Date: Wed, 5 Apr 1995 09:32:54 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary April 5, 1995 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 1995, Information, Inc., Bethesda, MD ************************************************************ "Senate Votes to Require Telling Mothers of H.I.V. Results" "Russian HIV Law Angers Europe" "From One Case, Tracing the AIDS Virus' Web" "Testing AIDS Vaccine in Thailand Makes Medical and Ethical Sense" "2nd AIDS Drop-In Center Planned for Women, Kids" "AIDS Puts Japan Society on Trial" "Who Put the Lid on gp120?" "Human Herpesvirus-Like Nucleic Acid in Various Forms of Kaposi's Sarcoma" "The Disease Busters" "Winning the War" ************************************************************ "Senate Votes to Require Telling Mothers of H.I.V. Results" New York Times (04/05/95) P. B4; Sack, Kevin On Tuesday, the New York State Senate passed a bill that would require the state to inform mothers of the results of the mandatory HIV tests that are currently performed anonymously on newborns. The debate over notifying mothers of HIV test results appeared to be over in the last legislative session when Senate and Assembly leaders and Governor Mario M. Cuomo agreed on a compromise bill that would have required physicians to advise pregnant women and new mothers about the benefits of testing. That measure would not have required New York to notify mothers of the results of HIV tests. Although the Assembly passed the bill, the Senate shifted its sentiment and killed the measure in the session's final hours. Current Gov. George E. Pataki said on Tuesday that he would sign the mandatory notification bill if it passed the Legislature. "Russian HIV Law Angers Europe" Washington Times (04/05/95) P. A15 Health experts and governments on Tuesday criticized the Russian law that requires all foreigners planning extended stays in the country to prove they are not infected with HIV. Although opinions in Asia varied on whether the law would help stop the spread of AIDS, in Western Europe the law was generally viewed as blatant discrimination. Russia, however, is not the first country to impose such restrictions on travelers. In China, for example, foreigners planning long-term visits have been required to submit to tests to prove they are HIV-negative since 1989. "From One Case, Tracing the AIDS Virus' Web" Philadelphia Inquirer (04/05/95) P. A1; Vedantam, Shankar A voluntary confidential project in Pennsylvania is being used as an example of the success of partner notification programs in state health departments across the country. The first patient in the program was a prisoner in Berks County who requested to be tested for HIV. After testing positive, he agree to help and gave health workers four names of former drug and sex partners. The project took just over a year and led researchers to 121 people, most of whom they were able to test. As of last May, health officials had linked 44 infected individuals to the prisoner. Of that number, 21 did not know they were infected. "This is not about blame or tracing where an infection came from, but about people getting help," said Katharyn Waldron, a former HIV counselor with the Pennsylvania Department of Health, which conducted the project. Once people are identified as HIV-positive, they are given counseling and access to medical help. "Testing AIDS Vaccine in Thailand Makes Medical and Ethical Sense" Philadelphia Inquirer (04/05/95) P. A11; Caplan, Art Although many people claim that testing vaccines in poor nations is unethical, they are wrong, writes Art Caplan, director of the Center for Bioethics at the University of Pennsylvania, in the Philadelphia Inquirer. Almost 75 percent of all HIV infections have occurred in sub-Saharan Africa, Caplan notes. More than 3 million people in Southeast Asia are also infected with the virus. The fastest way to prove the efficacy of a vaccine is to study a population in which the infection rate is growing rapidly. A population with a high risk of AIDS requires fewer individuals to be tested to show a preventive effect from a vaccine, which is one reason why the World Health Organization is interested in Thailand, Brazil, and Uganda as sites for vaccine trials. The ethical problems of conducting tests in such countries involve the participants' comprehension of the nature of the test and the false security that some may feel from receiving the vaccine. If, however, it is possible to identify particular groups in impoverished nations that face extreme risks of contracting HIV and nothing can be done to reduce those risks, it makes sense to try a vaccine, concludes Caplan. "2nd AIDS Drop-In Center Planned for Women, Kids" Baltimore Sun (04/05/95) P. 5B; Sugg, Diana K. Several nonprofit groups on Tuesday announced a proposed drop-in program and day care center in Baltimore, Md., for women and children with AIDS. Organizations involved in the collaboration include HERO, a major provider of AIDS services and education; AIDS Interfaith Residential Services; Chase-Brexton Health Services; Lifesongs for AIDS, and the United Way. HERO already operates a drop-in center in Baltimore for approximately 700 male AIDS patients. The second center will serve about 300 women and 44 children under age 12, said Dr. Leonardo Ortega, the agency's executive director. At the new center, women will be able to talk with a social worker or a support group, and get leads on temporary jobs free of charge. The day care center will be one of only five of its type in the country, officials said. In the future, the center and day-care program may be presented to managed care companies as affordable alternatives to existing methods of caring for AIDS patients, said David Shippee, executive director of Chase-Brexton Health Services. "AIDS Puts Japan Society on Trial" Chicago Tribune (04/04/95) P. 1-1; Goozner, Merrill The rare public appearance last week of three Japanese hemophiliacs with AIDS coincided with the conclusion of testimony in a six-year-old court battle against the Japanese government and five pharmaceutical companies, which are accused of selling HIV-tainted blood products. In an unusual move, the suit charges the government with deliberately delaying the introduction of a safer product because it was foreign-made. The hemophiliacs have asked public prosecutors to file murder charges against the government-appointed medical expert who delayed approval of the new product. The plaintiff's lead attorney has accused Baxter International Inc. and four other drug companies of knowing as early as July 1982 that the coagulants made from imported blood may have been contaminated. Japan approved a clotting factor made from pooled dried blood in February 1983. In July 1985, after two years of clinical trials on patients, the government approved the new heat-treated coagulants from Baxter and five other drug companies. The suit alleges that 50 percent of Japan's HIV-infected hemophiliacs contracted the virus during the two years that Baxter's safer product was kept off the market. "Who Put the Lid on gp120?" New York Times Magazine (03/26/95) P. 50; Green, Jesse Many scientists believe that a vaccine known as gp120 could be helpful in preventing AIDS, but the drug has not been fully tested. In March 1992, gp120 underwent Phase I testing, where it was shown to safely induce very strong immunogenicity in volunteers. The National Institute for Allergy and Infectious Diseases (NIAID)--which financed the trials--agreed to progress to Phase II testing of the vaccine, where it performed disappointingly against field isolates of HIV. However, in experiments conducted by gp120 manufacturer Genentech and by Chiron Biocine, the vaccine appeared to protect five chimpanzees from the virus. Prospects that the vaccine would move on to Phase III trials were damaged on May 29, when the Chicago Tribune ran a front-page story asserting that some volunteers had become infected with HIV during Phases I and II. The story was garbled in subsequent media coverage so that many concluded the vaccine was made of live HIV and made people ill. According to the NIAID, the volunteers actually contracted the virus as a result of "high-risk behaviors." Trials were faced with upset volunteers and a shortage of new recruits. At the June 17 meeting of the AIDS Research Advisory Committee, AIDS activists vehemently protested the initiation of Phase III trials of gp120. In response, NIAID Director Anthony Fauci agreed not to expand the program. Critics--like Anne-Marie Duliege, associate director of clinical research at Chiron Biocine--call Fauci's action "a purely political, manipulated decision." One scientist said, "It was the most unintellectual discussion about a scientific issue that I have ever had the unhappiness to witness." Genentech is now considering dropping the project, while Chiron Biocine and Therion Biologics have reduced their efforts at AIDS vaccine development by half. Thailand obtained permission from the World Health Organization to test the vaccine and commenced trials in February. "Human Herpesvirus-Like Nucleic Acid in Various Forms of Kaposi's Sarcoma" Lancet (03/25/95) Vol. 345, No. 8952, P. 759; Huang, Y.Q.; Li, J.J.; Kaplan, M.H. et al. Huang et al. examined the relationship between a new human herpesvirus-like agent and various forms of Kaposi's sarcoma (KS) using polymerase chain reaction (PCR). The DNA sequences of this agent were found in 7 of 8 classic KS specimens, 12 of 12 AIDS-related specimens from the United States, and 7 of 10 samples from African endemic KS. Polymorphism of the herpesvirus-like DNA in the Kaposi's tissue from different populations was detected by both single-strand polymorphism and direct sequencing. Southern and northern blotting were also used to identify the virus in some Kaposi's tumors. The researchers concluded that this herpesvirus may be implicated in the pathogenesis of different forms of KS found among distinct and unrelated populations. "The Disease Busters" U.S. News & World Report (03/27/95) Vol. 118, No. 12, P. 48; Brownlee, Shannon Epidemiologists at the National Center for Infectious Diseases (NCID) at Atlanta's Centers for Disease Control are responsible for tracking down the source of every mysterious disease outbreak in the United States. They are also sent overseas when foreign governments request help in a public health matter. Foremost among their worries are the increasing tendency of microbes to mutate and thereby become resistant to antibiotics, and the ever-smaller number of antibiotics that can treat some of the most resistant infections. During the 1980s, drug companies began to shift their focus away from infectious diseases, with only a dozen new antibiotics receiving approval between 1989 and 1993. In light of this trend, NCID's disease-watchers await the next AIDS-like epidemic with dread. The Republican Congress and its commitment to fiscal austerity also leaves the agencies staffers, most of whom could earn significantly more in the private sector, with little hope for any increases in their budget; instead, the trend is leaning toward employing fewer people to perform NCID's crucial tasks. More than 100 NCID staffers have lost their jobs due to early retirement and buyouts. This comes at a time not only when the number of antibiotic-resistant diseases is rising, but the number of diseases overall is increasing as well. NCID epidemiologists believe that the number of diseases spread from animals to humans is on the increase, pushed on by the destruction of the rain forest--one of the world's most abundant source of viruses. Food-borne illnesses such as those caused by e.coli are rising in number as well, and NCID would like to have more money in its budget to study them. While NCID estimates that $75 million to $100 million per year would be a reasonable budget for its activities, last year Congress allocated it only $6.7 million. "Winning the War" The Advocate (03/21/95) No. 677, P. 59; Zachary, Bohdan In an interview with the Advocate prior to his death from AIDS-related complications on Feb. 10., award-winning author Paul Monette spoke about the personal and global effects of the AIDS epidemic. Monette said that he had rid himself of the shame that is linked to people with AIDS. "The time when one could die quietly in bed surrounded by one's loved ones at the ripe age of 80 is gone," he explained. He described the condition of AIDS research as "helter-skelter," and said although he thought researchers were trying to reduce certain infections, "the whole picture of a cure just seems to me to be misguided." Monette said he wished to be remembered as the first voice for telling the story of the effects of AIDS.