THE COMING WAVE (An Interview With Mother Abigail)

Page #57
NOVEMBER 26, 2010
CARSON CITY
MOTHER ABIGAIL'S STUDY

Q: I arrived a little after noon at MAs and we settled quickly into our favorite chairs. I think we were both anxious to continue our excellent conversation of yesterday.

MA: We talked a long time last night didn't we?

Q: Yes MA it was a great afternoon. Thank you very much for sharing the lovely food and the hospitality of your house.

MA: You are quite welcome - it was fun for me. Do you remember where we were?

Q: That is the great advantage of taking good notes MA, we were about to discuss the Third Wave that you are so worried about.

MA: Indeed. It is probably obvious to you by now that I taught you all about the wonderful world of bugs and how they operate, so that we could have this conversation now.

Q: Yes I suppose so, all the lessons about Influenza and all the lessons of viral reproduction always kept coming back to the HIV virus. Why not just start with HIV?

MA: Several reasons, number one being that H1N1 is very much in the news as is H5N1 and they are the perfect examples to learn how all the bells and whistles work in the fast moving life of your RNA virus. Second, I am not sure you would have stuck to the subject had it not had the potential for a good article about the virus du jour.

Q: You are probably right. From what we have discussed these last few years, you are afraid that the HIV virus is going to become more virulent, aren't you?

MA: Very much so. It is different - highly mutagenic and very deadly. What do we mean when we say "Mortality Rate"?

Q: It means what percentage of the people it infects die.

MA: Correct. Now what is the mortality rate for those poor souls who become infected with the HIV virus?

Q: I am not sure. I know people are living longer with the disease and some don't seem to get sick at all. I thought at one time that it was 100% fatal, but I am not sure that is correct.

MA: It is not. A very very small percentage of people never get ill, many are living a long time with different drug cocktails and many die very rapidly. It is truly all over the board. Much of the answer lies in where you live, how you acquired the virus and what level of treatment you can afford. You will not see many hard numbers on this question any more, as you do other diseases, for just these reasons. But there is one question that you can answer fairly certainly, and that is "how many people who acquire the HIV virus get well?"

Q: There is no real cure is there?

MA: No, once infected it seems impossible to kill the virus. There are always claims that X or Y have a complicated system for rooting out and destroying all the virus in a body, but I do not believe this is true. We understand all too well how this horrible bug can hide in places that render it all but untreatable. The sad truth is that HIV+ is a condition that, as of this time, is treatable but permanent.

Page #58

Q: But it is very hard to transmit, right?

MA: Mostly. Mother to unborn infant, heterosexual sex, homosexual sex, blood transfusions and needle sticks are avenues for transmission - but on balance you would have to say that outside the human body it is a very fragile bug. However once it gains entry to the human body, via any means, it is all but invincible.

If you think of the thin layer of atmosphere that protects the earth and keeps us from looking like the moon - the human immune system is very much akin to that layer.

Were it not for that immune system we would all be "bubble boys" needing an artificial system of protection to keep the world from killing us. There are a multitude of bugs and fungi that would kill us very rapidly without that internal system of defense.

And therein lies the dilemma. HIV lives to destroy that system.

Q: Why can't we kill it?

MA: Think of all the changes that have occurred in science and medicine since 1980. Yet HIV remains untouched. If you have enough resources then you can afford treatment to greatly prolong your life - however the virus remains undefeated - only waiting.

Q: But can't we eventually find a way to kill it?

MA: Perhaps if there were time. Child do not underestimate this virus. Having obtained a foothold in our species it used air travel to gain access to the developed world. In this continent it traveled in the underworld of gay sex to spread from East to West.

Then again using air travel it continued in its march to geographical saturation until it now resides in over 30 million bodies - in every corner of the globe. Think of those 30 million poor souls as independent laboratories, each producing uncountable reproductions and mutations daily - with only one goal.

Q: And what would that goal be?

MA: To break out.

Q: You mean to be more virulent, don't you?

MA: Yes, it has only one purpose, only one drive and only one effect - it kills human beings.

This bit of malevolent RNA has now colonized the planet earth and is working on a scale that you cannot imagine to move from host to host more efficiently. As it now exists, it is very difficult for it to pass from host to host. That being so, any mutation that allows it more access to a wider number of carriers will be highly beneficial to the organism and its relentless attack on our species.

Q: I can understand that. But it has not evolved in that arena yet, why do you believe that there is a likelihood of it becoming more transmittable?

MA: There are really not that many potential outcomes.

1. We find a way to kill it.
2. It continues to be a manageable chronic illness.
3. It becomes more virulent.

Page #59

Q: Yes but that has always been the situation. Why now would it change?

MA: Oh there is that question isn't there. I have spent the last few years teaching you the very best science and understanding that we have on this subject and now we come to a departure in that protocol. Are you certain you would like to go in that direction?

Q: I have worked for a long time, changed the direction of career and will forever be incomplete if I do not. So the short answer is yes.

MA: Then perhaps we better have a cocktail.

Q: Thought you would never ask....

Mother Abigail set about to make our favorite afternoon delights. Being that it is winter I prefer Crown on the rocks and MA normally has Frangelico and tea.

I have been building to this conversation for the last two days and now I feel we are about to go into the arena that MA has, thus far, excluded me from.

The afternoon has drifted away but the fire is warm and I yearn to be back in that odd place that I drift into when she is so spellbinding with her discussion.

MA: One thing before we continue. You need to draw a line between our prior conversations and this one. All the information and discussion prior to this has been as accurate and documented as is humanly possible. There are things that could change tomorrow, but I have tried to be fair and scientific in my presentations to you. Do you understand that?

Q: Sure MA, I will do just as you ask but I believe that everyone knows by now that what your thesis is well founded in science and I have never had one person dispute the data that you have laid out.

But it is going to be different now isn't it?

MA: Yes, very different.

Q: Good.

Q: You see things don't you?

MA: No. I simply have hunches, premonitions and occasionally I know about future events. "See" is the wrong verb, feel would be closer to the truth.

Q: Did you "know" about SARS?

MA: I would say it was a very strong premonition. I am always watching for outbreaks and when I heard the first little blip about the "unknown pneumonia" in China it gave me that feeling that this was serious and would grow to be dangerous. "Knowing" is a bit different.

Q: Are you ever wrong?

Page #60

MA: Oh sure, sometimes the hunches turn out different than what I originally thought, sometimes the premonitions have little twists or permutations that I did not imagine.

Q: And the "knowing"?

MA: No, when the feeling is that strong the events are normally coming. It is hard to explain, but you just know something. And child I assure you that I am not alone in this talent. Many parents can tell you that they just know something about their children. Certain gamblers make unusual bets and then explain that they just knew X Y or Z was going to win.

This intuitive nature of our species is what I have been trying to teach you about when we speak of increased perceptual ability. This "fourth dimensional perception" is real and evolving.

Q: And you know about HIV?

MA: Yes, very much so.

Q: When did you first know and what was it that you felt?

MA: I knew from the first day we discovered it was a virus. And, in truth, perhaps even a bit before that announcement - because I had been looking for such an event. My entire life I have had this strong premonition that in my lifetime we would see a virus arise that would dramatically change our species. That feeling led me to science in school, medicine in college and Virology in practice. It has always been with me and remains today.

At first it was just the overall idea that such an event was upcoming, but as the years progressed and I became more mature, the details have filled in and I am left with a "knowing" that is fairly complete and has been coming to pass before my old eyes.

Q: Did it bother you?

MA: Why no, it is part of what I am. Just a little section of my mind that occasionally reminds me that there are dark clouds on the horizon.

I was fully content to sit in this wonderful chair and hope that I would be wrong on the outcome, but almost certain that I would not. That was of course before God sent you to the cabin at the Lake.

Q: MA, with all due respect, I don't think God sent me to your cabin.

MA: Oh really. Perhaps one day you will look back on the events that led you to my garden that afternoon and have a different opinion. But as for me, it was obvious that here - in your desire to write about me - was the perfect opportunity to try and do something different than just carry the knowledge to my grave. Also it was apparent that, for some reason, it was time.

Q: Time for what?

MA: Oh, for many things. If you were sitting in my garden with a pen and paper, then it was time to tell the story as I see it. And if it was time to tell that story - then there must be a need for that information.

Q: Do you mean that you feel we can stop this coming wave?

MA: No, as I have explained, that wave has already washed over this world - but there are some things that still might be done to help those who are watching.

Page #61

Q: When you say those who are watching what do you mean?

MA: One of the sites that you have been writing on about our conversation is called "FluTrackers", correct?

Q: Yes of course.

MA: Do you read the many threads that have to do with pandemic preparedness and all the reports of exotic diseases that pop up worldwide?

Q: From time to time.

MA: Well they are watching. Not only those fine folks but there is a survivalist movement in our country that grows steadily with new converts.

In fairness, they will all tell you they are watching for something different. Some are looking for financial collapse, some are looking for totalitarian government movements, and some are looking for plagues, earthquakes, and the end of time.

But many are those who are watching.

I am not the only person with the nagging feeling that there is something very dark on the horizon.

Q: But your interpretation of these dark clouds is tied into your vocation. Could it be that the reason you fear an outbreak - is because that is the subject you know best?

MA: Of course it is possible, anything is possible. I suppose the smart money would be betting on me just being the crazy lady in the big house. But that does not change the story that I am telling you. These events are my understanding of our immediate future and are not the result of any external influence.

Q: Fair enough. You say that because the HIV virus is already pandemic there is little we can do to stop the "coming wave". How can that be true?

MA: We have fought against the HIV virus for over thirty years and yet it continues to march forward - were this organism to change its virulence the sheer scope of that event would be overwhelming.

Q: And you fully believe that transformation is coming?

MA: It is imminent.

Q: Well you have spent a lot of time explaining to us how each chemical challenge we throw at this virus results in it changing very rapidly to evolve a defense to that challenge. And I fully understand that it is highly mutagenic. But it is neuraminidase that really concerns you isn't it?

MA: Yes, as I have laid out for you these last few years, we know that neuraminidase enhances HIV's ability to replicate and it just has too many possible side effects for us to purposely be dosing HIV+ patients with chemicals that disrupt the normal neuraminidase function in their system.

That does not mean that the change in HIV virulence will be directly attributable to this treatment, but I have my suspicions.

Q: Do you mean that you are not certain why the virus changes?

Page #62

MA: No I am not. I believe, and this is only my belief - not science, that the virus is on the verge of a complete breakout of its current behavior and will soon change both its transmission vector and its virulence.

The nuts and bolts of what precipitates this transformation are not clear to me and, in truth, we may never know the answer to that question.

Q: Ma if you are not sure how it changes then how can you be so certain it will be dangerous?

MA: Well, it is not so black and white as you make it. What I believe is that it will change. It will go airborne and it will become quick and deadly. When it makes that magic mutation that gives it the ability to ride the water droplets expelled in a cough or sneeze to the lungs of a healthy person - not only will it have found the mechanism for rapid transmission but the mutation will also set in motion a very different chain of events from what we know now.

When the new HIV virus arrives in the lungs of a new patient there is the great potential for a positive feedback loop to be established between the new invader and the host's immune system. At the arrival of the new pathogen, cytokine will signal the body to send T Cells to fight the infection. The T cells, upon being stimulated by the cytokine will begin to produce even more cytokine.

This is the normal reaction and happens all the time. But we have a real problem don't we?

Q: HIV lives on T cells?

MA: Yes of course. So now we have the feedback loop. T cells rushing to the lungs where they are infected with new virus and more and more cytokine being produced by the body. The result is called a "Cytokine Storm". The lungs begin to fill with fluids and immune cells. The result is sudden death. When this event takes place in the lungs, it can kill a healthy young person in less than 48 hours. We learned this lesson in the 1918 flu outbreak.

Q: So the hardy virus can jump from lungs to lungs and once there put in motion a very serious reaction that will kill you rather quickly. Is that about it?

MA: Just about, the only addition I would add is that once the new bug creates this "soup" in the lungs - with each cough or sneeze this deadly pathogen is sent on an airborne journey looking for a healthy lung to infect..

Q: OK, I see all that and I understand why you have been so concerned about doing anything that might increase the chance of the virus mutating.

But, what I don't really see is this - Say it happens as you say, somewhere in Russia or China the virus is successful in breaking out and infecting a patient, his family and even some health care workers - wouldn't it quickly be quarantined and controlled? Even SARS can be contained.

MA: Yes were there to be an isolated breakout and the proper barrier nursing techniques could be initiated, then the prognosis would be for containment. But that is not to be the case.

Q: I don't understand what you mean.

MA: There is a very unusual phenomena in the world of Virology called "coincidental spontaneous mutation". We use this term to describe an event where the same mutation breaks out in multiple locations in the same time frame.

The causality of this event is highly debated but the phenomena is well documented.

Q: Recently?

Page #63

MA: Very recently. In 2009 there was an event that occurred concerning the H1N1 novel virus that should have sounded the alarm bells for all those who are watching these pandemics.

There was a mutation of the H1N1 virus that occurred in Brazil, China, Japan, Mexico, Ukraine, and the United States. The mutation is called H1N1/D225G.

This mutation directly attacks the lungs, causing swelling and hemorrhage. Symptoms include progressive over 38C temperatures, breathing difficulty, a dry cough producing blood, and destruction of lung tissue starting in the lower lungs. Time from onset of symptoms to death was 4-7 days.

When we performed post mortems we found the lungs were blackened, as if burnt, perhaps related to lung hemorrhage.

Both the D225G marker, a so-called ‘domain changing receptor’, and the symptoms listed above seem to link this variant to the Spanish Flu Pandemic of 1918.

The multiple coincidental spontaneous mutations were so startling that some people believed we had seen a test run of a biological agent. That was not true.

What we experienced was soon repeated again when clusters of Tamiflu resistance patients appeared in Wales and North Carolina. These patients all acquired an identical change in the H1N1 virus - yet lived a world apart.

It is not a new phenomena. There have been many reports, historically, about bugs acquiring resistance seemingly overnight. Again, the mechanism for this type of event are completely unknown to us. There are so many things that occur in our physical world that seem bewildering - yet commonplace.

That is the great joy of science, to reach into that unknown realm and search for those natural rhythms that are just beyond our understanding.

Q: I don't know what to say. I had no idea such a thing was even possible. But it makes the hair on my neck stand up when you talk about the effects the mutation has on the lungs. Is that what happened in 1918?

MA: Well we have to be careful about overreaching but yes something very similar to this event. That bug killed the young and healthy with impunity. Once again, in a cytokine storm the more robust your immune system is - the more devastating the feedback loop.

Q: It is almost like we are, step by step, building up to your vision of the HIV mutation. All these events are so similar to what you postulate.

For the first time MA, I am a little frightened.

MA: And why is that?

Q: I suppose because before this discussion your theory seemed just too far fetched to make any sense. But when you frame the outbreak with all this in the background - it is just a bit too real for me.

I am in the position of having read your writings stretching over nearly a decade and it is impossible to forget how prescient you have been on so many issues. That worries me when your predictions begin to make not only reasonable sense but have a small ring of truth.

MA: Ring of truth?

Page #64

Q: Well yes, there is something in your tale that seems, to me, believable. I am forced, for the first time, to ask myself "could it really happen?" And viewing your past history of remarkable calls in the field of Virology - I would prefer not to answer that question. It is the knowledge that I would rather avoid that question that frightens me.

MA: I can understand your concern. There is a certain rhythm to life and many times it seems to telegraph the direction that it is moving in.

We are often just passengers on this cosmic train and that knowledge can be a bit unsettling.

Let's have a drink and take a break for a moment.

Q: She must have seen that I was not quite all there. My mind was going over this new revelation. I had no idea that organisms could change so quickly and in concert of all things. It was the piece of the puzzle that never seemed quite right.

From our first conversation I was aware that MA was awaiting a viral outbreak of a scale that would change our species. So what - I know people who believe aliens visit us from time to time. Everyone to their own.

But this outline of events is lacking the huge leap of faith that I always assumed she had made. I suppose it could be possible...

MA: Here is a fresh Crown on the rocks. I will be right back - I am making tea.

Q: I put another log on the fire and tried to gather my reporter persona. My desire to see this conversation played out in detail now appears to have gone a bridge too far. It is safe and warm to view others as odd or eccentric, all the time smugly maintaining a safe distance from the message. But I feel a bit compromised.

Q: MA, are you saying that there are to be multiple simultaneous mutations worldwide?

MA: Yes.

Q: And I assume this large scale outbreak is what overpowers the health care systems?

MA: There will never be a real opportunity for containment. This is not Hollywood. No hero will develop a magical antidote just in time to save the beautiful woman. No, this event is of such a consequence that, by the time the scale is apparent, the issue will be settled.

Because the virus is airborne the first three days of outbreaks will saturate such a large population that all the wheels will rapidly come off even the best health care systems. The first task will be to understand what is happening and it will, all to rapidly, become apparent that it is a very hot bug and that it is pandemic.

But by the time the extent of what has happened is well known - there will be no recourse.

Child, there is no recourse even now. We cannot kill this creature. We have only kept it at bay for these many years and that era of detente is rapidly ending.

Q: But MA, you make it sound so hopeless. How could you believe such a thing?

MA: There are things that I believe and things that I know. This virus and its coming change are something I know. I know in detail and specificity that defies all common understanding - yet my knowledge remains.

And now you know.

Page #65

Q: I stopped talking for a few moments and stared into the fire with my thoughts. It was too much to assimilate on one afternoon, now early evening. But this was my last night in Carson and my last night interviewing the remarkably complex lady who long ago signed on to a web site as "Mother Abigail". I looked up and she was serene and quiet in her big black chair.

If this is all true, are you saying only isolated groups will survive - like in past bottlenecks?

MA: No, unfortunately groups will not be so lucky. All those well prepared groups who believe that when the stuff hits the fan they will survive because of where they live or where they will retreat to - will make one tragic error. They will welcome carriers into their retreats before the scope and speed of the outbreak are well known. It will be their undoing.

This outbreak is of a different scale. The penetration of the virus into human culture and population, the speed of the spread of the airborne variant, and the closeness of human contact in our modern age are all factors that, except for a few isolated pockets, mark the end of the rise of Homo Sapien Sapien.

It is very close to an extinction event.

Q: You say isolated pockets?

MA: Yes, there will be those few who, at first report of the strange deaths, will depart immediately to a place they have chosen and stocked with provisions. This will not be groups but the next step down - families.

This place will have ample water and be so removed from human contact that the virus will burn through our species without finding them in their place of refuge.

It will be these families that must carry on with our hopes and dreams of better days.

This is not an easy concept to understand but in all this trauma and tragedy - there is transformation. A sort of genetic winnowing and even, in the macro sense, a choosing.

For those who are awaiting this event, and child do not be deceived, they are many in many lands. These coming events are not unknown. They have a feeling, a premonition, a precognition of what lies ahead. It is growing in their hearts and they will not hesitate to flee at that crucial moment when flight and isolation are still possible.

Q: Precognition?

MA: Yes. We have spent a very long time discussing how in our species there is a range of abilities in the area of perception. Perception will be the only determinant in this bottleneck.

The time is so close that most of the staging for the refuge will have started long ago. They have chosen their spot, they are stocking the larder and they only wait. For they also know.

It is our time and as difficult as it may be, this is what we will do.

Q: Will you go to the lake?

MA: No, I am a doctor and I will serve in that capacity as best I can. This is my home and I am happy with my life's work and I am at peace with my Lord. In this small town we will do what we can against a foe that carries only darkness and finality.

Page #66

Q: But the towns will fail?

MA: All groups, towns, villages and cites will fail. There is no refuge in these places. Only death.

Q: Do you mean that there are other people who believe this is coming and are ready to flee to some place out in the boonies and just wait for it all to pass?

MA: Yes, exactly that.

Q: We just looked at each other for a bit. I saw in her both relief and contentment. She seemed very much at peace on the cold November night.

You are glad to have told me, aren't you?

MA: Very glad. It has come full circle now and what you write will give comfort and hope to so many folks who often wonder if their thoughts are dark because of an emptiness in their heart or because the future is dark.

To them your words will be a soothing balm.

Q: Well MA that is a lot to ask from a guy like me, I will certainly do my best to represent your thoughts accurately, but I just don't know about all that other stuff.

MA: I am certain that you will do your best. This is your calling. You have come a long way from my garden at the lake and I am very proud of you. Do not worry, just write it as you remember.

Q: I have one last question before I go, how will these folks know. Are you going to write, or will it be on the news or what?

MA: That is to be easy. All the systems are now in place. The Internet is here, the pandemic blogs are all up and watching and we only wait. It will be out of Egypt, because of the powerful infrastructure watching for H5N1 outbreaks, where most people will hear the first news. When you hear of the sudden outbreak in Egypt, leave immediately. Use only self service gas pumps, do not stop and do not have any human contact from that point on.

If you are alone, or with your family run to a refuge. Wait for it to burn out. Be patient and then patient some more. Let the darkness pass over the earth. It will be quicker than any Hollywood disaster movie could ever portray. But it will pass.

Q: Well that is pretty clear. Egypt huh?

MA: That is where you will first know.

Q: I looked at my drink and the ice had all melted. I was not sure what time it was or how long we had been talking, but I was mentally and physically exhausted. I let out a big sigh.

MA: Would you like a drink?

Q: No thank you. I am about done. It has been such a long day and there is so much to consider that I best get back to the hotel and rest. I leave for the coast tomorrow and right now the bed sounds very appealing.

MA: Are you satisfied that we have covered your questions?

Q: Absolutely, it was important to have this day. All the hard things needed to be said and understood. You have laid it out for me in the most basic way possible. Now I can write the ending knowing I am being true to what you believe. I think that is what I really wanted.

MA: I do as well.

Q: I can never thank you enough for spending all the time with me and giving my readers an opportunity to share in your vision and thoughts. You have been very kind to me.

MA: It was my great pleasure.

Q: I rose and gathered my coat walking to the door. As we stood at that door, I felt I might never see her again and it pained me in a very deep place. She took my hand in her badly shaped right hand and held it for a moment smiling. We only said good night, and I was gone.

Out on the street I walked. without thoughts, to my car in the dark. It was bitterly cold.

Euro crisis: Why Greece is the sick man of Europe
19 December 11 20:00 ET

By Anthee Carassava
BBC News, Greece

......

Most worryingly, HIV infections are soaring with experts anticipating a 52% rise for this year alone.

Most of the increases have so far been attributed to intravenous drug users. By some accounts, the Lancet reported, users “deliberately self-infect” to gain access to benefits of 700 euros a month and faster admission onto drug substitute programmes.

Other HIV carriers have been infected because of unsafe sexual practices.

“It’s crazy what’s happening out there on the streets,” says Elizabeth Kanellopoulou, president of the union of Greek prostitutes. “Prices have dropped, more boys and girls have taken to the trade, the type of customers have changed and the conditions of employment have all drastically altered.

“What was a must until recently - the use of a condom - is now almost nowhere.”

http://www.bbc.co.uk/news/mobile/world-europe-16256235

Arab world faces hidden AIDS epidemic

BEIRUT — In an Arab world rife with social stigma, government inaction and often limited access to education and medical care, experts warn that an HIV epidemic is on the rise.

“In the Middle East and North Africa, the HIV epidemic has been on the rise for the past decade,” said Aleksandar Sasha Bodiroza, HIV/AIDS adviser at the United Nations Population Fund (UNFPA).

“The number of people needing treatment in the region has spiked from approximately 45,000 in 2001 to nearly 160,000 in 2010,” Bodiroza told AFP.

“This has put the Middle East and North Africa among the top two regions globally with the fastest growing HIV epidemic.”

A United Nations report released this month said the number of people becoming infected with HIV has slowed worldwide, with AIDS-related deaths also on the decline as access to treatment becomes more widespread.

But the Arab world has been slow to catch up. Here, HIV contraction rates and AIDS-related deaths are increasing as public awareness, government response and access to adequate medical services have been slow to progress.

While there is little reliable data on the Middle East and North Africa, the United Nations estimates between 350,000 and 570,000 people live with the HIV virus in the region, home to a population estimated at more the 367 million.

One study, published recently on the open-access Public Library of Science, put infection rates among men who have sex with men at 5.7 percent in Egypt’s capital Cairo — and at 9.3 percent in the Sudanese capital Khartoum.

And while some countries have begun to take small steps towards fighting a growing but hushed problem, shame and stigma show very little sign of waning in a region where same-sex relationships and premarital sex are often a crime.

That stigma has become a fact of life for one young man in Beirut, reached through a group that provides free support for people who are HIV-positive or suffer from AIDS.

“If I were to sum it up in one word, I would say my life is one big secret,” said the 29-year-old, who has known he is HIV-positive for three years.

“While I came out to my family a long time ago, this is something I have not shared with them. I could never burden them with that.”

Infection is typically concentrated among high-risk groups, including injecting drug users, men who have sex with men and sex workers and their clients.

“Life for someone carrying the HIV virus is very difficult... they suffer an inability to talk about the disease freely with people who are close to them, and we have cases where individuals were kicked out of the family,” said Brigitte Khoury, clinical psychologist at the American University of Beirut Medical Centre.

“So while some families do offer support, it’s mainly a life of secrecy, deception and living in fear of the worst.”

That fear, experts say, is often what keeps HIV-positive individuals from seeking treatment.

“Stigma and discrimination are among the primary reasons that people living with HIV or key populations at higher risk of HIV infection do not have access to essential HIV services,” Bodiroza said.

“These two factors also limit the ability of governments and civil society to provide services.”

Many states in the Arab world require that foreigners take an AIDS test before issuing visas or residency permits.

Making headlines this month was the case of a South African journalist who was deported from Qatar after being diagnosed with HIV and sacked by the satellite network Al-Jazeera.

Section27, a public interest legal group based in South Africa, has asked the country’s delegation to the International Labour Organisation to file a complaint against Qatar.

But some more liberal countries in the region have begun to publicise the problem, with a media campaign in Egypt and Lebanon hitting the airwaves and billboards last month.

The “Let’s Talk” campaign, which runs until the end of December, is organised by UNFPA in partnership with the two countries’ health ministries, and encourages people to be tested.

The campaign, which in Lebanon stars a former beauty queen and wildly popular band Mashrou3 Leila, also supplies a list of free and anonymous testing centres for both countries.

But despite the tentative progress, experts say governments are less likely than ever to turn their attention to the rising epidemic in a region gripped by political upheaval.

“The common thread that links all countries in the region is the impact of stigma and discrimination, which are (among) the primary reasons that people living with HIV or at-risk populations do not have access to essential services,” said Bodiroza.

“Without strong leadership, it is unlikely that these issues will be fully or properly addressed.”

http://news.nationalpost.com/2011/12/07/arab-world-faces-hidden-aids-epidemic/

Is the virulence of HIV changing? A meta-analysis of trends in prognostic markers of HIV disease progression and transmission

Herbeck, Joshua T.a; Müller, Viktorc; Maust, Brandon S.a; Ledergerber, Brunod; Torti, Carloe; Di Giambenedetto, Simonaf; Gras, Luukg; Günthard, Huldrych F.d; Jacobson, Lisa P.h; Mullins, James I.a,b; Gottlieb, Geoffrey S.b

Abstract

Objective: The potential for changing HIV-1 virulence has significant implications for the AIDS epidemic, including changing HIV transmission rates, rapidity of disease progression, and timing of ART. Published data to date have provided conflicting results.

Design: We conducted a meta-analysis of changes in baseline CD4+ T-cell counts and set point plasma viral RNA load over time in order to establish whether summary trends are consistent with changing HIV-1 virulence.

Methods: We searched PubMed for studies of trends in HIV-1 prognostic markers of disease progression and supplemented findings with publications referenced in epidemiological or virulence studies. We identified 12 studies of trends in baseline CD4+ T-cell counts (21 052 total individuals), and eight studies of trends in set point viral loads (10 785 total individuals), spanning the years 1984–2010. Using random-effects meta-analysis, we estimated summary effect sizes for trends in HIV-1 plasma viral loads and CD4+ T-cell counts.

Results: Baseline CD4+ T-cell counts showed a summary trend of decreasing cell counts [effect = −4.93 cells/μl per year, 95% confidence interval (CI) −6.53 to −3.3]. Set point viral loads showed a summary trend of increasing plasma viral RNA loads (effect = 0.013 log10 copies/ml per year, 95% CI −0.001 to 0.03). The trend rates decelerated in recent years for both prognostic markers.

Conclusion: Our results are consistent with increased virulence of HIV-1 over the course of the epidemic. Extrapolating over the 30 years since the first description of AIDS, this represents a CD4+ T cells loss of approximately 148 cells/μl and a gain of 0.39 log10 copies/ml of viral RNA measured during early infection. These effect sizes would predict increasing rates of disease progression, and need for ART as well as increasing transmission risk.

http://journals.lww.com/aidsonline/Abstract/2012/01140/Is_the_virulence_of_HIV_changing__A_meta_analysis.9.aspx

14 January 2012 - Volume 26 - Issue 2 - p 193–205

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