From CLEARINGHOUS@delphi.com Thu Apr 14 09:28:22 1994 AIDS Daily Summary April 14, 1994 The Centers for Disease Control and Prevention (CDC) National AIDS Clearinghouse makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC, the CDC Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1994, Information, Inc., Bethesda, MD "Use of Heat OK'd in Bid to Kill HIV in 6 Patients" Baltimore Sun (04/14/94) P. 10A The Food and Drug Administration has granted a physician permission to heat the blood of six AIDS patients to see if this will cure them, despite scathing condemnation of the method. The agency notified Dr. Kenneth Alonso that he could proceed with a small, closely-monitored study to determine whether hyperthermia kills HIV in patients' blood. Alonso and a colleague developed the method in 1990, but the National Institutes of Health dismissed the research by reporting that a patient didn't even have AIDS, but cat scratch fever. Challenged by skeptics, Alonso moved the experiment to Mexico, where the third patient undergoing the therapy died. Nonetheless, some of Alonso's patients insist that the method is effective, and some AIDS advocates continue to discuss it. "Hauser Isolates Drug That May Fight HIV" Journal of Commerce (04/14/94) P. 6B Hauser Chemical Research Inc. has completed a National Cancer Institute project to isolate a substance, extracted from a Cameroon plant, that may combat HIV. The federally sponsored agency intends to examine possible use of the substance, known as Michellamine B, to fight the virus that causes AIDS. The compound was first identified in 1991 by NCI. With the help of scientists at the University of Yaounde in Cameroon, the agency is now exploring cultivation of the African plant to generate future supply. "Drug Firms Announce Combination AIDS Strategy" Reuters (04/13/94); Fitzer-Schiller, Gail The Inter-Company Collaboration on AIDS Drug Development (ICC), a coalition of 16 pharmaceutical firms, has agreed on a new clinical plan to rapidly test triple-drug combinations to combat AIDS. ICC officials say the new protocol is identical to the same clinical model that yielded treatments for leprosy, tuberculosis, and various cancers. Each trial, they explain, will enroll 100 relatively healthy patients who have some manifestations of AIDS, but have not been treated with other drugs. Combinations showing promise will advance to larger, more tightly controlled studies to determine long-term safety and efficacy. Under this protocol, triple drug combinations can be tested more quickly than in double-blinded, placebo-controlled studies. "It's really an attempt with a relatively rough and quick method to identify those combinations out of a great number of combinations that may have special merit in treating AIDS and therefore deserve further and more formal study," says Dr. Juergen Drews, chairman of the ICC scientific panel. The first four trials are scheduled to begin this fall and, according to Drews, will involve Wellcome PLC's AZT in combination with Hoffman-LaRoche's ddC and proteinase inhibitor R031-8959; AZT in combination with Bristol-Myers Squibb's ddI and Boehringer Ingelheim's Nevirapine; AZT in combination with ddI and Glaxo Holdings PLC's 3TC; and AZT in combination with ddC and Nevirapine. Each of the trials will be funded by the companies whose drugs are being tested. "Australian With HIV Sent to Trial for Unsafe Sex" Reuters (04/14/94) An HIV-positive Australian man has been ordered to stand trial on charges of reckless endangerment that stem from his alleged unsafe sexual activity with two women. Identified only as Miss X and Miss Y, the two women testified in the Geelong Magistrate's Court that they had unprotected sex with the 28-year-old man. The charges were filed when a former workmate of the defendant notified an AIDS counselor and police that the man had been diagnosed with HIV, but was still having sex with women. "White House 'Action Agenda' on AIDS Is Lacking Specifics, Critics Complain" Houston Chronicle (04/13/94) P. 7A; Cimons, Marlene The Clinton administration on Tuesday unveiled what it called "an action agenda" against the AIDS epidemic, but AIDS organizations found the plan to be lacking in both action and specific details. The paper cites many objectives, among them strengthening research efforts, eliminating obstacles to the development of an effective AIDS vaccine, increasing health services to HIV patients, and developing education programs to prevent transmission of the virus. But critics complain that the plan does not call for specific ways to achieve these goals. "These [goals] are important--but they are goals, and not actions," says Dr. Mervyn F. Silverman, president of the American Foundation for AIDS Research. "Now is the time to prioritize the major steps that need to be taken. We need to know who's going to do what, and how much money is it going to cost? This doesn't do that." Dan Bross, executive director of the AIDS Action Council, agrees. "A real plan looks at existing programs, and reflects existing and future budget considerations," he says. "This is too broad. It's too general. We need timelines attached to it. We need dollars attached to it. We could have said all this two years into the epidemic--not 13 years into the epidemic." His comments reflect growing sentiment among AIDS organizations that it is time for the Clinton administration to move beyond rhetoric. White House AIDS Policy Coordinator Kristine Gebbie responded that the documents released on Tuesday are only the beginning of a process. "Canadian Compassionate Treatment Project of AIDS Patients Extended Three Months" Business Wire (04/13/94) Dr. R. Morisset, the physician conducting the Canadian Compassionate Treatment of 10 HIV patients with Advanced Viral Research Corp.'s Reticulose, recommended that the project be extended. "Based upon the review and analysis of the data from the Compassionate Treatment of HIV patients with Reticulose for three months, decision has been made to extend the Compassionate Treatment for an additional three months to obtain sufficient data to be statistically significant," said Morisset. "Bothell, Wash., Biotech Firm Sticks With Promising Outlook on AIDS Treatment" Knight-Ridder/Tribune Business News (04/13/94); Williams, Scott A few weeks ago, the small Bothell, Wash.-based biotechnology company MicroProbe announced a new class of antiviral drugs found effective against HIV in laboratory tests. The company's research, which involves the manipulation of small pieces of DNA, separates it from other biotech companies that are searching for an AIDS cure, says Chief Executive Harvey Hoyt. Rather than trying to treat the body's reaction to viruses, MicroProbe's drugs work inside human genes, where they would effectively inhibit HIV replication, explains Rick Meyer, the company's chief scientific officer. The drugs may also be effective against Epstein-Barr virus and cytomegalovirus, two infections often linked to AIDS. The company believes its new drug, which will be tested on humans no earlier than 1995, doesn't have the toxic side effects associated with AZT, one of the most commonly used anti-AIDS treatments. Other, less understood drugs could inactivate an infected gene, thus killing a virus, speculates Meyer. The ability to eliminate an entire gene has implications for treatment of AIDS, cancer, and alcoholism--which some research has tied to specific types of genes. "We will be the first company to permanently inactivate a gene," predicts Hoyt, although no timetable has been set for development of these drugs. "New Nation-Wide Trial Tests Timing of Switch From AZT" AIDS Treatment News (04/02/94) No. 196, P. 4; James, John S. The first clinical AIDS trial to be conducted jointly by the federally sponsored AIDS Clinical Trials Group and military institutions will examine whether an advanced blood test can indicate the most appropriate time to switch from AZT treatment alone to other therapies. All volunteers will begin the study by taking AZT alone as the active drug. As the trial progresses, their blood will be tested for the presence of a particular mutation of HIV known as codon 215--the most serious mutation known to cause resistance to AZT. When, if at all, mutation is detected, the patients will be secretly assigned to either continue AZT therapy, switch to AZT plus ddI, or switch to the triple combination of AZT plus ddI and nevirapine. The objective of the trials is "to validate that [the '215 mutation'] precedes the increase in viral burden...and decline in CD4 count which had been observed in association with clinical failure" of AZT, and to determine if adding other drugs will prevent the increase in viral burden and drop in T-helper count. "CDC Spotlights Numbers of Minorities With AIDS" American Medical News (04/04/94) Vol. 37, No. 13, P. 26 One in every five American AIDS patients is a gay or bisexual male who is an ethnic minority, according to a report released last month. Gay and bisexual men who are black, Hispanic, Asian/Pacific Islander, or Native American account for about 20 percent of the more than 61,700 AIDS cases in the United States as of June 30, 1993, the yearlong study calculated. Despite the high prevalence of AIDS among these communities, they receive only 1 to 13 percent of available city or county funds for prevention programs, reported the study. The survey of agencies, community workers, individuals, and health departments also concluded that the most effective programs for ethnic minority gay and bisexual men were those designed and operated by their peers, said Gilberto Gerald, whose consulting firm conducted the survey. "For far too long gay men of color have been rendered invisible in this epidemic," said Mario Solis-Marich of the National LLEGO, an organization for Hispanic homosexuals. AIDS activists will use the findings to lobby President Clinton for increased funding for prevention programs targeted at these groups. "Homophobia: A Cofactor of HIV Disease in Gay and Lesbian Youth" Journal of the Association of Nurses in AIDS Care (01/94-02/94) Vol. 5, No. 1, P. 39; Grossman, Arnold H. Whether they "come out," or whether they remain "closet" homosexuals, most gay and lesbian youth are affected by the prejudice and stigmatization forced on them by a homophobic society. Coping with an oppressive society creates unique stress and developmental variations in the sculpting of a homosexual youth's identity. These stresses are cofactors for HIV disease. They include cognitive, emotional, and social isolation; feelings of alienation and despair; suicidal thoughts; alcohol and drug abuse; and furtive sexual activity. Nurses and other health care providers need to be aware of these cofactors so that they may offer meaningful HIV/AIDS prevention programs targeting gay and lesbian young people.