Hi Cort, I think by complementary techniques she means the variety of tests they ran in the Science paper, most of which were serology-based (but not antibody detection tests), and one of which was an infectivity experiment. Alter stated that only the WPI paper had been so comprehensive; the point is that this multiple test approach improves one's chance of finding a mysterious virus, whereas PCR only is risky due to genetic variation and unknown subtleties relating to sample collection and processing. I actually wasn't disagreeing with you about the emphasis on getting to the bottom of the PCR discrepancy, as you will note from my last post, but only with your assessment (if I understood you correctly) that Mikovits' comments about doing more than PCR in any study fell on deaf ears... they didn't (Frank Ruscetti made sure of that!). However, I don't personally think they should focus exclusively on PCR, as serology can provide valuable information to further support their efforts in figuring out what is going wrong (for instance, if they can all find antibodies even when PCR is negative for one or more labs). And actually I don't think they are being exclusive; all parties seem to be using or working on different kinds of serological assays at the same time. Hi Kelly, I think people on this thread were arguing for clinical trials (at least I know I was, anyway!), not small, uncontrolled case studies. The difference between Coffin's approach and Mikovits' is the choice of parameter. Coffin wants to wait til we can accurately monitor viral load, while Mikovits wants to monitor other parameters for which there is already evidence of correlations with symptomology in ME/CFS. A great many clinical trials have been done in a great variety of diseases with no known causative agent; the parameters in these cases are usually clinical ones like those Mikovits suggested, and have sometimes been as simple as functional improvement -- usually with some form of objective measure, of course. [Among these are the deplorable clinical trials of antidepressants in CFS and FM patients which have used no 'objective' measures beyond highly questionable psychometric assessments (at most); obviously antiretrovirals have higher potential levels of toxicity, but antidepressants have their own safety issues.] It is worth pointing out, too, that viral load may not correlate with ME/CFS symptoms or observable pathology at all, as Coffin himself noted in another context. All true (for antiretrovirals that is, not for antivirals in general), but irrelevant to the question of holding off on antiretroviral trials until a qPCR assay is developed. Having been both, I am intimately familiar with that difference of perspective! And Dr. Mikovits is a scientist too, and we are discussing her argument, not a patient's. Also, as evidenced by the PNAS commentary, there is not (at this point) a scientific or clinical consensus opposing clinical trials until a viral load assay is developed. I should add that, in my experience, patients who support the idea of clinical trials of antiretrovirals are by no means predominantly ignorant of the scientific perspective or medical concerns. Longtime ME/CFS patients are all too familiar with the spider web metaphor, as we have experienced these effects over and over, through a series of alleged 'magic bullets'. It is wise to be extremely cautious with ARV's, and it looks to me like that caution is common on CFS patient forums.