Date: Tue, 13 Dec 1994 15:09:55 GMT From: awilson@smtpinet.aspensys.com (Wilson, Anne) AIDS Daily Summary December 9, 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 ************************************************************ "The Reliable Source" "She's Young, Beautiful, Educated--and She Has AIDS" "Distorted AIDS Policy Abetting Scourge?" "Court Upholds Rights of Hospital on HIV-Doctor" "Genzyme Begins Phase II/III Study of Argus Pharmaceuticals' TretinoinLF for Kaposi's Sarcoma Patients" "Researchers Doubt Maverick AIDS Theory" "'Power of the Penny' Campaign Benefits Emergency Needs of People with AIDS" "Immune Reconstitution for AIDS" "Postnatal Transmission of HIV-1 through Pooled Breast Milk" "Red Cross Had No Duty to Question Blood Donors" ************************************************************ "The Reliable Source" Washington Post (12/09/94) P. D3; Romano, Lois The Pediatric AIDS Foundation is creating the Elizabeth Glaser Scientists Program in memory of the AIDS activist who died last weekend. Glaser founded the Pediatric AIDS Foundation. Her family has requested that donations in her memory be made to the organization, which is based in Santa Monica, Calif. "She's Young, Beautiful, Educated--and She Has AIDS" USA Today (12/09/94) P. 11A; Reynolds, Barbara The cover model of December's "Essence" magazine is religious, has never used drugs, is educated, is not promiscuous-- and has AIDS. Rae Lewis-Thornton cannot get health insurance and says she will probably not live long enough to finish graduate school or have children. AIDS has become one of the media's most underreported stories, writes Barbara Reynolds, because too many decision-makers feel it's not their issue as AIDS is spreading among populations that society cares the least about--such as gays, drug users, Hispanics, and women. Reynolds questions how long we can be complacent when 200 people die from AIDS each day. "Women are more than twice as likely as men to become infected with the AIDS virus during heterosexual sex," says AIDS czar Patsy Fleming. Her office is pushing development of a vaginal microbicide to kill HIV and attack other sexually transmitted diseases. It is important for women to have a way to protect themselves without the male's knowledge, says Reynolds. Although Fleming says she does not expect the GOP takeover to significantly reduce AIDS funding, AIDS workers worry that fewer funds will reach frontline groups that work with people of color and women. "Distorted AIDS Policy Abetting Scourge?" Washington Times (12/09/94) P. A25; Fumento, Michael While the Centers for Disease Control and Prevention (CDC) predicted a 75-percent increase in new AIDS cases, reporting of new cases actually jumped 111 percent last year, writes Michael Fumento in a Washington Times commentary. The increase is attributable to a new expanded definition of the disease which the CDC implemented in response to pressure from activists. The media, however, did not report the 2-percent drop using the pre-1993 definition, or that the total of 361,000 cases under the new definition fell far below the original CDC prediction of 450,000 cases by 1993. The public was also not informed that the CDC was considering lowering the estimate of current infections from 1 million to 800,000. It is a shame that the public was not made aware how government policies may have led to an increase in AIDS cases and AIDS deaths, concludes Fumento. "Court Upholds Rights of Hospital on HIV-Doctor" Reuters (12/08/94); Mikkelsen, Randall The right of a Philadelphia-area hospital company to require an HIV-positive surgeon to inform potential patients of his infection was upheld by a federal judge on Thursday. In the first discrimination suit filed under the Americans With Disabilities Act by an HIV-infected health-care worker, Dr. Paul Scoles had sued Mercy Hospital of Bala Cynwyd, Pa., for imposing the patient-notification requirement on him as a condition for operating at the company's medical facilities. In 1991, hospital executives informed 1,050 patients that they had been operated on by an HIV-positive doctor, suspended Scoles' clinical privileges, and took his name off referral lists. One year later, Mercy agreed to restore Scoles' privileges on the condition that he tell his patients of his infection prior to operating on them. Claiming the requirement and surrounding publicity destroyed his career, Scoles sued for discrimination based on a handicap. The court, however, ruled that the consequences of Scoles infecting a patient with HIV were severe enough to justify Mercy's restrictions. "Genzyme Begins Phase II/III Study of Argus Pharmaceuticals' TretinoinLF for Kaposi's Sarcoma Patients" Business Wire (12/08/94) Genzyme Corp. and Argus Pharmaceuticals Inc. on Thursday announced the commencement of a Phase II/III clinical trial of TretinoinLF in patients with Kaposi's sarcoma--the most common malignancy seen in AIDS patients. TretinoinLF is Argus' intravenous liposomal formulation of a retinoid compound called all-trans-retinoic acid (ATRA). "The potential of the liposomal formulation is based both on its ability to improve delivery to relevant tissues and to produce sustained therapeutic levels in the blood by bypassing the most common clearance mechanism," said Genzyme's Richard Moscicki. Data recently presented at the American Society of Hematology annual meeting showed that administration of the liposomal formulation produced sustained high blood levels of the drug and that TretinoinLF was well tolerated. The Kaposi's sarcoma trial is designed to evaluate the safety and clinical activity of TretinoinLF at varying doses with two dosing schedules. Genzyme, in collaboration with Argus, is sponsoring the trial. "Researchers Doubt Maverick AIDS Theory" Reuters (12/08/94) In a series of articles released on Thursday, the respected journal Science described its three-month investigation into the status of claims made by University of California virologist Peter Duesberg that drug abuse, not HIV, is responsible for AIDS. Science found that while Duesberg has been promoting his theory for several years and has some followers, his theories are not generally accepted by fellow scientists. There is increasing evidence that reinforces the widely-accepted theory that HIV causes AIDS. The journal reviewed recent research on hemophiliacs, on the spread on AIDS in Thailand, and on the side effects of illegal drug use. The editors concluded that the studies do not support Duesberg's ideas. Some researchers, said Science, believe that enough is known about AIDS and HIV for the disease to pass "Koch's postulates"-- the standard in medicine for providing that a specific microbe causes a disease. "'Power of the Penny' Campaign Benefits Emergency Needs of People with AIDS" PR Newswire (12/08/94) We the People Living with AIDS/HIV, a self-help group of low-income people with HIV/AIDS in south central Philadelphia, is raising money through a coin collection campaign called "The Power of the Penny." "We'll take your pennies to the bank and convert them, not into dollar bills, but into more meals, more clothing, more housing, more support for low-income people with HIV/AIDS who won't make it through the holidays without a little help from their friends," said David Fair, the group's executive director. We the People operates a community center for people with HIV/AIDS that attracts an average of 3,000 visitors every month. Most of its support comes from public funding. The penny campaign is being supported by many center city businesses, which will receive penny donations--as well as other amounts--at their locations "Immune Reconstitution for AIDS" Science (11/18/94) Vol. 266, No. 5188, P. 1150; Rachel Nowak The theory that it is possible to cure late-stage AIDS by reconstructing the patient's immune system with a that of a baboon may soon be tested, if the proposal is approved by the ethics review board at the University of California, San Francisco (UCSF). Transplant surgeon and immunologist Suzanne Ildstad conceived the plan to transplant baboon bone marrow into four late-stage AIDS patients. Ildstad, UCSF AIDS researcher Paul Volberding, and others have created a baboon whose immune cells are 15 percent human, although it is not yet clear whether the cells are functional. The clinical trial plans a cautious approach designed to minimize the risk to patients. The first patient will receive very low doses of irradiation and immunosuppressive drugs--both of which can be toxic to HIV-infected patients--and only if the levels are tolerated will the second patient undergo the procedure. Some AIDS researchers, however, claim that human trial are premature. Two of the many questions they would like answered before trials begin are will the baboon immune cells be able to effectively attack agents that infect AIDS patients, and is the damaged human immune system capable of "educating" the baboon stem cells to tolerate human tissue. "Postnatal Transmission of HIV-1 through Pooled Breast Milk" Lancet (11/19/94) Vol. 344, No. 8934, P. 1432; Nduati, R. W.; John, G. C.; Kreiss, J. In a letter to the editor appearing in the Lancet medical journal, Nduati et al report a case of HIV-1 infection in Kenya that is likely due to pooled breast milk. Because of a decrease in his mother's milk production, a male infant's milk intake was supplemented for four weeks with freshly unpasteurized pooled milk from the mothers of other infants admitted to the same unit. During an evaluation for failure to thrive, he was noted to have generalized lymphadenopathy. HIV-1 infection was confirmed when an HIV ELISA test came back positive, as did repeat ELISA and western blot tests. The boy received all his primary immunizations at the mission hospital in which he was born and his mother was assured that both the needles and syringes were sterile. It is probable that the boy became infected from pooled breast milk, although his prematurity and oral thrush might have made him more susceptible to acquisition of infection. While recommendations to pasteurize donor breast milk and screen donors for HIV-1 antibodies have been made, it is not likely that the recommendations have been widely accepted in developing countries. This case highlights the need for attention to the potential of HIV transmission through breast milk--especially in areas of high seroprevalence, conclude Nduati et al. "Red Cross Had No Duty to Question Blood Donors" National Law Journal (11/28/94) Vol. 17, No. 13, P. B14 In the case of Doe v. American National Red Cross, the U.S. District Court for the District of Maryland has held that the Red Cross had no duty in 1984 to question blood donors regarding their sexual history or orientation. The brother and daughter of Ms. Doe, who tested HIV-positive in 1990 and died in 1992 after receiving contaminated blood in 1984, sued the Red Cross, claiming it was negligent for not screening donors by asking direct questions about their sexual history. In making its decision, the court noted that at meetings conducted by the Red Cross, leaders of the Washington, D.C., area homosexual community expressed unanimous opposition to donor questioning. They said that it would be unlikely for gay men to tell the truth about their sexual history on a questionnaire for fear of stigmatization. The court said it would be unreasonable to find the Red Cross was required to engage in direct donor questioning when faced with widespread hostility from the gay community. If the questioning occurred, the Red Cross might have subjected itself to liability from AIDS-infected donees because it ignored the active resistance of the gay community to direct questioning.