this. While we're expressing our own opinions, the choices make sense to me (and I don't see "production of antibodies" as coupled to this figure at all - so I agree that would be arbitrary). You also seem to misunderstand that "constitutional symptoms" are a harbinger of AIDS (and that "conditional" would make no sense at all in this context), thus they are placed just at the transition between clinical latency and AIDS. That could be clarified in the caption, certainly. It's just a diagram, so the caption/text should indicate that all timing indicated - on the current version or your new one - is highly variable person-to-person. -- Scray (talk) 00:28, 27 November 2013 (UTC)
  • In my previous comment I mixed up the words 'constitutional' and 'conditional'. Fixed now.
  • 'production of antibodies' or 'formation of latent cells' is not coupled to this figure but 'seeding of lymphoid organs' is? It's completely arbitrary. (Btw, Thesefigures in other reliable sources consider the antibodies so important that they even add a third graph for them to the diagram, while leaving out the text like I did.)
  • As for the widespread use of the figure, most of those instances are derivatives of this very wikipedia figure. Ignoring those (plus the original figure this is based on, linked above), there are few left that also include the additional text. SPLETTE :] ^{How's my driving?} 12:02, 27 November 2013 (UTC)

Label positions

Many of the positions of the text labels in the old version seems rather random and therefore cause confusion. For example: 'Death' is placed right underneath of 'Symptoms of AIDS' therefore giving the impression that death was one symptom of AIDS. The three brackets for 'Acute HIV symptoms', 'Clinical Latency' and 'Symptoms of AIDS' are each placed at a different height making it harder to read the diagram and distinguish between those three phases. In the new version of the diagram, I chose to use the same style for start and end point of the infection ('Infection' & 'Death'). Unlike the other text labels, these two labels describe a precise point in time and therefore contain a vertical arrow to indicate the beginning and end of the infection. For the three phases 'Acute HIV Syndrome', 'Clinical Latency' and 'AIDS Syndrome' I chose a subtle but clear to distinguish gradient in the background. Unlike with the three horizontal brackets in the old version, the gradients in the new version extend downwards and therefore make it easier to distinguish the three phases visually.

• Comment Agree that the labels for infection and death could be clearer in the way you describe, simply by editing the current version. The gradients reduce contrast between text and background, reducing legibility. -- Scray (talk) 00:36, 27 November 2013 (UTC)
  • Sorry, but the gradients are so subtle that I really don't see how they are an issue concerning reduced contrast. Are you really saying the new version of the figure is less legible than the old one? SPLETTE :] ^{How's my driving?} 12:02, 27 November 2013 (UTC)

X-axis & the two graphs

In the old version the x-axis extends to the left beyond 0 weeks (to approximately -1 weeks) and to the right beyond the point of death. In my opinion it makes more sense and is more intuitive to let the x-axis start with the infection and end with death.

The old version also contains two errors (apparently due to sloppy drawing of the graphs): The start of the blue graph ('Primary Infection') does not line up with 0 weeks but is placed at about 1 week. (Check the 2000px version of the old version or open it in a graphics program and draw a vertical line, if you don't believe it.) That doesn't make any sense at all. The graph should obviously start with 'Primary Infection' at 0 weeks. The other thing is the start of the viral load graph. Is there any good reason why it should not extend down to the x-axis? I don't think there is. One might argue that there is a lower level of PCR tests to detect viral RNA, however, that limit is somewhere about 40 copies/ml and therefore even below the x-axis.

• Comment not particularly consequential, and readily fixed in the current version (we can wait to see consensus before deciding whether to edit current or new). -- Scray (talk) 00:36, 27 November 2013 (UTC)
  • It's not particularly important if the graphs starts at the correct point? I thought this was a scientific article... SPLETTE :] ^{How's my driving?} 12:02, 27 November 2013 (UTC)

Font + Size

The original font size of the smaller text labels in the old version is 12pt, making it very difficult to read any of the text unless a larger version of the diagram is being viewed. The text size was increased to 14pt in the new version. One might consider to increase the text size of the axis labels as well (maybe skipping every other label on the CD4 axis). To add clarity to the overall look I chose a san serif font.

I hope you agree with my reasons for changing the diagram. Let me know what you think and if you approve using the new version in the article. SPLETTE :] ^{How's my driving?} 23:12, 26 November 2013 (UTC)

• Comment Font and size are readily fixed in the current version. Overall, I guess it's apparent that I prefer the current version, but applaud your effort and agree that there are some things that could be tweaked; more importantly, this figure reflects reliable sources and unifies some key features of HIV infection. -- Scray (talk) 00:36, 27 November 2013 (UTC)

Vitamin D & HIV/AIDS

Why don't anyone talk about the actual cure for HIV/AIDS? Vitamin D3 normally at doses 10,000IU or above, cures HIV/AIDS (all patient's treated at this dose or above, tests negative for HIV within two months), CD4 count rises dramatically above 600 x 10^6 and of all things leukocytosis occurs (10,000 x 10^6 ml) and a mild fever may occur. The problem is that I am the primary source and I was given no encouragement by anyone to write this in any scientific journal because I am only an undergraduate student. — Preceding unsigned comment added by Mataylor1983 (talk • contribs) 08:24, 29 November 2013 (UTC)

I encourage anyone with a cure for HIV to present it at an international HIV conference and publish it in a reputable peer-reviewed journal. Once secondary sources provide evidence of notability and authenticity, we can seriously consider adding to WP. Absent such support, this is not the place to talk about speculative cures (particularly when many people with HIV have received vit D3 / cholecalciferol at that level as supplementation without being cured). -- Scray (talk) 16:25, 29 November 2013 (UTC)

I have not read any study in which very high doses of vitamin D3 have been used as medicine, I believe that the studies that do exist is concerning 400IU to 2000IU of Vitamin D3 and they found that vitamin D3 levels correlate with CD4 count and negatively correlate with viral levels. I don't think its fair for them to expect an undergraduate student to receive government funding for a high dose vitamin D3 study which hasn't been done yet? If Scray knows where to find such a study, please reference it. We all agree on using secondary sources I just hope that some doctor decides to look into that person's story and investigate vitamin D3. And this is the place to talk about it politely even if its only speculation, perhaps the page itself could be updated with the studies that show that vitamin D3 has a positive effect on CD4 counts and has a negative correlation with viral load. So far the page itself does not even mention Vitamin D3, not even in the alternative treatment section.