Saturday, December 24, 2011

The future of XMRV: A doctor's view

Michael Snyderman MD says:

The retraction of Lombardi et al by Science is not the end of the story. Negative studies looking at only XMRV are not relevant. Because XMRV is gone, Dr. Coffin and other scientists cannot go beyond their data as they have done and say that HGRVs do not cause CFS and by extension other human disorders. I counsel these scientists to not exclude other evidence which I have to believe they are fully aware of and will repeat below.

As a physician I am used to looking for as much evidence, from as many aspects as possible before excluding a diagnosis. This includes clinical evidence; after all we are not just test tubes. For example, the classic laboratory tests for B12 deficiency can be negative and yet the patient can respond to B12 administration. In this latter case the penalty for dismissing the diagnosis prematurely would be brain and spinal cord damage for the patient. As physicians, we know that there are indeed false positive lab findings but also, and just as importantly, false negative results. The textbook picture exists only in the textbook.

The first chapter of our story was written 30 years ago from three independent laboratories, including Robert Gallo's at the NIH. Lest the scientists forget this, the studies proved the association of MLRVs and human disease.

The second chapter is mine. As you know, I tested positive in Dr. Mikovits laboratory for antibodies to MLRVs. As you know, both my leukemia and my CFS have responded to ARVs. If I had listened to Dr. Coffin's advice to not take ARVs, I would have lost at least 18 months of life. Dr. Coffin and Science have seen my results. The only comment Dr. Coffin made was that it had to represent "selective toxicity" which as an Oncologist with 40 years' experience, I can confidently exclude.

Bruce Albert of Science never commented but relies heavily on Dr. Coffin's judgment. I presented my data at a peer-reviewed Hematological Malignancy conference at MD Anderson Cancer Institute in 2010 and it was well received. including by the physician that is considered the premier researcher in my leukemia, Dr. Kanti Rai. I am just one patient, but I am a typical patient and I am told the association of HIV and AIDS was initially made with data from only a few patients.

So where does that leave us? Research will continue. We still have some scientists with enough courage and wisdom not to abandon the quest. There is a virus, or viruses and these will be found. This story will never end, despite Dr. Coffin and Science. The viruses are likely to be involved in many more disease processes and the world will be a better, or at least healthier place, when they are tamed.

Michael Snyderman, MD

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