Date: Thu, 24 Aug 1995 09:28:28 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 08/24/95 AIDS Daily Summary August 24, 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 ************************************************************ "Japan Tobacco to Move Ahead With AIDS Drug" "Across the USA: D.C." "Chinese Court Rejects AIDS Damages Case" "Latino Show Returns with Messages for Immigrants" "The TV Column: Today's Specials" "Gilead Sciences Names Michael K. Inouye Vice President, Sales and Marketing" "FDA Reform: Activists' Proposals" "Natural History of HIV-1 Cell-Free Viremia" "HIV-Associated Diarrhoea and Wasting" "Tuberculosis's Long, Slow Burn" ************************************************************ "Japan Tobacco to Move Ahead With AIDS Drug" Reuters (08/24/95) Japan Tobacco Inc. (JT) has announced that it will proceed with its clinical testing of an AIDS drug jointly developed with Agouron Pharmaceuticals Inc. of California. "We made a contract with Agouron to jointly develop and commercialise an anti-HIV drug last December, and today we decided to move to the next step in clinical testing in the United States," JT explained. Earlier on Thursday, JT shares skyrocketed from a report that it would announce a decision regarding the drug. Although JT has already paid $6 million to Agouron to help develop the drug, and will pay the company another $24 million following the positive results in initial safety checks and preliminary testing, the two companies will now share the costs of developing the AIDS treatment. "Across the USA: D.C." USA Today (08/24/95) P. 5A The District of Columbia's largest private AIDS care provider may be forced to reduce its services due to late payments from the city government. Whitman-Walker Clinic director Jim Graham says the city owes more than $600,000. "Chinese Court Rejects AIDS Damages Case" Reuters (08/24/95) A Chinese court has dismissed a case filed by a patient against a hospital and a physician for releasing the results of a test for HIV, the Wen Hui daily reported on Thursday. In the first such case in China, the unnamed patient sought damages for psychological pain after the doctor told the patient's family, employer, and a government health department that the patient was infected with HIV. However, two subsequent HIV tests were negative and a third was inconclusive. A district court upheld the patient's claim in July, and ordered the doctor and hospital to issue an apology and pay $1,861. On appeal to the Intermediate People's Court, however, a judge overturned the verdict, ruling that the physician had acted "in a responsible way to both society and the patient." "Latino Show Returns with Messages for Immigrants" Washington Post (08/24/95) P. D.C.1; Constable, Pamela "Linea Directa," the only Spanish-language public service television show in the metropolitan Washington area, has returned to the air, eight months after losing its funding from the District of Columbia's government and disappearing from the air waves. For five years, co-producers Eduardo Lopez and Arturo Salcedo worked out of the D.C. Mayor's Office on Latino Affairs, putting out 50 low-budget yet popular shows on issues including AIDS prevention. Last winter, however, the men lost their jobs due to budget cuts, and the show was canceled. Now, Lopez and Salcedo have worked out an agreement with the city, under which the Office on Latino Affairs will provide a monthly contribution and official sponsorship, as well as a low-rent studio and pledges of production funds from a number of foundations and agencies. "The TV Column: Today's Specials" Washington Post (08/24/95) P. D4; Carmody, John ABC said on Wednesday that it will tape "Sinatra: 80 Years My Way" at a Nov. 19 black-tie affair in Los Angeles. The two-hour program will be an "all-star celebration commemorating [Sinatra's] upcoming 80th birthday and his spectacular career in music, film, and television," according to ABC. Entertainment president Ted Harbert reported that the event will include performances by some of the world's most popular entertainers, and that proceeds will benefit AIDS Project Los Angeles and the Barbara Sinatra Children's Center. "Gilead Sciences Names Michael K. Inouye Vice President, Sales and Marketing" Healthwire (08/23/95) Gilead Sciences Inc. has named Michael K. Inouye as its vice president of sales and marketing. Inouye will take charge of the development of that division as Gilead nears commercialization of its most advanced drug candidate, VISTIDE, which is currently in studies for the treatment of cytomegalovirus retinitis, a blinding disease in AIDS patients. Most recently, Inouye served as vice president of sales and marketing for InSite Vision Inc., where he managed the commercialization plans for late-stage opthalmic products. "FDA Reform: Activists' Proposals" AIDS Treatment News (08/04/95) No. 228, P. 6; James, John S. There are now several proposals on the table for changing the U.S. Food and Drug Administration (FDA), at least three of which were initiated by AIDS activist organizations. The first, a consensus letter on FDA reform that has been signed by 10 major AIDS organizations, proposes 11 principles as the basis of any FDA reform. These principles include continuing the agency's mission of protecting and advancing public health, allowing pre-approval access to experimental drugs that show potential for serious and life-threatening illnesses, and ensuring that data are gathered on all populations likely to use a new drug. A second proposal, the FDA Reform Consensus Draft Statement, focuses on avoiding delays and streamlining the process of getting new treatments to people faster. Finally, AIDS activist Jim Driscoll has spent several months discussing FDA reform with Congressional offices. Driscoll is interested amending the FDA's mission so that it also encourages the rapid development of medical science and allows drug companies to teach doctors about well-accepted off-label uses of their products. "Legislative reform of the FDA is the surest way to speed a cure for AIDS," according to Driscoll. "Natural History of HIV-1 Cell-Free Viremia" Journal of the American Medical Association (08/16/95) Vol. 274, No. 7, P. 554; Henrard, Denis R.; Phillips, Jack F.; Muenz, Larry R. et al. In an attempt to characterize the natural history of viremia with HIV and its relationship with disease progression, Henrard et al. studied 42 homosexual men who seroconverted to HIV-1 in the early- to mid-1980s. The subjects were tested each year for quantitative virion-associated HIV-1 RNA, p24 antigen, and CD4 cells. During the course of the study, the HIV-1 RNA levels remained stable; only 14 percent of the subjects had at least 10-fold increases in the three to 11 years of follow-up. Both univariate and multivariate analyses revealed that initial and subsequent HIV-1 RNA levels, p24 antigenemia, and a percentage of CD4 cells were independently predictive of disease progression to AIDS. The findings indicate that there is a balance between HIV-1 replication and efficacy of immunologic response that is created soon after infection and continues through the asymptomatic phase of the disease. The faulty immunologic control of HIV-1 infection, therefore, could be as important as the rate of viral replication in assessing survival free from AIDS. HIV-1 RNA levels may be effective markers for predicting clinical outcome, the authors conclude, because the individual stable levels of viremia were established soon after infection. "HIV-Associated Diarrhea and Wasting" Lancet (08/05/95) Vol. 346, No. 8971, P. 352; DuPont, H.L.; Marshall, G.D. DuPont and Marshall present the case of a 34-year-old Hispanic bisexual male who, nearly four years after his HIV diagnosis, began to experience bothersome diarrhea without fever. The diarrhea persisted for more than a year, despite treatment with a number of drugs. The two primary explanations for this HIV/AIDS-related problem are opportunistic enteric infection and HIV enteropathy. Approximately half of the patients with AIDS-related diarrhea are diagnosed with an infectious agent. DuPont and Marshall's patient was infected with a member of the order Microsporidia. He was treated with metronidazole without effect, though it has occasionally been useful in relieving illness related to microsporidiosis. This patient illustrates several of the clinical problems associated with HIV, diarrhea, and wasting. The illness is generally prolonged. In addition, the cause may not always be obvious, and may often involve a complex interaction between infection by enteric pathogens and intestinal immune defects. Because the cause can vary, the authors conclude that it may be necessary to conduct numerous evaluations and to use combinations of both specific and non-specific drugs to improve quality of life and provide relief. "Tuberculosis's Long, Slow Burn" Science (08/04/95) Vol. 269, No. 5224, P. 637 One success story in the history of public health is the effect of anti-tuberculosis (anti-TB) measures taken at the end of the 19th century. Now, however, researchers at the University of California at San Francisco claim that the disease was dying out anyway, without the help of the medical community. Using a model based on TB's known transmission characteristics, the researchers report that a TB epidemic occurs as three overlapping subepidemics. While the first epidemic quickly runs its course, the second and third begin gradually, but end very slowly, and can produce an epidemic of more than 100 years. Although improved living standards and cleaner cities probably contributed to the disease's downfall, they worked within the epidemic's decline, says lead researcher Sally Blower. Her model also offers insight into the future of TB, which is resurging in the United States, in part because of AIDS and drug-resistant strains of TB bacteria.