Date: Thu, 4 Jan 1996 09:31:17 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 01/04/96 AIDS Daily Summary January 4, 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 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 1996, Information, Inc., Bethesda, MD ************************************************************ "Transplant Patient Going Home" "Judge Throws Out Lawsuit Alleging Fraud by Coram" "City's Free Female Condoms Popular, Appearance Aside" "Hospice Program to Serve Homeless Man with AIDS" "'Positive' in the Face of Living with HIV" "The Safe Thalidomide" "'Gross Underestimation' of Occupational HIV Infection" "HIV in the Over-50s in South London" "Healthcare Needs of HIV-Infected Persons in Hospital, Outpatient, Home, and Long-Term Care Settings" "Predictions: New Drugs in the War on AIDS" ************************************************************ "Transplant Patient Going Home" Washington Post (01/04/96) P. A3 Jeff Getty, the AIDS patient who was injected with baboon bone marrow on Dec. 14, will be released from San Francisco General Hospital today. According to hospital spokeswoman Alice Trinkl, Getty has made good progress in recovering from the pioneering operation and "is doing fine." Trinkl added that it may be some weeks before doctors know if the procedure was successful in boosting Getty's immune system to help it fight the disease. Related Stories: New York Times (01/04) P. A3; USA Today (01/04) P. 1D "Judge Throws Out Lawsuit Alleging Fraud by Coram" Wall Street Journal (01/04/96) P. B5 A federal judge in Chicago threw out a lawsuit by Caremark International, alleging that Coram Healthcare Inc. fraudulently concealed its plan to acquire Lincare Holdings Inc. The suit is related to Coram's acquisition of Caremark's home-infusion business for $309 million last April. Coram first brought a suit in September, claiming that Caremark had overstated the value of the business and did not reveal the scope of a federal probe of the business. In June, Caremark admitted to mail fraud charges and agreed to pay $161 million in penalties and civil damages. Related Story: New York Times (01/04) P. D2 "City's Free Female Condoms Popular, Appearance Aside" Philadelphia Inquirer (01/04/96) P. A1; McCullough, Marie The Philadelphia Department of Public Health has given away 80,000 female condoms in the last five months, despite their unattractive appearance. The condom give-away is part of the city's campaign against sexually transmitted diseases and unwanted pregnancies. The condoms, lubricated polyurethane sheaths with rings at both ends, are distributed at health centers, family-planning clinics, and community groups. Reality, the female condom from Female Health Co. in Chicago, has been on the market for about 18 months. The female condom is especially popular because it allows women to protect themselves, it can be put on in advance, and is more comfortable than male condoms. "Hospice Program to Serve Homeless Man with AIDS" Philadelphia Inquirer (01/04/96) P. B2 The Good Shepherd Program at St. John's Hospice, a service that provides residential care for as many as 11 homeless men in Philadelphia who have AIDS or any another serious illness, will be formally dedicated on Friday by Cardinal Anthony Bevilacqua. The Archdiocese of Philadelphia said that the program has been open since December and already has six members. Under the program, the men will receive safe transitional housing, medical care, and life skills to prepare them for more permanent residences. "'Positive' in the Face of Living with HIV" USA Today (01/04/96) P. 8D; Roush, Matt "Positive: Life with HIV" is a four-hour cultural documentary that discusses the possibilities and varieties of life for people affected by HIV. The program, which will air on PBS, is upbeat, combining poetry, comedy, performance art, and dance, but also deals openly with such emotions as despair and anger. The first part of the program, titled "Community," focuses primarily on a group house in Harlem. The second portion, "Identity," features an Oklahoma married couple who discuss being shunned at numerous churches. Each of the program's four hours combine humor, sorrow, and candid self-expression to show the human side of the disease. "The Safe Thalidomide" New York Times (01/03/96) P. A14; Shaw, C. Frank According to C. Frank Shaw, professor of chemistry at the University of Wisconsin, a recent New York Times article on the resurgence of thalidomide failed to mention an important factor. Shaw notes in a letter to the editor of the Times that the version of the drug that caused birth defects in the 1950s and 1960s was made up of two molecules that are identical, yet mirror images of each other. Only one of these forms of thalidomide is teratogenic and produces birth defects. New technology enables the preparation of only the less-toxic, left-handed structure, so that the right-handed thalidomide molecule can be left out of current drugs. In conclusion, Shaw states that knowing the distinctions of thalidomide's molecular structure and their implications may help alleviate both concerns of new patients and disgust in earlier patients. "'Gross Underestimation' of Occupational HIV Infection" AIDS Alert (01/96) Vol. 11, No. 1, P. 5 Many health care workers say that the true number of occupational HIV seroconversions is greatly underreported, but federal officials claim there is no way to obtain more accurate figures. Patricia Fleming, chief of the reporting and analysis division of the Centers for Disease Control and Prevention's (CDC's) surveillance branch, notes that the agency has collected data on infected health care workers since the beginning of the epidemic. Reporting, however, is not required. The CDC therefore keeps two lists of HIV-positive health care workers--one for documented instances of occupational transmission and a second for possible cases of such transmission. Currently, there are 46 documented cases and 97 probable cases, compared to 33 documented and 69 possible cases as of 1992. Fleming and other CDC officers admit that this method of transmission is underreported, but claim they can do nothing because reporting is voluntary and is frequently hampered by litigation and confidentiality concerns. "We can conduct follow-up investigations, but sometimes people don't want to cooperate," Fleming explained. Jamie Cohen, of the Service Employees International Union, also said that the low number of reported cases "reduces the level of action needed by manufacturers to eliminate inherently dangerous devices from the market and by health care facilities to buy only safer devices." "HIV in the Over-50s in South London" Lancet (12/16/95) Vol. 346, No. 8990, P. 1639; Drobniewski, F.A. ; Irish, D.; Poddar, J.; et al. To determine the incidence of HIV-1 infection among senior citizens, British scientists studied more than 1300 men and women over the age of 50 for a period of 18 months. Among the males, the general rate of infection was 1.4 percent, with the greatest percentage found in the 50-59 group as compared to the 60-74 and 75 years plus age-bands. The highest rate of infection in the women was also found in the 50-59 age group--1.1 percent, though no other infections were found so the overall average was therefore 0.35 percent. Because nearly 5 percent of the men undergoing voluntary HIV-1 testing from 1985 and 1994 were seropositive, and more than 3 percent of the sick 50- to 59-year-old males and 0.3 percent of the 60- to 74-year-old men tested HIV-1 positive, the researchers suggest that doctors bear HIV-1 infection in mind when dealing with older men, especially those with respiratory illnesses. "Healthcare Needs of HIV-Infected Persons in Hospital, Outpatient, Home, and Long-Term Care Settings" Journal of the Association of Nurses in AIDS Care (11/95-12/95) Vol. 6, No. 6, P. 21; Baigis-Smith, Judith; Gordon, Dorothy; McGuire, Deborah B.; et al. Baigis-Smith et al. conducted a three-year study to identify and describe the healthcare needs of HIV-positive individuals in the four primary care settings. Patients' needs were assessed using an adaptation of the Community Health Intensity Rating Scale, called the Healthcare Needs Scale for Patients with HIV/AIDS, that measures the multidimensional healthcare needs created by the disease process. The representative sample included 386 patients in hospitals, outpatient clinics, long-term care facilities, and their own homes. As a whole, the patients were most concerned about their finances. More than 50 percent of all participants were worried about a lack of income or financial resources, and some 48 percent voiced concerns about employment problems. In addition, one-fifth of the respondents said that the family process--that is, family's and friends' inability to adapt to the demands of the disease, which then affected the patient's health--was a significant problem. Twenty percent also said that sleep problems interfered with or made it impossible for them to conduct their normal activities. Overall, the percentage of patients reporting needs on any of the 24 items listed in the survey was greater in the hospital and outpatient settings than in other settings, and a greater proportion of patients reporting long-term care needs were in home care. "Predictions: New Drugs in the War on AIDS" U.S. News & World Report (12/25/95-01/01/96) Vol. 119, No. 25, P. 80; Fauci, Anthony In U.S. News & World Report, Anthony Fauci--head of the National Institute of Allergy and Infectious Diseases--predicts that in 1996, "there will be an explosion of new research on the body's natural ability to block HIV replication." Many researchers, he says, will be investigating chemokines, natural substances made by the body's cells that were recently identified after years of research. In addition, combination drug therapies will play a large role. The newly approved drugs 3TC and saquinavir will be used in several studies in early HIV infection. Fauci further predicts that new data will be released on the benefits of starting drug therapy when HIV infection is realized. Although an AIDS vaccine will not be discovered in 1996, Fauci concludes that "we'll gain increments of knowledge that will bring us closer."