Date: Thu, 5 Dec 1996 10:09:30 -0500 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 12/05/96 AIDS Daily Summary December 5, 1996 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 National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD ****************************************************** "SyStemix Therapy for HIV Is Cleared for Tests in Humans" "Across the USA: Florida" "Medicinal Marijuana Brings Legal Headache" "HIV Donors' Names Ordered Released" "Science & Health Bulletin: Zimbabwe--Condoms" "Sudan--Health: Religious Leaders Oppose AIDS [Education]" "Science & Health Bulletin: Kenya Says [AIDS Rate Is Declining]" "New Approaches Reduce Perinatal Transmission" "The Role of a Mutant CCR5 Allele in HIV-1 Transmission and Disease Progression" "HIV Risk Behaviors and Obstacles to Condom Use Among Puerto Rican Men in New York City Who Have Sex With Men" ****************************************************** "SyStemix Therapy for HIV Is Cleared for Tests in Humans" Wall Street Journal (12/05/96) P. B6 SyStemix's gene therapy to treat HIV infection has received approval from the Food and Drug Administration for human clinical trials, the company announced. The therapy involves removing a patient's stem cells, treating them with a gene engineered to resist HIV, and reinjecting the cells with the hope that they will reproduce and limit the spread of the virus. The approach is unlike previous gene therapy attempts in that it uses stem cells. The trial, a cooperative effort with Sandoz Pharmaceuticals, will start early next year. "Across the USA: Florida" USA Today (12/05/96) P. 11A Florida officials reports that the names of state residents who test positive for HIV will not be collected for at least six months, due to concerns about confidentiality. "Medicinal Marijuana Brings Legal Headache" Washington Post (12/05/96) P. A1; Claiborne, William; Suro, Roberto New laws in California and Arizona that allow the medical use of marijuana are creating conflicts for drug officials, who have been meeting in Washington this week to determine how to enforce the measures. Advocates of the new laws are concerned that the measures could lose public support as some activists call for legalization of the drug. State officials are struggling to enforce federal anti-drug laws, while the new state laws say the use of illegal drugs is justified by medical necessity. For example, in California only the recommendation of a doctor is required for anyone to possess marijuana. The law allows doctors to recommend the drug for patients with cancer, AIDS, anorexia, chronic pain, or "any other illness for which marijuana provides relief." The drug is widely used by people with HIV to stimulate appetite and battle weight loss. Some experts say marijuana may suppress the immune system, however, and that chemicals in the smoke could be dangerous. "HIV Donors' Names Ordered Released" Toronto Globe and Mail (12/03/96) P. A8; Downey, Donn Despite objections by the Canadian AIDS Society, the Ontario Court of Appeals ruled Monday that the names of 13 HIV-positive men who donated blood in 1984 and 1985 should be disclosed. The judge held that the greater public interest was served by the disclosure. Although the ruling called for the release of the names within 24 hours, a lawyer for the AIDS society said he would ask for a delay while the society weighs whether to appeal the decision to the Supreme Court of Canada. The society had claimed that the release of the names would discourage people from seeking voluntary HIV testing. "Science & Health Bulletin: Zimbabwe--Condoms" PANA Wire Service (12/04/96) Female condoms will become available in Zimbabwe in April or May of 1997, AIDS policy officials report. The British Overseas Development Administration and the U.S. Agency for International Development will help to provide the condom at a subsidized price. The sale of the female condom was approved in Zimbabwe in November, after 30,000 women petitioned the government for a method to protect themselves from HIV and other diseases. Of the 10.5 million residents in Zimbabwe, an estimated 1 million people are infected with HIV. "Sudan--Health: Religious Leaders Oppose AIDS [Education]" IPS Wire (12/04/96) AIDS awareness programs in Sudan have been halted by conservative religious leaders, frustrating efforts by health officials to fight the epidemic. Dr. Tajani Abdalla, head of Sudan's National Laboratory, said AIDS programs "have failed and will continue to fail, not because of funds, but because of the attitudes of the people." Islamic religious leaders, who believe that "Allah can cure AIDS," have repeatedly led opposition to AIDS education programs. In 1995, an estimated 7,000 Sudanese were reportedly infected with HIV, but the actual number is expected be much higher. The Islamic government has outlawed sex education through the media since 1993, and has also restricted the importation of condoms. "Science & Health Bulletin: Kenya Says [AIDS Rate Is Declining]" PANA Wire Service (12/04/96); Masebu, Peter Health officials in Kenya have announced that the government's AIDS campaign has effectively slowed the spread of the disease in some parts of the country. Joshua Angatia, Kenya's health minister, reported that about 200,000 people had died from AIDS since 1994 and that an estimated 1.2 million people were currently infected with HIV. He also announced that the government was developing a national policy to deal with the social cultural factors that influence HIV transmission. "New Approaches Reduce Perinatal Transmission" AIDS Alert (11/96) Vol. 11, No. 11, P. 127 To further reduce the rate of perinatal HIV transmission, researchers are testing new treatment methods, including more rapid delivery, shorter courses of zidovudine (AZT), and the combination of AZT and other drugs. Since 1994, when AZT was found to reduce transmission rates by two-thirds, the rate of perinatal transmission has declined from an average of 21 percent to 10 percent. Dr. Yvonne Bryson, of the University of California at Los Angeles, says that transmission may be further reduced to less than 2 percent. A trial combining AZT and the drug HIVIG, anti-HIV immune serum globulin, will be completed in two years. "What we are anticipating is a further reduction in the transmission rate, from that of 8 percent with AZT to something that we hope would approach zero," said David Gury, of North American Biologicals. Preliminary results from the study indicate that antigen levels were reduced to zero within 24 hours. Researchers are also evaluating the safety and efficacy of new antiretroviral drugs for the prevention of perinatal transmission. Many issues related to perinatal transmission--including the impact of viral load, childbirth conditions, and breastfeeding--are also being examined. "The Role of a Mutant CCR5 Allele in HIV-1 Transmission and Disease Progression" Nature Medicine (11/96) Vol. 2, No. 11, P. 1240; Huang, Yaoxing; Paxton, William A.; Wolinksy, Steven M.; et al. To infect CD4 cells, most sexually transmitted strains of HIV-1 require the Beta-chemokine receptor 5 (CCR-5) to act as a co-receptor. It has been shown that individuals with a homozygous defect in the CCR-5 gene are virtually resistant to HIV-1 infection despite repeated exposures. Further study has also suggested that heterozygotes could be better able to survive infection than individuals without the defect. David D. Ho, of the Aaron Diamond AIDS Research Center, and colleagues, analyzed the CCR-5 genotype of 1,252 homosexual men to evaluate the impact of the gene on HIV-1 transmission and disease progression. They report that, while none of the HIV-positive participants were homozygous for the defect, 3.6 percent of the uninfected Caucasian men in the study were homozygous. Heterozygotes did not appear to have any protection from HIV-1 infection, but the authors say this group did seem to have some protection from disease progression. "HIV Risk Behaviors and Obstacles to Condom Use Among Puerto Rican Men in New York City Who Have Sex With Men" American Journal of Public Health (11/96) Vol. 86, No. 11, P. 1619; Carballo-Dieguez, Alex; Dolezal, Curtis Little research has been conducted to determine what barriers to condom use exist for minority men, especially Latino men, who have sex with other men. To explore this area further, Alex Carballo-Dieguez and Curtis Dolezal of Columbia University interviewed 182 Puerto Rican men living in New York City who are homosexual or bisexual. They report that, among half the men who engage in anal sex with other men, condoms were used inconsistently or not at all. Similar condom use was reported by two-thirds of the men who had vaginal sex, and by three-fifths of the men who had anal sex with women. Most of the men reported having unprotected oral sex and more than one sexual partner during the previous year. Thirty percent of the men were HIV-positive. The reason cited most often for not using condoms was dislike or discomfort, followed by perceived low risk, trusting and being emotionally connected to one's partner, unavailability of condoms or inconvenience, lack of control, and indifference. In conclusion, the researchers note the need for other HIV protection methods, such as a microbicidal gel.