Date: Thu, 12 Jan 1995 09:07:53 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 01/12/95 AIDS Daily Summary January 12, 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 1994, Information, Inc., Bethesda, MD ************************************************************ "AIDS Virus Shown by Research to Be Relentless in Reproducing" "End Is Sought to Blood Test that Barred Many Donors" "Anti-Gay Measure Is Defeated" "Contest to Give Hindi Name to AIDS" "Broder Bids Adieu on a High Note" "AmFAR's ART Against AIDS Japan Show Opens in Soho" "Early Predictors of Outcome for HIV Patients with Neurological Failure" "Judge: HIV Test Results Aren't Admissible" "When to Use Fluconazole" "AIDS Caregivers Struggling with Assisted Suicide" ************************************************************ "AIDS Virus Shown by Research to Be Relentless in Reproducing" Washington Post (01/12/95) P. A3; Brown, David New research has shown that the immune system of an AIDS patient is in a state of all-out war against a relentlessly multiplying virus. HIV can develop resistance to new drugs in as little as one month after the patient begins taking them, which reinforces the tremendous difficulty of developing drugs to keep the infection in check. The immune system's ability to survive years of infection, however, suggests that it may retain an extremely strong capacity for regeneration even late in the disease, if a way to stop the viral reproduction can be found. The two studies estimate that about half of the HIV particles in the bloodstream are killed off every two day, only to be replaced by new microbes. Two research teams gave AIDS patients potent anti-viral drugs. The drugs either stopped viral production or stopped the virus from infecting additional cells. In either instance, the body gained the opportunity to clear itself of the virus and to replenish its destroyed CD4 cells. Both teams measured a decline in virus particles in the blood, as well as an increase of CD4 cells. The daily "turnover" of CD4 cells was estimated to be between 1.8 billion and 2 billion cells, while 100 million to 680 million virus particles were produced each day. Related Stories: New York Times (01/12) P. A1; USA Today (01/12) P. 1D "End Is Sought to Blood Test that Barred Many Donors" New York Times (01/12/95) P. B9; Altman, Lawrence K. A federal panel on Wednesday recommended that blood banks stop performing a screening test that has permanently excluded approximately 1 million potential blood donors in the United States, even though they are healthy. While the recommendations of the panel on infectious disease testing for blood transfusions, convened by the National Institutes of Health, are not binding on health groups in such cases, they are generally followed after review. The test, which is an indirect way of detecting hepatitis C, is obsolete and ineffective, said the panel. A lack of standardized interpretation of test results has contributed to inconsistent rules on the exclusion of donors and has led to the needless disposal of 200,000 units of blood each year. The elimination of the test would not reduce the safety of the blood supply because other tests now detect various forms of hepatitis and HIV. Because it will take time to review the recommendation, the decision is not expected to relieve the acute blood shortage that exists in much of the country. "Anti-Gay Measure Is Defeated" New York Times (01/12/95) P. A15; Dunlap, David W. In a special election on Tuesday, voters in West Palm Beach, Fla., upheld an anti-discrimination ordinance. The voters defeated a proposal that would have removed "sexual orientation" as a classification under which people are protected against bias in employment, housing, and public accommodations. Opponents of the proposal claimed it would legalize discrimination. "Why are we passing laws that promote and validate a life style that causes untold deaths and costs," asked Sarah Brack Nuckles--a member of the City Commission who voted against the ordinance when it was enacted last September--referring to the toll taken by AIDS. David Canton, director of the American Family Association of Florida, alleged that the city had circumvented due process to force a special election, limiting voter turnout to those with the most at stake. "Contest to Give Hindi Name to AIDS" Reuters (01/12/95) India's National AIDS Control Organization (NACO) is offering a 10,000 rupee ($330) prize for the best entry in a contest to give a Hindi name to AIDS. So far, the responses have included names such as Black Cobra, Untimely Cremation Ritual, and The Doctors Cannot Save Him Now. According to NACO, there are 1,017 cases of full-blown AIDS and 17,124 confirmed cases of HIV infection in India. The Indian Institute of Economic Growth, however, estimates that the actual number of AIDS patients in India could be as high as 10,000, with up to 1.5 million HIV-infected Indians. "Broder Bids Adieu on a High Note" Boston Globe (01/11/95) P. 12; Foreman, Judy; Bass, Alison Contrary to the usual press releases and conferences that occur when there is a major development, news of the short-term decline in breast cancer mortality was first announced during Dr. Samuel Broder's farewell address to the National Cancer Advisory Board. Broder is leaving the National Cancer Institute in April to work at a Miami pharmaceutical firm, IVAX Corp. During the early days of the AIDS epidemic, Broder came to national attention when he pioneered the use of AZT to slow disease progression. Broder said that his resignation in part stems from his frustration with the view that government impedes progress. "AmFAR's ART Against AIDS Japan Show Opens in Soho" PR Newswire (01/11/95) Art Against AIDS Japan, a four-week show at the Thread Waxing Space, opens today in Soho, New York. The show features two exhibitions entitled "The Artist's Camera" and "Tradition and Invention: Contemporary Artists Interpret The Japanese Garden." Actress Tatum O'Neal will host the show, which includes the sale of works by such leading contemporary artists as Roy Lichtenstein, William Wegman, and Jenny Holzer. Proceeds will benefit the American Foundation for AIDS Research (AmFAR). "Early Predictors of Outcome for HIV Patients with Neurological Failure" Journal of the American Medical Association (01/04/95) Vol. 273, No. 1, P. 35; Bedos, Jean-Pierre; Chastang, Claude; Lucet, Jean-Christophe et al As part of a descriptive study of HIV, researchers studied 84 consecutive HIV-infected patients who were admitted to an infectious disease intensive care unit (ICU) for neurological failure. They were also trying to determine the parameters on admission that are predictive of death within three months. Within 48 hours of admission, each patient received a thorough clinical, laboratory, and brain computed tomography (CT) scan workup. Eighty percent of the cases, or 67 patients, required mechanical ventilation within 48 hours of admission. The brain CT showed that 51 patients had abscesses, which in 47 patients were attributed to probable toxoplasmosis. There was a three-month survival rate of 32 percent. Factors predictive of death within three months admission to the ICU include a Glasgow Coma Scale score less than 7, signs of brain stem involvement, and the need for mechanical ventilation in the 48 hours after admission. No initial HIV-specific parameters were identified as predictive of death. The prognostic factors found only reflect the severity of neurological involvement in the various etiologies. "Judge: HIV Test Results Aren't Admissible" Washington Blade (01/06/95) Vol. 26, No. 1, P. 18; Chibbaro Jr., Lou A Mississippi judge ruled last month that the results of HIV antibody tests of two homosexual men who were murdered in October should not be admitted into court unless evidence in the pending trial warrants it. The ruling was considered a setback for16-year-old Marvin McClendon, who has been charged with the shooting deaths of Robert Walters and Joseph Shoemake. The defendant's attorney sparked fury in the AIDS activist community when he asked for posthumous HIV antibody tests on blood samples taken from the men. He argued that the results were needed to reinforce his client's assertion that he shot the men in self-defense. The request was approved, but the judge ordered the results to be sealed while he studied the question of whether the information should be admitted into court. McClendon told authorities he killed the two men after they attempted to rape him in their car. The judge's decision to hold off on whether to admit the test results came after the Lambda Legal Defense and Education Fund submitted a memorandum citing legal arguments opposing release of the HIV status of the victims. "When to Use Fluconazole" Lancet (01/07/95) Vol. 345, No. 8941, P. 6; Mangino, Julie E.; Moser, Stephen A.; Waites, Ken B. The significant increase in the incidence of invasive fungal infections among patients admitted to hospitals during the past decade is due in part to the increased use of broad-spectrum antimicrobial agents, long-term immunosuppressive therapy, and AIDS. Comparative studies of fluconazole--an oral and parenteral triazole--have found that it seems to be as effective as or better than other antifungal agents for the treatment of patients with mucosal candidosis. Amphotericin B and fluconazole are both effective initial therapies for cryptococcal meningitis in AIDS patients. Still, Amphotericin B is the preferred choice for induction because of its faster sterilization of the cerebrospinal fluid and lower mortality. Lifelong suppressive therapy with fluconazole in this population has proven to be better, and also better tolerated than Amphotericin B. Questions about optimum fluconazole therapy include whether intermittent or continuous suppressive therapy is indicated for patients with AIDS and recurrent mucosal candidosis. Although the drug is well tolerated and has few side effects, clinicians should be aware of potential problems regarding resistance, drug interactions, and cost. "AIDS Caregivers Struggling with Assisted Suicide" AIDS Alert (01/95) Vol. 10, No. 1, P. 12 "Rational suicide" is a phrase often used by those who advocate for the right of dying patients to determine the circumstances of their own deaths. For example, Tony Winik, a bisexual who had had AIDS for two years, appears to have committed "rational suicide" last summer. As Texas does not have an assisted suicide law, Winik relied on the best-selling manual, "Final Exit," for technical advice. His wife says only that "we had help" in addition to the book. She says that while her husband was not in severe pain, he had spent much of the summer in the hospital and was frightened of a prolonged and agonizing death. Susan B. Dunshee, of the Seattle-based Compassion in Dying, says that about half of the calls to the group are from AIDS patients. The group provides support and advice to dying patients who want to hasten their deaths, but does not write prescriptions or supply medication. Dunshee also says that, despite laws prohibiting physicians from assisting, suicide among AIDS patients is more common than death certificates indicate. The debate over assisted suicide focuses on how rational the suicides have been. Compassion in Dying insists that those who apply for help in dying comply with a lengthy procedure. THE END. --$----Novell--Attachment----$ X-NVL-Content-Type: TEXT X-NVL-Content-Charset: X-IBM-437 X-NVL-Content-Filename: ads0112 X-NVL-Content-Modification-Date: 12-Jan-1995 08:55:00 -0500 AIDS Daily Summary January 12, 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 1994, Information, Inc., Bethesda, MD ************************************************************ "AIDS Virus Shown by Research to Be Relentless in Reproducing" "End Is Sought to Blood Test that Barred Many Donors" "Anti-Gay Measure Is Defeated" "Contest to Give Hindi Name to AIDS" "Broder Bids Adieu on a High Note" "AmFAR's ART Against AIDS Japan Show Opens in Soho" "Early Predictors of Outcome for HIV Patients with Neurological Failure" "Judge: HIV Test Results Aren't Admissible" "When to Use Fluconazole" "AIDS Caregivers Struggling with Assisted Suicide" ************************************************************ "AIDS Virus Shown by Research to Be Relentless in Reproducing" Washington Post (01/12/95) P. A3; Brown, David New research has shown that the immune system of an AIDS patient is in a state of all-out war against a relentlessly multiplying virus. HIV can develop resistance to new drugs in as little as one month after the patient begins taking them, which reinforces the tremendous difficulty of developing drugs to keep the infection in check. The immune system's ability to survive years of infection, however, suggests that it may retain an extremely strong capacity for regeneration even late in the disease, if a way to stop the viral reproduction can be found. The two studies estimate that about half of the HIV particles in the bloodstream are killed off every two day, only to be replaced by new microbes. Two research teams gave AIDS patients potent anti-viral drugs. The drugs either stopped viral production or stopped the virus from infecting additional cells. In either instance, the body gained the opportunity to clear itself of the virus and to replenish its destroyed CD4 cells. Both teams measured a decline in virus particles in the blood, as well as an increase of CD4 cells. The daily "turnover" of CD4 cells was estimated to be between 1.8 billion and 2 billion cells, while 100 million to 680 million virus particles were produced each day. Related Stories: New York Times (01/12) P. A1; USA Today (01/12) P. 1D "End Is Sought to Blood Test that Barred Many Donors" New York Times (01/12/95) P. B9; Altman, Lawrence K. A federal panel on Wednesday recommended that blood banks stop performing a screening test that has permanently excluded approximately 1 million potential blood donors in the United States, even though they are healthy. While the recommendations of the panel on infectious disease testing for blood transfusions, convened by the National Institutes of Health, are not binding on health groups in such cases, they are generally followed after review. The test, which is an indirect way of detecting hepatitis C, is obsolete and ineffective, said the panel. A lack of standardized interpretation of test results has contributed to inconsistent rules on the exclusion of donors and has led to the needless disposal of 200,000 units of blood each year. The elimination of the test would not reduce the safety of the blood supply because other tests now detect various forms of hepatitis and HIV. Because it will take time to review the recommendation, the decision is not expected to relieve the acute blood shortage that exists in much of the country. "Anti-Gay Measure Is Defeated" New York Times (01/12/95) P. A15; Dunlap, David W. In a special election on Tuesday, voters in West Palm Beach, Fla., upheld an anti-discrimination ordinance. The voters defeated a proposal that would have removed "sexual orientation" as a classification under which people are protected against bias in employment, housing, and public accommodations. Opponents of the proposal claimed it would legalize discrimination. "Why are we passing laws that promote and validate a life style that causes untold deaths and costs," asked Sarah Brack Nuckles--a member of the City Commission who voted against the ordinance when it was enacted last September--referring to the toll taken by AIDS. David Canton, director of the American Family Association of Florida, alleged that the city had circumvented due process to force a special election, limiting voter turnout to those with the most at stake. "Contest to Give Hindi Name to AIDS" Reuters (01/12/95) India's National AIDS Control Organization (NACO) is offering a 10,000 rupee ($330) prize for the best entry in a contest to give a Hindi name to AIDS. So far, the responses have included names such as Black Cobra, Untimely Cremation Ritual, and The Doctors Cannot Save Him Now. According to NACO, there are 1,017 cases of full-blown AIDS and 17,124 confirmed cases of HIV infection in India. The Indian Institute of Economic Growth, however, estimates that the actual number of AIDS patients in India could be as high as 10,000, with up to 1.5 million HIV-infected Indians. "Broder Bids Adieu on a High Note" Boston Globe (01/11/95) P. 12; Foreman, Judy; Bass, Alison Contrary to the usual press releases and conferences that occur when there is a major development, news of the short-term decline in breast cancer mortality was first announced during Dr. Samuel Broder's farewell address to the National Cancer Advisory Board. Broder is leaving the National Cancer Institute in April to work at a Miami pharmaceutical firm, IVAX Corp. During the early days of the AIDS epidemic, Broder came to national attention when he pioneered the use of AZT to slow disease progression. Broder said that his resignation in part stems from his frustration with the view that government impedes progress. "AmFAR's ART Against AIDS Japan Show Opens in Soho" PR Newswire (01/11/95) Art Against AIDS Japan, a four-week show at the Thread Waxing Space, opens today in Soho, New York. The show features two exhibitions entitled "The Artist's Camera" and "Tradition and Invention: Contemporary Artists Interpret The Japanese Garden." Actress Tatum O'Neal will host the show, which includes the sale of works by such leading contemporary artists as Roy Lichtenstein, William Wegman, and Jenny Holzer. Proceeds will benefit the American Foundation for AIDS Research (AmFAR). "Early Predictors of Outcome for HIV Patients with Neurological Failure" Journal of the American Medical Association (01/04/95) Vol. 273, No. 1, P. 35; Bedos, Jean-Pierre; Chastang, Claude; Lucet, Jean-Christophe et al As part of a descriptive study of HIV, researchers studied 84 consecutive HIV-infected patients who were admitted to an infectious disease intensive care unit (ICU) for neurological failure. They were also trying to determine the parameters on admission that are predictive of death within three months. Within 48 hours of admission, each patient received a thorough clinical, laboratory, and brain computed tomography (CT) scan workup. Eighty percent of the cases, or 67 patients, required mechanical ventilation within 48 hours of admission. The brain CT showed that 51 patients had abscesses, which in 47 patients were attributed to probable toxoplasmosis. There was a three-month survival rate of 32 percent. Factors predictive of death within three months admission to the ICU include a Glasgow Coma Scale score less than 7, signs of brain stem involvement, and the need for mechanical ventilation in the 48 hours after admission. No initial HIV-specific parameters were identified as predictive of death. The prognostic factors found only reflect the severity of neurological involvement in the various etiologies. "Judge: HIV Test Results Aren't Admissible" Washington Blade (01/06/95) Vol. 26, No. 1, P. 18; Chibbaro Jr., Lou A Mississippi judge ruled last month that the results of HIV antibody tests of two homosexual men who were murdered in October should not be admitted into court unless evidence in the pending trial warrants it. The ruling was considered a setback for16-year-old Marvin McClendon, who has been charged with the shooting deaths of Robert Walters and Joseph Shoemake. The defendant's attorney sparked fury in the AIDS activist community when he asked for posthumous HIV antibody tests on blood samples taken from the men. He argued that the results were needed to reinforce his client's assertion that he shot the men in self-defense. The request was approved, but the judge ordered the results to be sealed while he studied the question of whether the information should be admitted into court. McClendon told authorities he killed the two men after they attempted to rape him in their car. The judge's decision to hold off on whether to admit the test results came after the Lambda Legal Defense and Education Fund submitted a memorandum citing legal arguments opposing release of the HIV status of the victims. "When to Use Fluconazole" Lancet (01/07/95) Vol. 345, No. 8941, P. 6; Mangino, Julie E.; Moser, Stephen A.; Waites, Ken B. The significant increase in the incidence of invasive fungal infections among patients admitted to hospitals during the past decade is due in part to the increased use of broad-spectrum antimicrobial agents, long-term immunosuppressive therapy, and AIDS. Comparative studies of fluconazole--an oral and parenteral triazole--have found that it seems to be as effective as or better than other antifungal agents for the treatment of patients with mucosal candidosis. Amphotericin B and fluconazole are both effective initial therapies for cryptococcal meningitis in AIDS patients. Still, Amphotericin B is the preferred choice for induction because of its faster sterilization of the cerebrospinal fluid and lower mortality. Lifelong suppressive therapy with fluconazole in this population has proven to be better, and also better tolerated than Amphotericin B. Questions about optimum fluconazole therapy include whether intermittent or continuous suppressive therapy is indicated for patients with AIDS and recurrent mucosal candidosis. Although the drug is well tolerated and has few side effects, clinicians should be aware of potential problems regarding resistance, drug interactions, and cost. "AIDS Caregivers Struggling with Assisted Suicide" AIDS Alert (01/95) Vol. 10, No. 1, P. 12 "Rational suicide" is a phrase often used by those who advocate for the right of dying patients to determine the circumstances of their own deaths. For example, Tony Winik, a bisexual who had had AIDS for two years, appears to have committed "rational suicide" last summer. As Texas does not have an assisted suicide law, Winik relied on the best-selling manual, "Final Exit," for technical advice. His wife says only that "we had help" in addition to the book. She says that while her husband was not in severe pain, he had spent much of the summer in the hospital and was frightened of a prolonged and agonizing death. Susan B. Dunshee, of the Seattle-based Compassion in Dying, says that about half of the calls to the group are from AIDS patients. The group provides support and advice to dying patients who want to hasten their deaths, but does not write prescriptions or supply medication. Dunshee also says that, despite laws prohibiting physicians from assisting, suicide among AIDS patients is more common than death certificates indicate. The debate over assisted suicide focuses on how rational the suicides have been. Compassion in Dying insists that those who apply for help in dying comply with a lengthy procedure. --$----Novell--Attachment----$--