Date: Mon, 07 Mar 1994 09:43:48 -0500 (EST) From: "ANNE WILSON, CDC NAC" Subject: CDC AIDS DAILY SUMMARY 03/07/94 AIDS Daily Summary March 07, 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 "Weighing Caution Against Compassion" New York Times (03/07/94) P. B5 (Fisher, Ian) New York's medical-parole program, designed to allow the state's sickest prison inmates the opportunity to die in dignity near friends and family, is up for renewal this month by the state Legislature. Although it will no doubt be approved, AIDS activists remain critical of the program. Medical parole targets terminally ill prisoners, many of whom are sick with AIDS. With an estimated 4,000 inmates who have already died from the disease, state officials say AIDS is the No. 1 killer of inmates, and that the prison system is now the largest AIDS care provider in New York. But, to the displeasure of advocates of prisoners with AIDS, only 30 of 447 applicants have been released under the program. Activists say this figure reflects an overcautiousness in the face of an epidemic of disease and death in prisons. More criticism stems from the criteria needed to qualify. On paper, an applicant must be terminally ill, severely incapacitated, and not serving time for violent crime. Corrections officers, however, have adopted inability to walk as an informal standard for release--a gauge of incapacitation that does not always reflect just how sick an AIDS patient is. In addition, many complain of the sluggish pace of applying for medical parole. More than 100 inmates have died while awaiting news on medical parole. "Needle Exchange Opposed" Boston Globe (03/04/94) P. 34 A needle exchange program for intravenous drug users at Cambridge Hospital in Massachusetts is being opposed by the mayor of Somerville and his constituents who live close to the city line, which runs behind the hospital. Somerville Mayor Michael E. Capuano said he asked the city's legal staff to find a strategy to halt the program, which is designed to curb the spread of AIDS. "Most housebreaks and crime are drug-related," said Capuano, expressing the views of many area residents. "That being the case, when you do something that attracts these people to one place, what you're doing is creating a potential for crime in that place that is great." But Cambridge Hospital administrator John G. O'Brien cited studies of similar programs in other cities which showed that needle exchange programs had no impact on crime rates. The program is scheduled to begin in about two weeks, according to O'Brien. "House Panel Approves Needle-Exchange Plan" Baltimore Sun (03/05/94) P. 3B For the first time in three years, a state House committee granted approval for a proposed needle-exchange program in Baltimore. The Environmental Matters Committee voted 13 to 8 to pass the measure and send it to the full House of Delegates. The legislation, heavily endorsed by Mayor Kurt L. Schmoke, would allow the city to provide injecting drug users with clean needles in an effort to prevent the spread of AIDS. Before they can implement the program, however, city officials need an exemption from a state law that prohibits the distribution of drug paraphernalia. Previous attempts to set up a needle-exchange in Baltimore were foiled by fears that the program would encourage drug abuse. This year's bill includes a treatment program for addicts, according to Howard Democratic Del. Virginia M. Thomas. "Germany--AIDS Killings" Associated Press (03/06/94) Bochum, Germany--An unemployed German worker, under the impression that he had infected his wife and two children with AIDS, killed them. The 31-year-old man, who was not identified, told police that he wanted to spare his family from long suffering. The man had read something in a doctor's report from an eye examination last year that falsely convinced him that he had AIDS and had infected his family. After strangling his 31-year-old wife and 4-year-old daughter, and suffocating his 2-year-old son, the man then tried to kill himself by slitting his wrists. He called his sister two days after the murders, and police discovered the bodies in the garage. The man was undergoing psychiatric evaluation, and has not been charged. "An AIDS Diary That Lights the Way to Death" Chicago Tribune (03/04/94) P. 2-3 (Reardon, Patrick T.) In "Diary of a Lost Boy," playwright Harry Kondoleon chronicles the final year in the life of an AIDS patient. The hero of the story is Hector Diaz, a young man whose smart-aleck sense of humor is at conflict with the depression and deterioration spawned by his illness. His gallows humor does not prevent the protagonist from experiencing fear, but provides a way for the reader to observe this fear without becoming overwhelmed by pity. "Rheumatoid Arthritis Advance May Be Relevant to AIDS" AIDS Treatment News (02/18/94) No. 193, P. 5 (James, John S.) London researchers report promising results in treating rheumatoid arthritis with a monoclonal antibody against tumor necrosis factor (TNF), a condition that is found naturally in the body but is often too high in HIV/AIDS patients. TNF can stimulate HIV growth directly, and is suspected to be an important contributing element of wasting syndrome. Pentoxifylline and thalidomide, two drugs being tested as potential AIDS therapies, reduce the levels of TNF in the body. The monoclonal antibody, produced by Philadelphia's Centocor company, may also be highly effective in blocking TNF. All of the 50 or so volunteers, who had failed standard treatments for rheumatoid arthritis, have had apparent success when treated with the monoclonal antibody, according to reports on the British Broadcasting Corporation. While this drug is not yet widely available, the results of the study--if confirmed--may advance the research on other drugs with a similar mechanism of action. "Le Monde Points a Finger at the US" Nature (02/17/94) Vol. 367, No. 6464, P. 584 (Butler, Declan) The French newspaper Le Monde has charged that the United States, for economic reasons, continued to distribute to hemophiliacs clotting factors it knew to be tainted with HIV. The newspaper published the minutes of a meeting of the Public Health Service (PHS) Task Force. The document demonstrated that manufacturers of clotting factors continued to distribute products that had not been heat-treated, even though heat-treated products were available. The minutes also reveal the intentions of the Food and Drug Administration to pressure manufacturers to cease the practice. Le Monde also referred to a report to the French government alleging that, in order to cut expenses, American transfusion centers continued to supply unheated products to hemophiliacs already under treatment, and reserved the heated products for hemophiliacs just beginning treatment. "Around the Nation: Massachusetts" Advocate (02/22/94) No. 649, P. 20 Blue Cross-Blue Shield of Massachusetts announced on Jan. 12 that it will pay as much as $500,000 to any of its 6,000 employees who contracts HIV on the job. "AIDSWatch: A Study in Complacency" Men's Fitness (02/94) Vol. 10, No. 2, P. 98 After 5,000 adults in Florida were tested for HIV, those who tested positive contracted fewer other sexually transmitted diseases, according to the American Journal of Public Health. The rate of infection for STDs among those testing HIV-negative, however, more than doubled. "High-Purity Factor Concentrates in Prevention of AIDS" Lancet (Great Britain) (02/19/94) Vol. 343, No. 8895, P. 478 (Schwarz, H.P.) Seremetis et al. conclude that high-purity products should be preferred for treating HIV-positive hemophiliacs. They base their recommendation on a study which showed that stabilization of CD4 cells with high-purity concentrates is the most striking seen with any AIDS treatment or prevention approach. If these findings are valid, say Schwarz et al. of Immuno AG in Austria, high-purity factor VIII concentrates would also have to be considered for treatment of HIV-positive patients who are not hemophiliacs. To prevent false hopes for these patients, Schwarz et al. suggest that the findings of Seremetis and colleagues be confirmed. In their opinion, the Seremetis study has several serious flaws. According to Schwarz et al., the methods of analysis did not properly consider the potential for bias in patient selection and use of antiretrovirals, the questionable endpoint, and selective withdrawal.