Date: Thu, 18 May 1995 09:25:51 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary May 18, 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 ************************************************************ "Measure Seeks to Bar H.I.V.-Positive Troops" "Health and Foreign Policy Agencies Brace for Budget Ax" "Syringe-Trade Fights AIDS" "When AIDS Testing Collides with Confidentiality" "Across the USA: Texas" "Blood Warning Not Given" "Millionaire Faced Humiliation, Trial Told" "Emergence of Flouroquinolone-Resistant Tuberculosis in New York City" "Immunological and Virological Markers in HIV Infection" "Red Hot Organization Plans Five New Anti-AIDS Efforts" ************************************************************ "Measure Seeks to Bar H.I.V.-Positive Troops" New York Times (05/18/95) P. B13; Schmitt, Eric House Republicans are expected to introduce legislation today to discharge more than 1,200 members of the military who are considered fit for duty, but have tested HIV-positive. Infected recruits are prohibited from enlisting, according to Department of Defense policy. However, HIV-infected troops who are already in the military are allowed to serve in the United States as long as they are physically able. They are barred from deployment overseas, a restriction which the Pentagon says is to guarantee the best medical monitoring of their illness. Rep. Robert K. Dornan (R-Calif.), who strongly opposes the presence of homosexuals in the armed services, now intends to add a new restriction when the House National Security Subcommittee on Military Personnel--which he heads--considers its portion of the Pentagon budget for fiscal 1996. Rep. Dornan would require an honorable discharge within six months of an HIV diagnosis. He and other Republicans claim that to preserve military readiness at a time when the armed services are reducing their numbers, the Pentagon should only keep people who are able to serve worldwide. Related Stories: Washington Times (05/18) P. A10; Baltimore Sun (05/18) P. 14A "Health and Foreign Policy Agencies Brace for Budget Ax" Washington Post (05/18/95) P. A29; Suplee, Curt Harold Varmus, director of the National Institutes of Health (NIH) said on Wednesday that Congressional plans to reduce NIH's budget by 5 percent to 10 percent and to freeze funding into the next century would devastate the world's foremost biomedical research institution. The House Budget Committee's plan would reduce by $566 million the fiscal 1996 budget. The Senate Budget Committee assumes a $1.13 billion, or 10 percent, budget cut. The Senate bill also stipulates that no reductions can be made in AIDS- and HIV-related research, which is currently about 12 percent of total NIH expenditures. The most significant immediate effect of the budget cuts would be to NIH's "extramural" research grants, which include funding for clinical tests of new drugs or disease treatments and account for 85 percent of the annual budget. "Syringe-Trade Fights AIDS" Baltimore Sun (05/18/95) P. 1A; Sugg, Diana K. After nine months, the Baltimore City Health Department's Needle Exchange Program has attracted about 2,300 people--almost five times more than expected for the first 12 months. Based on these results, city Health Commissioner Dr. Peter Beilenson wants to double the number of sites and people served, if the funding is available. Police, residents, and drug users say the exchange program has reduced the number of syringes on the sidewalks and addicts on the corners. A scientific study found that injection drug users are now sharing half as many needles, thus reducing the risk of spreading HIV. The premise of the program is that making needles readily available keeps addicts from spreading HIV and other infectious diseases. Needle exchange workers counsel people who come to the exchange about AIDS and not sharing needles. The users are also encouraged to be tested for HIV, which can be done at the exchange site. "When AIDS Testing Collides with Confidentiality" New York Times (05/18/95) P. B4; Purnick, Joyce Last week, the Clinton Administration canceled a seven-year program to anonymously test newborns for HIV. The decision was made by top Administration officials in Washington, despite some disagreement at the Centers for Disease Control and Prevention in Atlanta. Secretary of Health and Human Services Donna E. Shalala says the move was not political. "We thought there was a serious question about collecting information about which we didn't inform parents," she explains. The solution is not simple. Almost three-quarters of the infants who test positive do not have HIV; they carry their mother's antibodies only temporarily. Every mother whose baby tests positive, however, is HIV-positive. In effect, the baby is testing the mother and this is where politics and policy collide. "You can't tamper with confidentiality laws because there is such strong opposition from AIDS activists," says Assemblywoman Nettie Mayersohn of Queens, who has been pushing a mandatory testing and notification bill for New York State for three years. Shalala says her goal is to get all pregnant women in the United States prenatal care and testing, and all information possible about their babies. "Across the USA: Texas" USA Today (05/18/95) P. 10A Robert Swinea of Houston, Texas, is suing health providers in Kansas City, Mo., for $9.1 million after receiving a false HIV diagnosis. "He thought he was dying for two years," his attorney says. Swinea, who was then attending school in Missouri, said the doctors never tested him before prescribing AZT. "Blood Warning Not Given" Toronto Globe and Mail (05/17/95) P. A7 In 1985, the Canadian Red Cross (CRC) did not warn hemophiliacs that they had been given potentially HIV-infected blood from San Francisco because the CRC believed that shipment of blood had already been used, an inquiry heard on Tuesday. The inquiry, which is trying to determine how more than 1,000 hemophiliacs and transfusion recipients contracted HIV, is headed by Mr. Justice Horace Krever of the Ontario Court of Appeals. Hemophiliacs in Toronto, Ottawa, Hamilton, and London, Ont. were given the risky blood, which was stored in their freezers and injected as a clotting agent if the patients cut themselves. The CRC recalled the blood after the laboratory which supplied the blood warned the agency about three bad batches in January 1985. The hemophiliacs were never contacted directly, and only 208 of the 3,326 infected vials that had been distributed were returned. "Millionaire Faced Humiliation, Trial Told" Toronto Globe and Mail (05/17/95) P. A3; Feschuk, Scott An Edmonton millionaire testified on Tuesday that just days after photographer Conrad Boland learned he was infected with HIV, Boland threatened to publicize love letters from the millionaire to Marilyn Tan--who is charged with injecting Boland with tainted blood--unless he tried to persuade her to drop a lawsuit. Bruce Samson said that Boland was furious that Tan, his long-time lover, was suing him for a portion of his portrait studio. Samson said that although he agreed to speak with Tan, she refused to listen to him. An infectious diseases expert also testified that Boland likely contracted HIV around the time Tan is supposed to have injected him. He said that testimony from one of Boland's former workers indicates that Boland fell ill with diarrhea, swollen glands, and headaches in July 1992. Approximately half of HIV-infected people tend to show similar symptoms within four to eight weeks, the expert said. He added, however, that is was "very unlikely" that any of the virus could have survived after Tan's vials of contaminated blood were broken. "Emergence of Flouroquinolone-Resistant Tuberculosis in New York City" Lancet (05/06/95) Vol. 345, No. 8958, P. 1148; Sullivan, Elizabeth A.; Kreiswirth, Barry N.; Palumbo, Lucille et al. Sullivan et al. identified 22 patients infected with flouroquinolone-resistant Mycobacterium tuberculosis in New York City between January 1991 and November 1993. A total of 16 patients became resistant due to inadequate or inappropriate treatment. All patients with acquired resistance had been receiving at least three anti-tuberculosis drugs during the period when resistance emerged. Six patients had primary infection with flouroquinolone-resistant organisms and five acquired the organisms nosocomially. The researchers identified seven different patterns of restriction-fragment length polymorphism (RFLP) in 21 subjects. Twelve patients were infected with the same strain--one that is resistant to a number of drugs including isoniazid, rifampicin, streptomycin, and ethambutol. The researchers recommend that flouroquinolone, like other anti-tuberculosis drugs, be used as part of a multidrug regimen. To prevent the emergence of flouroquinolone-resistant tuberculosis, health care workers should ensure than all patients with multidrug-resistant tuberculosis are on directly observed therapy. "Immunological and Virological Markers in HIV Infection" AIDS Clinical Care (05/95) Vol. 7, No. 5, P. 1; Vella, Stefano Quantitative measures of CD4 lymphocytes in peripheral blood are still seen as the most reliable markers of HIV progression and the closest markers of AIDS progression and survival. Several studies, however, now show that CD4 levels are weak markers of drug activity and clinical efficacy. To be of value, marker candidates should have clear pathological association with HIV disease; have a role in the natural history of HIV infection; be measurable in the majority of patients; change as the patients worsens or improves; and change quantitatively with successful therapeutic intervention. To date, these criteria have not been fulfilled by any immunological or virological markers, including the p24 capture ELISA essay. Although p24 is an easily measurable marker whose decline may indicate in vivo antiviral activity by antiretroviral drugs, it has significant problems of sensitivity and specificity. None of the available markers have been accepted as a primary endpoint in clinical tests by most drug regulatory authorities. HIV-1 RNA quantitation is of interest as a virological marker in part because of the need for faster evaluation of treatments and the ability to reach conclusions about a regimen without having to wait for survival or progression differences. Thus far, it has only been included as a clinical endpoint in a few controlled trials. Eventually, HIV-1 RNA quantitation may be useful in treat/wait decisions, in evaluating drug responses, and in determining when changes in treatment are needed. "Red Hot Organization Plans Five New Anti-AIDS Efforts" Billboard (05/13/95) Vol. 107, No. 19, P. 12; Reynolds, J.R. The Red Hot Organization, which recently issued more than $1 million in new grants for AIDS education and relief, has announced plans for five new projects. To date, the organization has issued more than $5 million in grants from funds raised from its various recording and video projects. The most recent $1 million was from Arista's modern rock compilation "No Alternative," which features Nirvana, Soul Asylum, and Smashing Pumpkins. A total of $768,000 of the album's proceeds went to the American Foundation for AIDS Research (AmFAR). AmFAR administrates and distributes the Red Hot funds to various AIDS charities. Red Hot creates generically themed projects that combine elements from music, film, and other arts that entertain and convey AIDS information in ways that are appropriate and meaningful to specific communities.