Date: Wed, 09 Feb 1994 09:12:30 -0500 (EST) From: "ANNE WILSON, CDC NAC" Subject: CDC AIDS DAILY SUMMARY 02/09/94 AIDS Daily Summary February 09, 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 1993, Information, Inc., Bethesda, MD "HIV-Infected Women Awarded Damages" Toronto Globe and Mail (Canada) (02/08/94) P. A3 (Hess, Henry) In what is thought to be the first such case in Canada, three women who were infected with HIV through sexual transmission have been awarded $15,000 each for pain and suffering from Ontario's Criminal Injuries Compensation Board. Charles Ssenyonga, the man who infected them, died before a judge could rule on whether he had committed a crime, but board members announced their assurance that he was criminally negligent. They warned, however, that their decision does not oblige them to honor other similar claims. "It is important to note that what has been found criminal is not the transmission of HIV per se," said the panel, but Ssenyonga's "wanton and reckless disregard" he displayed for the women's lives by lying about his condition and repeatedly participating in unsafe sex while aware of his HIV infection. The panel members also said that the infected women must shoulder some of the blame for not being more vigilant about their own health. "The board does not condone the behavior of the alleged offender, but in the HIV world in which we find ourselves living today, it is the view of the board each person must accept some responsibility for the consequences of unprotected sexual intercourse." All three of the women have tested HIV-positive; two have developed symptoms of AIDS. "HIV-Positive Prison Inmates Seek to Enforce Job Rights" United Press International (02/08/94) San Francisco--Attorneys representing 300 HIV-positive prisoners on Tuesday asked a U.S. appeals court to order state officials to allow the prisoners to work in food service jobs at the California Medical Facility in Vacaville. Prison officials conceded that HIV-infected inmates could work in food service without presenting a risk to others because the virus is not transmitted through casual contact. But attorneys for the Department of Corrections contended that the refusal to let infected inmates prepare and serve food was justified because prison officials feared a violent reaction from uninfected inmates. Matthew Coles, a lawyer with the American Civil Liberties Union, argued that the policy violates the rights of infected inmates. "You can't let threats of violence be a completed defense in a civil rights case," he said. Last year, a federal judge ruled that the policy of banning HIV-infected inmates from working in food service was a violation of a 1990 agreement in which state officials agreed to stop segregating infected prisoners. "Yves St. Laurent to Give Out Condoms" Reuters (02/08/94) Paris--In Paris on St. Valentine's Day, French fashion house Yves Saint Laurent will pass out 200,000 condoms to promote its line of men's clothing and to endorse safe sex. As part of YSL's $335,000 campaign, it will stuff the condoms and an accompanying advertisement saying "Yves Saint Laurent Dresses Men," in mailboxes in neighborhoods and buildings primarily inhabited by young people. The clothier will also distribute condoms and the ad at universities and record stores throughout the city on Feb. 14, according to YSL executive Pierre Levy. He said the package will promote sales of a YSL poster, proceeds from which will benefit two anti-AIDS groups, one of which is headed by YSL chairman Pierre Berge. Levy said YSL is committed to raising French awareness of the importance of condom use to help stem the spread of AIDS. "The French have difficulty accepting the condom," Levy admitted. A poll last week indicated that France falls behind its European neighbors in use of condoms, but use is growing rapidly. "$1 Million to Fund Tests for Venereal Diseases" Reuters (02/09/94) London--The Rockefeller Foundation today launched a $1 million prize for the development of cheap, simple tests for chlamydia and gonorrhea, two sexually transmitted diseases prevalent in developing nations. If left untreated, these infections--especially among women--can cause a number of other diseases, as well as an increased risk for transmitting and contracting HIV. The foundation is offering the money as a prize in order to attract commercial as well as public and non-profit sectors. "AIDS, Ignorance and Aldermen" Chicago Tribune (02/08/94) P. 1-12 The spread of HIV and AIDS is a serious threat, agree the editors of the Chicago Tribune, and the epidemic is worsened by the spread of ignorance and misinformation. As an example of the latter, the editors point to a recent proposal by Ald. James Laski, who introduced an ordinance that would mandate HIV testing for thousands of city employees and other workers who have close contact with the public. The requirement would affect city police, fire, and public health workers, as well as private-sector employees at pools, health clubs, and restaurants. Employers would have to notify City Hall that the tests were conducted, although the results would remain confidential. The danger of this proposal, contends the Chicago Tribune, is that it diverts public attention away from how the virus is transmitted and what behaviors actually do present a risk. The editors remind Laski that the virus cannot be spread by coughing, kissing, or contact with doorknobs, telephones, or toilet seats. Instead of scaring constituents into thinking they can get AIDS from a waiter or health club attendant, the Tribune editors suggest that Laski warn them against intravenous drug use and pre- or extra-marital sex. Instead of the mandatory exam, says the Chicago Tribune, perhaps what City Hall really needs is an IQ test for aldermen. "103 AIDS Medicines Now in Development" Wholesale Drugs (01/94) Vol. 46, No. 1, P. 20 A questionnaire by the Pharmaceutical Manufacturers Association has found that for the seventh year in a row, drug firms have boosted the number of new medicines and vaccines in development for AIDS and AIDS-related diseases. According to the report, 74 pharmaceutical manufacturers are researching 103 possible treatments for AIDS and AIDS-related illnesses. Of those 103, 11 are drugs awaiting FDA approval, while 23 have entered the final stage of testing. Currently, only 21 drugs have received approval for treatment of AIDS or AIDS-related disorders. Almost 50 percent of the drugs under development would treat opportunistic infections, which represent 90 percent of AIDS-related fatalities. "CDC Looking at New Model for Enhanced HIV Counseling" AIDS Alert (01/94) Vol. 9, No. 1, P. 4 A study by the Centers for Disease Control and Prevention may determine whether a counseling assessment model designed for smoking cessation can also help people practice consistent condom use. Researchers used the model to evaluate 694 clients with new symptoms visiting five sexually transmitted disease clinics. According to their responses on often they had vaginal and anal sex with primary and other partners, how often they used condoms, and what their short-range and long-term intentions for condom use were, participants were classified into one of five stages of change. Only 21 percent of men and 14 percent of women interviewed said they always used a condom. By contrast, nearly 64 percent of the women and 55 percent of the men said they had not used a condom at all with their primary partner during the past month. "The data show that, at least with respect to their primary partners, there are still an awful lot of people who have not even thought about adopting safe behaviors," says Martin Fishbein, a visiting professor at the CDC. Fishbein says the study confirms that counseling needs to be more "client-centered," with counselors being "more sensitive to the needs of their clients and what stage they are in." During the next year, the study will evaluate the stage-of-change model to see if it can change behavior in clients at high risk for HIV infection. If it proves effective, Fishbein says enhanced counseling may become available for high-risk clients. "Red Ribbon Restaurants Tie Up Tables for AIDS $$" Nation's Restaurant News (01/31/94) Vol. 28, No. 5, P. 7 (Ruggless, Ron) More than 60 Houston restaurants are active in the Red Ribbon Restaurant Project, a fundraising effort to benefit AIDS treatment and research. Operators set aside one table in the establishment--designated by a special red ribbon obelisk--and donate 10 percent of the proceeds from that table to AIDS service organizations. "We want to increase awareness about AIDS and raise money for both outreach programs and research into the disease," says Guy Yount of Key magazine, co-chair of the project. Response has been favorable, according to Yount, who notes that some restaurants report average monthly donations as high as $300. "It's the most popular table in many restaurants," he says. Proceeds benefit four outreach programs, including a residential facility for children with AIDS, an organization that cares for pets belonging to AIDS patients, a fund that pays for insurance premiums and emergency prescriptions, and a treatment center. Also benefiting is the Houston Clinical Research Network at Rice University. "Co-Infection and Synergy of Human Immunodeficiency Virus-1 and Herpes Simplex Virus-1" Lancet (Great Britain) (01/29/94) Vol. 343, No. 8892, P. 255 (Heng, Madalene CY et al.) Using the CD4 molecule as a receptor for entry, HIV can infect and reproduce T helper cells. Because activated macrophages also express the CD4 molecule, they too are vulnerable to infection. Cells that do not express the CD4 molecule, such as keratinocytes, normally cannot be infected by HIV. However, in tissues co-infected with herpes simplex type 1 (HSV-1), HIV virions were found to infect presumably untouchable keratinocytes. This is not unusual in vitro; a number of other viruses have been reported to enhance HIV viral transcription under these circumstances. But Heng et al. report what is thought to be the first in-vivo documentation of reciprocal enhancement of viral replication linked to co-infection of keratinocytes and macrophages by HIV and HSV in patients with AIDS and herpes simplex lesions. The virions in the infected cells--most of which contained the HIV-1 envelope needed for infection to occur--were larger, morphologically atypical, and appeared to be hybrids. The increased viral load as well as the closeness of the virions to the cutaneous surface may result in greater risk for transcutaneous transmission of both viruses. The findings of Heng et al. demonstrate the need for incorporation of suppressive treatment for herpes simplex in AIDS regimes. "Nonpeptide Cyclic Ureas are HIV Protease Inhibitors" Chemical & Engineering News (01/24/94) Vol. 72, No. 4, P. 24 Researchers at DuPont Merck Pharmaceutical Co. have discovered nonpeptide cyclic ureas that inhibit HIV protease. Unlike DuPont's protease inhibitor, others that have been developed generally have been peptide-based compounds with low absorption from the gastrointestinal tract and rapid breakdown in the bloodstream. Published x-ray crystal structures of HIV protease-inhibitor complexes commonly feature a structural water molecule linking bound inhibitor to the enzyme's active site. Through a string of rational design and molecular modeling steps, Patrick Y.S. Lam and his colleagues at DuPont Merck designed a set of nonpeptide cyclic ureas in which the carbonyl oxygen copies the hydrogen-bonding traits of this structural water molecule. One compound underwent initial clinical trials last summer, but was rejected for further development. According to Lam, however, "cyclic urea analogs with greatly improved properties have recently been identified and are under investigation."