Date: Fri, 28 Jun 1996 13:02:01 -0400 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 06/28/96 AIDS Daily Summary June 28, 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 ****************************************************** "AMA Backs Mandatory HIV Testing of Pregnant Women and Newborns" "FDA Clears Drug to Treat Blindness in AIDS Patients" "New Blood Treatment May Help Fight AIDS" "Doctors Discover New Worm, One That's Lethal to Humans" "HIV Infections on the Rise in Japan" "STD Expert Says CDC's Gonorrhea Guidelines Are Outdated" "Restricted Expression of KS-Associated HHV8 Found in KS Tissue" "Bacterial Infections Associated With HIV-Related Oral Lesions" "Test Case" "Public Spending on AIDS" ****************************************************** "AMA Backs Mandatory HIV Testing of Pregnant Women and Newborns" Washington Post (06/28/96) P. A2 In a surprising reversal on a controversial issue, the American Medical Association announced Thursday the organization's endorsement of mandatory HIV testing for all pregnant women and newborns. The group had advocated voluntary testing because doctors did not have the tools to treat pregnant women with HIV. This changed, however, with the discovery that AZT can markedly reduce the risk of transmitting the virus to the child. Opponents to mandatory testing, including AIDS activists, civil libertarians, and some mothers, argued that testing would lead to discrimination. Many doctors also argued that mandatory testing would drive the women most at risk away from medical care. The AMA's decision does not carry legal weight, but the group's policies do influence lawmakers. "FDA Clears Drug to Treat Blindness in AIDS Patients" Wall Street Journal (06/28/96) P. B3 The Food and Drug Administration has approved Gilead Sciences' drug Vistide as a treatment for cytomegalovirus, a virus that causes blindness in AIDS patients. The drug is Gilead's first commercial product. Analysts have predicted that the approval could lead to approximately $45 million of sales over the next year. Gilead, which has been investing heavily in research and development, had a net loss of $10.8 million, or 42 cents a share, on sales of $779,000 in the first quarter. The company's stock rose 75 cents, to $23.75, in Nasdaq Stock Market trading. "New Blood Treatment May Help Fight AIDS" Washington Times (06/28/96) P. A3 Researchers at the Naval Medical Research Center reported Thursday that a new preliminary experiment has allowed them to produce a large number of immune cells that seem to resist HIV in the laboratory. Carl June and colleagues report their results in today's issue of the journal Science. Human trials of the method, which uses monoclonal antibodies to treat the isolated CD4 cells, may start in the next few months. After treatment, the cells resisted HIV when exposed to it in the test tube. In the clinical trials, researchers will take blood from patients, treat it with the antibodies, and return it to the patient's bloodstream. "Doctors Discover New Worm, One That's Lethal to Humans" New York Times (06/28/96) P. A18; Altman, Lawrence K. A new worm, similar to a tapeworm, but more dangerous and potentially deadly to humans, has been identified by doctors. Parts of the worm were found in an AIDS patient a year after he died from the infestation. Doctors had identified the man's cause of death as an AIDS-related cancer, but later found the large mass of tissue believed to be cancer was caused by the worm's rapid growth. Researchers at Stanford University and the Kaiser-Permanente Medical Center in Santa Clara, Calif., reported their discovery in the journal Lancet, warning doctors so that they can better treat patients. They do not know whether the man's AIDS-weakened immune system had any effect on the course of the infestation. "HIV Infections on the Rise in Japan" Reuters (06/27/96) The Japanese Ministry of Health and Welfare, AIDS Surveillance Committee reported that 112 new cases of HIV were documented in the country between March and April of this year. Among the new infections, 74 were among Japanese citizens, 53 resulted from heterosexual activity, 21 were related to homosexual contact, two were the result of perinatal transmission, and one case was attributed to intravenous drug use. Two cases were believed to be caused by the transfusion of HIV-tainted blood. Since HIV-antibody testing was implemented for blood donations in 1986, no other transfusion-related HIV infections have been reported. "STD Expert Says CDC's Gonorrhea Guidelines Are Outdated" Reuters (06/27/96) The Centers for Disease Control and Prevention should update guidelines for treating patients with gonorrhea, Sharon Safrin, coordinator of the STD/HIV Prevention Training Center at San Francisco General Hospital, reports in the June 15 issue of Internal Medicine News. She said the three-year-old guidelines, which recommend ciprofloxacin and ofloxacin as first-line agents against Neisseria gonorrhoea, are outdated. Resistance to these drugs has developed and been reported worldwide. Safrin says resistance has not been a problem with two other drugs recommended in 1993, ceftriaxone and cefixime. "Restricted Expression of KS-Associated HHV8 Found in KS Tissue" Reuters (06/27/96) Kaposi's sarcoma (KS)-associated herpesvirus (KSHV), or human herpesvirus 8 (HHV-8), has been implicated in the disease. Don Ganem and colleagues at the University of California at San Francisco have studied the pattern of KSHV/HHV-8 gene expression in KS tissue, and found that most infected cells in KS are latently infected, with lytic viral replication restricted. These findings suggest that the currently available antiviral drugs for KS, such as acyclovir, are not the most effective because they target the lytic replication cycle. "Bacterial Infections Associated With HIV-Related Oral Lesions" Reuters (06/27/96) The most common bacterial infections in the oral cavity in HIV patients are necrotizing ulcerative gingivitis, periodontitis, and linear gingival erythema, John S. Greenspan and colleagues at the University of California at San Francisco report. The review of diagnosis and management of oral lesions was published in the June issue of the Journal of Respiratory Diseases. Because antibacterial drugs can disturb the normal balance between bacteria and fungi in the oral cavity, antifungal medications may be added to treatment. Greenspan estimates that about 10 percent of HIV patients have necrotizing gingivitis. "Test Case" Advocate (06/25/96) No. 710, P. 33; Moss, J. Jennings When Congress reauthorized the Ryan White CARE Act in May, it included a controversial provision to require HIV testing of newborns by the year 2000 under certain conditions. AIDS activists hope the conditions will keep the mandate from being implemented but say they fear that the provision's passage will lead to more mandatory testing. R. Scott Hitt, chairman of President Clinton's Advisory Council on HIV/AIDS, says that testing of newborns could lead to more widespread testing, but that the reason for mandating testing is well-intentioned. The argument behind mandatory testing for infants is based on studies showing that AZT treatment can reverse a newborn's HIV status. Rep. Gary Ackerman (D-N.Y.), a supporter of mandatory testing for newborns, says that widespread mandatory testing will not necessarily result from the measure. However, Rep. Tom Coburn (R-Okla.), says large-scale testing is his goal. Before mandatory testing of infants is implemented, the government will spend $10 million helping states encourage pregnant women to be tested voluntarily while tracking the rate of perinatal transmission by state. Depending on their success at reducing transmission by the turn of the century, the states might then have to implement mandatory newborn testing. "Public Spending on AIDS" Governing (06/96) Vol. 9, No. 9, P. 48 In 1994, public programs spent $3.75 billion on health care for people with HIV and AIDS. A new publication, "HIV/AIDS Facts to Consider: 1996," delivers the most recent information on caseloads, costs, transmission, and treatment, as well as state policies and programs. To purchase a copy, contact the Book Order Department, National Conference of State Legislatures, 1560 Broadway, Suite 700, Denver, CO 80202, or phone (303) 830-2054.