Date: Thu, 03 Mar 1994 09:21:42 -0500 (EST) From: "ANNE WILSON, CDC NAC" Subject: CDC AIDS DAILY SUMMARY 03/03/94 AIDS Daily Summary March 03, 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 "Japan-U.S. Joint Team on AIDS to Visit Philippines" Reuters (03/03/94) Tokyo--The United States and Japan will soon send a joint team to the Philippines to conduct a study on how to tackle the AIDS epidemic there, announced a Foreign Ministry official. While the official declined to give further details, another ministry official was quoted by the Kyodo news agency as saying the team would visit the Philippines March 16-24. The team will gather data on AIDS, study the country's policy on the disease, visit health facilities, and survey how international organizations cooperate when AIDS is concerned, said the official. The joint team's visit to the Philippines is in accordance with an agreement between President Bill Clinton and Prime Minister Morihiro Hosokawa to cooperate on global problems. Under the pact, the United States will contribute $9 million and Japan will offer $3 million over seven years to deal with AIDS and population issues. The two countries intend to send similar joint missions on AIDS and population growth to about a dozen countries in Southeast Asia and Africa, according to the ministry official. "Complaint Board Disavows Diaz Views on Gay Games" New York Times (03/03/94) P. B3 (Hicks, Jonathan P.) In response to criticism of one of its members, New York's Civilian Complaint Review Board voted to disavow recent comments about AIDS and homosexuals as made by the Rev. Ruben Diaz. The board rebuked Diaz and disclaimed remarks he made in Spanish publications that the Gay Games, scheduled to be held in New York this June, would cause AIDS cases to rise and promote greater acceptability of homosexuality among young people. In the column, Diaz contended that "some of the gay and lesbian athletes are likely to already be infected with AIDS or can return home with the virus." The board's resolution declared that the comments had not been made on behalf of the board, and that "neither Rev. Diaz nor any other member of the Civilian Complaint Review Board may speak on behalf of the board." Although gay groups have criticized him and some council members have called for his resignation, there are no provisions to remove Diaz from the board. Mayor Rudolph W. Giuliani, while stressing his disagreement with Diaz's statements, said the minister had a right to express his "religious and moral views." "AIDS Threat to Hospital Workers--Study" Reuters (03/03/94) London--Doctors screened the blood and urine of 875 people treated in the emergency department of a busy London hospital, and found many more cases of HIV infection than anticipated. According to doctors at St. Mary's Hospital, one in 40 young or middle-aged people treated in the facility's emergency ward was infected with HIV--four times the number presented in a previous London study. The study found that 2.4 percent of St. Mary's emergency ward patients between the ages of 16 and 45 were HIV-positive, and warned of the high risk of exposure to hospital emergency workers. "Our findings should alert authorities in inner cities to the prevalence of HIV infection in patients attending accident and emergency departments, even in a hospital with a large HIV clinic," the study said. "There is a continuing risk of HIV infection to health care workers, particularly inexperienced senior house officers practicing emergency medicine in an environment that is often frenetic." "Blood Package Angers Lawyers" Toronto Globe and Mail (Canada) (03/01/94) P. A3 (Mickleburgh, Rod) Calling it "totally inappropriate" and "offensive," the Law Society of Upper Canada has denounced a key stipulation of the provincial $30,000 annual compensation packages for Canadians who contracted HIV during the country's tainted-blood scandal. The law society is angered by a provision for acceptance that obliges lawyers to sign a certificate testifying that their clients were under no duress or pressure when they agreed to accept the compensation. Society treasurer Paul Lamek said many of the concerned parties are clearly under duress because the provinces have issued a March 15 deadline for acceptance, a decision that means they must waive the right to sue anyone who may have been responsible for their HIV infection through the blood supply. Some have equated the deadline to putting a gun to their heads, especially since the federal inquiry into the scandal has just begun hearings. "They are requiring lawyers to say there's no pressure on their clients. Of course there's pressure," said Lamek. "There's immense pressure." "Wellcome's Patents on AIDS Drug Face Challenge in Europe" Financial Times (Great Britain) (03/02/94) P. 1 (Wise, Peter; Simon, Bernard; Green, Daniel) Wellcome's patents on the AIDS drug AZT may face a direct challenge in Europe next month when a Portuguese company releases a Canadian-made version of the antiretroviral. The Portuguese government has given Farma APS Productos Farmaceuticos permission to market Apo-Zidovudine, which is manufactured by Canada's largest generic drug maker, Apotex. Apo-Zidovudine would cost 15 to 20 percent less than Wellcome's Retrovir, and could be available as early as April, according to Augusto Paiva dos Santos, director-general of Farma APS. The company said it might export the drug to other European Union countries and did not foresee any legal obstacles. Wellcome, however, has been embroiled in a series of patent disputes with other companies, including Apotex, over the right to sell AZT. While Wellcome has thus far been successful, it may be vulnerable in Portugal because of its patent laws. Wellcome has a local patent on the manufacturing process, but not on the material itself. To prove patent infringement, it would have to show that Apotex's product was made through a patented process, which could be much more difficult than merely showing that the end product was chemically identical. "Imreg Files Orphan Drug Applications" Business Wire (03/02/94) New Orleans--Imreg Inc., a New Orleans-based biotechnology firm, has filed Orphan Drug Applications with the Food and Drug Administration for the use of its investigational biopharmaceutical, IMREG-1, and synthetic counterparts. IMREG-1 has been filed for treatment of HIV patients who have weakened immune systems but are not able to tolerate antiretroviral drugs, or for whom antiretrovirals are not recommended. The drug is also being filed for use in treating multiple drug-resistant tuberculosis as an adjunct to conventional treatment of TB, as well as treatment of TB in immunologically compromised patients. Under the Orphan Drug Act, the sponsor of an approved orphan drug enjoys exclusive approval for that drug for the orphan indication for seven years after the drug's approval for marketing by the FDA. "AIDS Activist Is Dead" Houston Chronicle (03/02/94) P. 8A Aldyn McKean, a founding member of the AIDS advocacy group ACT-UP, was recently discovered dead in his apartment. The 45-year-old McKean, a long-term survivor of AIDS, apparently died of complications from the disease. "AIDS Digest: And in Brief..." Washington Blade (02/18/94) Vol. 25, No. 7, P. 29 Johns Hopkins University in Baltimore is recruiting pregnant women who are infected with HIV to participate in nationwide clinical studies of an experimental AIDS vaccine. The trial will investigate whether the vaccine can prevent HIV transmission from mother to fetus. Volunteers must be asymptomatic, between the ages of 16 and 40, and have a CD4 cell count of at least 400. "AIDS Reform in Cuba" Advocate (02/22/94) No. 649, P. 16 Last month, Cuba dissolved its controversial, eight-year-old practice of obligatory quarantine for all persons infected with HIV. The system was replaced by another, in which local physicians are responsible for the conduct of their HIV patients. Cuban health officials said they abandoned the former system, which confined HIV-positive patients to special sanitariums, because of advances in AIDS treatment. Skeptics, however, implied that the real reason for the change is linked to evidence that the regime of Cuban premier Fidel Castro had grown so cash-poor that it could no longer subsidize the sanitariums. Whatever the reason, Cuban health officials said they will continue to keep close surveillance on the conduct of HIV-infected people and threatened to send miscreants back to the sanitariums, where AIDS advocacy groups say poor living conditions prevail. According to Dr. Manuel Santin, director of epidemiology for the Cuban public health ministry, in Cuba "irresponsible conduct is simply suicide." "Self-Care, Psychological Distress, and HIV Disease" Journal of the Association of Nurses in AIDS Care (10/93-12/93) Vol. 4, No. 4, P. 15 (Valente, Sharon M. et al.) Valente et al. studied the relationship of perceived impact of HIV status, psychological distress, and subsequent changes on self-care activities among 223 men and women who were either HIV-positive, or whose HIV status was unknown. Perceived impact was defined as intrusive, unwanted thoughts about HIV risk or status, or the purposeful avoidance of these thoughts. Psychological stress was defined as feelings of hopelessness or depression. And self-care behaviors were identified as activities aiming to maintain health, prevent disease or disease progression, and manage symptoms that develop in relation to health problems. Significant findings included a positive correlation between depression and the number of symptoms experienced. The quantity of symptoms also indicated a positive correlation with changes to unhealthy self-care behaviors, such as poor nutrition, imbalance in rest and activity, and substance abuse. The impact of event avoidance and depression were also associated with changes to unhealthy self-care behaviors, although helplessness was linked to fewer unhealthy changes.