Saturday, March 20, 2010

You can't always get what you want (Musings on HIV's discovery & how ads become news)

This blog is about what we think we're getting compared to what we're actually getting, hence the blog's title, taken from an old Rolling Stones classic:
The blog
  1. Briefly reviews HIV's discovery and how the initial HIV screening test was developed and by who - a intriguing tale if there ever was one
  2. Discusses how development of the anti-HIV test may have become the top story in AABB Smartbrief, Mar. 3, 2010
As background, I subscribe to several e-newsletters, including AABB Smartbrief. The top story from March 3, 2010 was "HIV blood testing revamped global health crisis for 25 years." The issue's subject line was, "March 3, 2010 - HIV blood test helped address health crisis."
Note that the AABB Smartbrief item focuses on Abbott's test and reads almost as though Abbott played a heroic role:
  • Before Abbott, a global, broad-based health care company, developed a blood test that could be used to screen blood donors for antibodies to HIV, one in every 100 blood transfusions were infected with HIV in some U.S. cities. That first test took Abbott scientists nine months working around the clock to develop....
Part 1: Trip down memory lane - DISCOVERY OF HIV AND ANTI-HIV TEST
The discovery of what we now call HIV and development of the initial HIV screening test is fascinating - a saga that I once used to increase student interest in transfusion medicine and the related topics of
  • How research has transmogrified from a world of colleagues sharing knowledge for the benefit of all to one where secrecy and cutthroat intrigues reign, largely due to the commercialization of research and the potential for immense wealth;
  • How money can influence the ethics of those involved in research and providing health care
The HIV saga centres on two researchers, Robert Gallo and Luc Montagnier, and the patenting of the HIV screening test by the Americans. I'll review the key elements and leave it to readers to flesh out the story by reading the linked resources.

A biography of Robert Gallo and the controversy over who discovered the AIDS virus and its initial screening test is reported in brief here (American perspective):
The complete saga of the HIV test and its associated patent dispute is documented in

Institutional response to the HIV blood test patent dispute and related matters.Staff Report of the Subcommittee on Oversight and Investigations Committee on Energy and Commerce, United States House of Representatives
The HIV test controversy is complex and messy, but the main elements (simplified) include:

1. Gallo's lab (Laboratory for Tumor Cell Biology or LTCB), which was working on isolating what it called HTLV III, received a LAV sample (lymphadenopathy associated virus) from Luc Montagnier's lab at the Institut Pasteur (IP) in Paris in Sept. 1983.
2. The following April, Gallo claimed to have discovered the AIDS virus, HTLV-III.

It turned out that Gallo's AIDS virus was Montagnier's LAV. The French had discovered the virus first, shared it with the Americans for research purposes, and the Americans claimed the discovery. We do not know how this happened (Gallo' lab had several possible explanations), just that it did.

3. In April 1984 the U.S. Department of Health and Human Services (HHS) filed a patent for the Gallo lab's anti-HTLV III antibody test. The French had developed a similar test (anti-LAV) and had filed for a patent in Sept. 1983.

On April 23, 1984, HHS Secretary Margaret Heckler announced:
  • "... the probable cause of AIDS has been found -- a variant of a known human cancer virus [this turned out to be false, but Gallo had discovered leukemia-related HTLV-I and also HTLV-II], called HTLV-III ... a new process has been developed to mass produce this virus ... we now have a blood test for AIDS which we hope can be widely available within about six months. We have applied for the patent on this process today."
4. Subsequently, Gallo's lab sold the HIV cell line to Abbott, which developed the American test.

5. The Institut Pasteur eventually initiated legal action, arguing that Gallo's blood test was based upon a virus substantially identical to the LAV strain first isolated by Montagnier. After much obfuscation (particularly by American researchers about how HTLV-III and LAV came to be the same virus), the lawsuits were ultimately settled, as documented in
When it was finalized in March 1987, the settlement included agreements for blood test patents, patent royalties, and scientific events. Montagnier and Gallo agreed to call themselves co-discoverers of the AIDS virus and co-authored "Chronology of AIDS Research" that supposedly reflected the most significant contributions of IP and LTCB scientists.
HIV Blood Screening Tests
The two sides agreed that both group's patents would remain in place with the names of each side's scientists added to the other side's patent, supposedly because an inadvertent error was made in listing the inventors when patent applications were filed.

Both sides also agreed to donate most of the blood test royalties to a foundation established as part of the agreement. 25% of the combined donated royalties were committed for AIDS research; HHS and IP received the remaining 75% in equal shares.

This arrangement was changed in 1994 to provide a larger royalties share to the Institut Pasteur, presumably because HHS belatedly realized that the IP had not received a fair share. Gallo's use of the IP virus for the LTCB blood test was barely mention by HHS.

6. It's worth noting that in 1985 France delayed introduction of the American HIV screening test. According to critics, the delay was to buy time to commercialize the French test, as reported in Blood Money (one reporter's overview of the French 'tainted blood' scandal from Discover Magazine).
Regardless, as could be anticipated with any new diagnostic test, Abbott's anti-HIV test initially had considerable problems with false positives and negatives. Tidbit - The American Red Cross task force initially chose the French test over the American, not politically correct for the times or later.

The HIV discovery controversy and Abbott's anti-HIV test difficulties are documented in
7. Naturally, following the lawsuit resolution, everyone played nicey-nice and developed a suitable cover story:
8. In 2008, the awarding of the Nobel Prize in Medicine & Physiology to Montagnier and his colleague Barre-Sinoussi (omitting Gallo) re-opened the controversy.
Predictably, many U.S. commentators cried foul, as exemplified in this commentary: A prize tarnished. Euro-bias robs Gallo of a Nobel Prize

The author essentially concludes that if unfair Europeans won't give Americans like Gallo the Nobel Prize, the USA should set up its own prize, one to eclipse the Nobel.

Tidbit: Americans have won many more Nobel Prizes than citizens of any other country.

As mentioned, the AABB Smartbrief March 3 issue focuses on Abbott's role in developing the HIV blood test 25 years earlier. The AABB Smartbrief item points to this article:
Nowhere does this news item indicate that it is a re-write of this Abbott's press release:
Of course, it's standard practice for news media to use press releases almost verbatim as an easy way to get stories. Indeed this practice is one of the benefits of press releases. LIke many press releases, this one was picked up by numerous news organizations, most of which indicated the source.

The Smartbrief linked news item, focusing on Abbott as it did, made me look further into AABB Smartbrief. Here's what I found. Did you know that companies can sponsor these news section items?
  • Top Story
  • Science & Health
  • Hot Topics
  • Emerging Trends
  • Industry News & Practice
According to the AABB Smartbrief advertising media kit, for a fee, sponsors can
  • Integrate their message and brand into the day’s top news
  • Include their logo at the top of the news section and messaging below the stories
As the brochure claims,

AABB SmartBrief has quickly grown to become the most frequently read AABB news vehicle. Surpassing 17,000 subscribers in May 2009, the daily e-newsletter has more than 260,000 impressions during an average month. Of those readers, approximately 30 percent open AABB SmartBrief every day, and 8.5 percent click through on a story.

Side bar on privacy
For interest, the display of one ad to one viewer on one web page is called an impression (a unit of advertising on the Web). Each time an ad loads onto a user's screen, it can count as one impression.

I was not surprised that AABB Smartbrief knows how many readers open the newsletter daily since I have occasionally been frustrated to notice an automatic reply sent from my computer without my permission to, e.g.,
  • Here's your auto (was Re: July 16, 2007 - VA facilities to use automated disease surveillance system) I was so annoyed that I saved this one
Also, opening e-mail messages can be tracked via graphics in formatted e-mail messages so that a record can be kept of which IP addresses have received and opened specific e-mails (a troubling invasion of privacy). Graphics used for tracking are sometimes called "Web bugs," especially if the tracker is not the same company as the message sender.

I'm unaware whether AABB Smartbrief uses embedded graphics to obtain viewer statistics, but it does use autoresponders, and it does track the open-rates of e-mails and click behaviors from e-mails to help identify which newsletter parts are most popular with readers, as noted in its privacy policy.

About information sharing, the Smartbrief policy states:
  • No personal information is ever shared with any other partner organizations, advertisers or other third parties without first obtaining the explicit consent of the subscriber.....
  • We also may collect or have a third-party collect on our behalf aggregated statistical information about our subscribers and the ways in which they use our products and services. This information does not identify you personally. We use this information for market research purposes and to improve the quality of the products and services we offer. We reserve the right to disclose aggregated, non-personally identifiable information collected from our users to third parties for any purpose.
Every AABB Smartbrief contains advertisements that are designated as such. But it turns out that top news stories and other apparent news items can be advertisements paid for by sponsors.

AABB Smartbrief does not hide this policy. The info is there for anyone who scrolls to the bottom of any e-mailed AABB Smartbrief and clicks on "Download Media Kit."

But the advertisement-becomes-news-story policy is not exactly transparent. Without accessing the innocuous advertising media kit, you would never know what you are getting.

Did Abbott pay AABB Smartbrief to get its self-congratulatory press release integrated into the day's top news story via a proxy, Digital Journal, operating as a 'participatory' news outlet since 2006?

We will likely never know. But it's certainly possible. As the song goes, you can't always get what you want, but you can keep on trying.

It's a given that we cannot believe at face value what we see in newspapers, hear on television, and read on Internet blogs like this one. Not surprisingly, the newsletters we subscribe to via our professionals associations also need to be critically analysed, just as research papers do.

I'll conclude by saying that I enjoy AABB Smartbrief immensely and always open it and scan for items of interest, allowing my acess and reading choices to be tracked.
My new pastime is to assess if any given top story, emerging trend, etc., is a legitimate news item or a "integrated" paid advertisement. And isn't the HIV saga still intriguing after all these years?

Comments are most welcome BUT, due to excessive spam,  please e-mail me personally or use the address in the newsletter notice.