Date: Wed, 21 Jun 1995 09:31:35 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary June 21, 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 ************************************************************ "Unit of Roche Sets Up Lottery for AIDS Drug" "House Panel Begins AIDS-Training Probe" "The TV Column" "Researchers Back Medical Use of Pot" "AIDS Panel Lacks Drug Abuse Experts" "'Red Tape' Holds Up $5 Million in Federal, State AIDS Funds" "Three Nonprofits Win Property Management Awards from Bankers Trust" "Sensitization of T Cells to CD95-Mediated Apoptosis by HIV-1 Tat and gp120" "Mixed-Strain Infection with a Drug-Sensitive and Multidrug-Resistant Strain of Mycobacterium tuberculosis" "When Treatments Go Untried" ************************************************************ "Unit of Roche Sets Up Lottery for AIDS Drug" Wall Street Journal (06/21/95) P. A5; Waldholz, Michael Under an agreement with the U.S. Food and Drug Administration (FDA), Hoffmann-La Roche Inc. will provide the AIDS drug Invirase, free of charge, to 2,280 patients in the United States through a special lottery. Invirase, which is generically known as sequinivir, is the first of the class of experimental AIDS drugs called protease inhibitors to be offered to a large group of people not enrolled in a clinical trial. Roche decided to hold the lottery because only a limited supply of Invirase is available. The lottery will be open only to patients who have not responded to other drugs, or who have very low levels of immune system cells. A company spokesman said that Roche's telephone lines will be open today to receive calls from people interested in entering the lottery. "House Panel Begins AIDS-Training Probe" Washington Times (06/21/95) P. A12; Scarborough, Rowan On Thursday, the House Government Reform and Oversight subcommittee will conduct the first congressional investigation of President Clinton's mandatory AIDS-prevention training. The subcommittee will hear first from two federal workers who believe the classes are too sexually explicit. The panel will try to determine whether the program is, in fact, mandatory for all federal employees. In 1993, based on a directive by the president, then-White House AIDS coordinator Kristine Gebbie ordered attendance because it "removes any 'stigma' attached to an interest in HIV/AIDS." However, her successor, Patricia Fleming, told the subcommittee that the memo "was interpreted by many agencies as a requirement that all workers participate in such classes. This was incorrect." Fleming said that each agency could decide whether attendance was required. A subcommittee staff member said on Tuesday that the hearing may result in legislation placing limits on workplace training. "The TV Column" Washington Post (06/21/95) P. D6; Carmody, John At least 45 cable television networks are participating today in the third annual "Day of Compassion" for people who have HIV or AIDS. HBO, for example, at 3 p.m. will broadcast "A Dangerous Affair" from its "Lifestories: Families in Crisis" series, to be followed by the movie "And the Band Played On." On the Disney Channel, members of "The Mickey Mouse Club" will discuss AIDS awareness at 3:30 p.m., and at 8 p.m. the network will air "A Special Evening with Elton John," a concert benefiting the rock singer's AIDS organization. Bravo will show the AIDS documentary "One Foot on a Banana Peel, the Other Foot in the Grave" at 11:30 p.m. The movie "Philadelphia" will air on Showtime at 9:45 p.m., along with a special introduction about the "Day of Compassion." Related Story: New York Times (06/21) P. C18 "Researchers Back Medical Use of Pot" USA Today (06/21/95) P. 1A; Levy, Doug Researchers argue in today's Journal of the American Medical Association that marijuana should be legalized for prescription as a treatment for certain medical conditions. Marijuana has been known to alleviate nausea resulting from cancer treatments; appetite loss in AIDS patients; and pain from such diseases as multiple sclerosis. Dr. Lester Grinspoon of Harvard Medical School contends that cancer patients gain more relief from smoking marijuana than from taking a pill laced with THC, the active ingredient in marijuana. Despite the valid medical research on marijuana, the American Medical Association (AMA) is against its recreational use, says AMA spokesman Dr. Roy Schwarz. "AIDS Panel Lacks Drug Abuse Experts" New York Times (06/21/95) P. A18; Josepher, Howard President Clinton's new AIDS advisory panel lacks experts who represent substance-abusing populations, writes Howard Josepher, executive director of Arrive, in a letter to the editor published in the New York Times. More than 50 percent of all new AIDS cases in the past five years have been in substance users, he notes. In addition, HIV infection is increasing in women faster than among any other group, with the majority of infections coming from drug use or sexual intercourse with a drug user. If the President is serious about addressing the AIDS epidemic, he must include people who are knowledgeable about substance abuse, Josepher concludes. "Sensitization of T Cells to CD95-Mediated Apoptosis by HIV-1 Tat and gp120" Nature (06/08/95) Vol. 375, No. 6531, P. 497; Westendorp, Michael O.; Frank, Rainer; Ochsenbauer, Christina et al. The reduction of CD4 T cells in AIDS is associated with the rapid turnover of HIV-1 and apoptosis. Although the molecular mechanism of HIV-related apoptosis is unknown, T-cell apoptosis may be affected by viral proteins--such as HIV-1 Tat and gp120--and T-cell-receptor (TCR)-induced apoptosis was recently shown to involve the CD95 (APO-1/Fas) receptor. Westendorp et al. demonstrate that HIV-1 Tat strongly sensitizes TCR- and CD4(gp120)-induced cell death by upregulation of CD95 ligand expression. They observed that Tat concentrations that were effective in cultures of HIV-1-infected cells were also found in blood samples from HIV-infected patients. The findings suggest that HIV-1 Tat and gp120 hasten CD95-mediated, activation-induced T-cell apoptosis, a mechanism which may contribute to AIDS-related CD4 T-cell depletion. "Mixed-Strain Infection with a Drug-Sensitive and Multidrug-Resistant Strain of Mycobacterium tuberculosis" Lancet (06/10/95) Vol. 345, No. 8963, P. 1512; Theisen, A.; Reichel, C.; Rusch-Gerdes, S. et al. In a letter to the editor published in the Lancet, Theisen et al. present the case of a patient infected with two different strains of Mycobacterium tuberculosis, one drug-sensitive and one multidrug-resistant (MDR). After being diagnosed with M. tuberculosis, a 24-year-old Nepalese patient was administered quadruple therapy with isoniazid, rifampicin, ethambutol, and pyrazinamide. After 29 days, therapy with pyrazinamide was stopped because of substantial hepatoxicity. The sensitive strain was repeatedly cultured until day 57 of treatment, at which time the specimens tested negative. On day 100, a sputum sample was again positive for tuberculosis (TB), and was now resistant to rifampicin and isoniazid. DNA fingerprinting with the mixed-linker polymerase chain reaction (PCR) technique showed the isolate to be completely different from the initial drug-sensitive one. The patient improved significantly after being switched to triple therapy with pyrazinamide, ethambutol, and prothioamide. The researchers believe that the incidence of MDR TB was due to coinfection with two wholly different strains. They recommend repeated resistance testing, particularly in patients with delayed response to therapy and in those who come from high prevalence areas for MDR TB. "When Treatments Go Untried" AIDS Treatment News (06/02/95) No. 224, P. 5; Smith, Denny Potential AIDS treatments often go untried due to a lack of availability for millions of people, particularly in developing countries, writes Denny Smith in AIDS Treatment News. Other common reasons include lack of motivation, insufficient information, acceptance of the "terminal" prognosis, disinterested health care providers, and over-eager concerns about expense. Also, many people will not take the approved antiretrovirals--AZT, ddI, ddC, and D4T--because they have heard they are ineffective or even that they are "poison." These drugs can inhibit HIV progression to some extent, and also can cause some side effects. This subculture of misinformation is characterized by inconsistency. For example, some people who refuse to take AZT will take the other nucleosides--some of which have potentially more serious toxicities. A person should not be faulted for having legitimate doubts about drug toxicities, but a doctor's well-reasoned treatment approach should be considered more than a patchwork story from an evening newsmagazine. In general, there is a lack of a widely accepted, coherent HIV treatment strategy. Such problems should be solved with long-term plans that anticipate strategies that are created together by both HIV-infected people and the health professions, Smith concludes.