Date: Tue, 19 Sep 1995 13:16:43 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 09/19/95 AIDS Daily Summary September 19, 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 ************************************************************ "House Extends AIDS Law" "Immune Response, Thai Firm Set Pact on Vaccine for HIV" "New AIDS Drug Shows Promise, Merck Says" "AIDS Threat for 1 Percent of Burmese" "Thai Police Bust Two Members of AIDS-Thieves Gang" "AIDS Rapist Imprisoned 12 Years" "22,000 Take Part in AIDS Walk" "Cytomegalovirus Retinitis and Low CD4+ T-Lymphocyte Counts" "Resistance of Microorganisms to Disinfection in Dental and Medical Devices" "Opioid Use in HIV Patients with Neurological Changes" ************************************************************ "House Extends AIDS Law" New York Times (09/19/95) P. A18 The U.S. House of Representatives voted on Monday to extend the Ryan White CARE Act until the year 2000. The legislation provides funding for states, cities, and health care centers to help treat people with AIDS. The federal government will offer $633 million in grants under the law during fiscal 1995. In addition, the measure would also back state programs that require the HIV testing of infants. The Senate has already voted to continue the Ryan White CARE Act. Differences between the two versions must now be worked out in the final bill. Related Story: Washington Post (09/19) P. A6 "Immune Response, Thai Firm Set Pact on Vaccine for HIV" Wall Street Journal (09/19/95) P. B7 Immune Response Corp. has completed a deal worth up to $25 million with Thailand's Trinity Medical Group Co. to continue development of a potential HIV vaccine. It is estimated that Trinity will spend $10 million to test Immune Response's vaccine and may make a $15 million equity investment in the Carlsbad, Calif., company. The Ministry of Public Health in Thailand has authorized a one-year, placebo-controlled clinical trial in about 300 HIV-infected persons, Immune Response said. The trial is intended to "run in parallel" with clinical trials being conducted in the United States, including a proposed study of about 3,000 HIV-infected individuals that is now being considered by the U.S. Food and Drug Administration, a company spokesman said. "New AIDS Drug Shows Promise, Merck Says" Philadelphia Inquirer (09/19/95) P. A3; Collins, Huntly A study of 73 patients with advanced AIDS indicates that Merck & Co.'s protease inhibitor Crixivan is more potent than any previously developed AIDS drug, said the company's director of clinical research Dr. Ferdinand Massari on Monday. According to Merck researchers at the Interscience Conference on Antimicrobial Agents and Chemotherapy in San Francisco, the drug significantly reduced HIV levels in the patients' blood and raised the number of T-cells. In the study, Merck researchers compared Crixivan with AZT as well as a combination of the two drugs, and found that none of the patients taking only AZT had viral levels that could not be detected. After six months, 20 percent of the protease inhibitor group and 40 percent of the combination group had no detectable levels of HIV in their blood, while both groups also demonstrated a 40 percent to 75 percent increase in T-cells, the scientists said. "AIDS Threat for 1 Percent of Burmese" Financial Times (09/19/95) P. 6; Bardacke, Ted The World Health Organization (WHO) estimates that at least 400,000, or 1 percent, of Burma's citizens are infected with the virus that causes AIDS. Several social factors make Burmese citizens vulnerable to HIV, including a high number of injection drug users, social tolerance of prostitution, and large amounts of cross-border trade with nearby nations, said the WHO's D.J. Goodwin, who also noted that condoms are costly and rare in Burma. Some AIDS prevention organizations used the WHO's alarming statistics, which were presented at an international conference on AIDS in Asia and the Pacific, to urge the international community to end a ban on foreign aid to the country, particularly humanitarian assistance. "Thai Police Bust Two Members of AIDS-Thieves Gang" Reuters (09/19/95) Two Bangkok men accused of committing robberies by threatening to stab others with needles containing HIV-infected blood have been arrested, Thai authorities report. The two young men were arrested in a Bangkok shopping center on Monday, soon after robbing a man, the police said. The police believe the men are members of a gang that has committed several robberies of shopping centers and department stores using blood-filled syringes. It is not yet known whether the syringes actually contained HIV-tainted blood or not. "AIDS Rapist Imprisoned 12 Years" Toronto Globe and Mail (09/18/95) P. C4; Claridge, Thomas Charles Winn, an HIV-infected man who confessed to risking a woman's life by raping her, has been sentenced by a Canadian court to 12 years in jail. Mr. Justice David Fairgrieve of the Ontario Court's Provincial Division said it was "difficult to envisage a more dangerous threat than an unrestrained, unrehabilitated, HIV-positive rapist," when explaining why he dismissed a joint request for a seven-year sentence. During the trial, in which Winn pleaded guilty to one charge of sexual assault, he acknowledged that he had beaten the woman in the head and face while raping her. Judge Fairgrieve also said Winn had confessed to risking the woman's life "both by ejaculating into her mouth and into an open facial wound caused by him and by ejaculating inside her vagina during the act of forced sexual intercourse." "22,000 Take Part in AIDS Walk" Los Angeles Times (09/18/95) P. B1; Leeds, Jeff Twenty-two thousand people flooded the streets of Hollywood on Sunday for AIDS Walk Los Angeles, an annual event which is expected to generate $3.2 million this year for local AIDS programs. According to organizers, attendance in the 10-kilometer event has increased every year since it began ten years ago. AIDS Walk Los Angeles, now California's largest AIDS fundraiser, has inspired similar benefits in San Francisco, New York, and other cities. "Cytomegalovirus Retinitis and Low CD4+ T-Lymphocyte Counts" New England Journal of Medicine (09/07/95) Vol. 333, No. 10, P. 670; Baldassano, Vincent; Dunn, James P.; Feinberg, Judith et al. A total of 62 HIV-infected patients with CD4 T-lymphocyte counts below 100 were examined before entry into a study on the prevention of cytomegalovirus (CMV)-induced end-organ disease, report Johns Hopkins University's Baldassano et al. in a letter to the editor of the New England Journal of Medicine. Fifty-three patients had CD4 levels below 50, including seven who had CMV retinitis. Of these seven--the only ones out of the total 62 to have CMV retinitis--three had bilateral retinitis and four had disease that was immediately sight-threatening. According to the researchers, the findings suggest that undiagnosed CMV retinitis is common enough to justify the routine screening of persons with CD4 counts under 50. "Resistance of Microorganisms to Disinfection in Dental and Medical Devices" Nature Medicine (09/95) Vol. 1, No. 9, P. 956; Lewis, David L.; Arens, Max Although the U.S. Centers for Disease Control and Prevention advises that only heat sterilization be used for all reusable devices entering the oral cavity, chemical disinfection is still widely used for reprocessing dental equipment in many parts of the world. Lewis and Arens assessed the role of lubricants in high-level chemical disinfection procedures and that of some equipment in disease transmission. The authors report in the journal Nature Medicine that HIV in whole-blood samples and Pseudomonas aeruginosa in blood and plasma survived high-level disinfection when lodged in lubricants used in dental equipment and medical equipment called endoscopes. In addition, prophylaxis angles--devices which are used to clean and polish teeth--exhibited the potential to carry enough blood-contaminated saliva to infect human lymphocyte cultures with HIV. Lewis and Aren's findings highlight the need to heat-sterilize reusable dental devices, although high-level chemical disinfection is still advised for endoscopes. "Opioid Use in HIV Patients with Neurological Changes" Journal of the Association of Nurses in AIDS Care (07/95-08/95) Vol. 6, No. 4, P. 28; Paice, Judith A.; Pugliese, Janet C.; Fitzpatrick, Joyce E. Paice et al. discuss the complex issue of pain in people with HIV or AIDS. It is often difficult or impossible to diagnose and treat the pain. The matter is further complicated by the neurological shifts that frequently occur in HIV infection. Although the use of opioids is often connected with these neurological events, there is no evidence that HIV patients are more likely to experience cognitive changes related to opioids than other groups, such as people with cancer. Opioid antagonists, meanwhile, are particularly effective when opioid use causes respiratory depression. However, inappropriate use of the commonly-used antagonist naloxone can induce a withdrawal syndrome and a recurrence of extreme pain.