Date: Fri, 4 Oct 1996 09:39:45 -0400 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 10/04/96 AIDS Daily Summary October 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 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 ****************************************************** "Merck to Sell AIDS Drug at Single European Price" "Pataki Signs Bill on Managed Care for Poor" "HMOs May Not Always Be Best for Long-Term Ills" "Doctor's AIDS Infection Was Labor Accident" "Japan Arrests Health Official in HIV Scandal" "Tanzania: Quality Control Needed for Condoms" "Malawi: Family Planning and Sex Education Not [Effective]" "Or Is it the Host, Sir?" "AIDS Update" ****************************************************** "Merck to Sell AIDS Drug at Single European Price" Financial Times (10/04/96) P. 22; Green, Daniel U.S. pharmaceutical firm Merck is planning to give its new AIDS drug Crixivan (indinavir) a single price across the European Union as part of an effort to stop the practice of traders purchasing drugs in low-cost Southern Europe and re-selling them in higher-priced northern markets. The drug will be one of the first products to be priced according to the Ecu, a weighted average of European currencies. Merck notes that the Ecu pricing decision is also in anticipation of the eventual launch of a single currency in Europe. Crixivan will cost Ecu9.64, or about $12.24 in U.S. currency, for a one-day supply. "Pataki Signs Bill on Managed Care for Poor" New York Times (10/04/96) P. B6 New York Gov. George E. Pataki signed a bill Thursday that will put over 2 million Medicaid recipients into managed care networks by early 1997. The exceptions will be those people who are in nursing homes and other institutions. The law will also allow the state to certify "special needs" managed care plans for recipients who are infected with HIV or who require psychiatric care. Officials anticipate that the law will save $1.5 billion in medical costs over the coming five years. New York's current Medicaid expenditures total about $25 billion a year in federal, state, and local funds. To ease concerns of consumer groups, the legislation requires that all participants must be counseled on how a managed care plan works before they sign up, and they must also be offered a choice of at least two plans. "HMOs May Not Always Be Best for Long-Term Ills" Wall Street Journal (10/04/96) P. C1; Jeffrey, Nancy Ann A new study from New England Medical Center professor John E. Ware Jr. and his associates highlights issues concerning how well elderly and poor people with chronic illnesses are served by health maintenance organizations (HMOs). The report suggests that HMOs may not be the best choice for senior citizens and others with long-term health problems because HMOs are often not eager to assume the costly and complicated problems of those with long-term, progressive conditions that may require multiple visits to specialists and intensive daily management. Ware and his associates concluded that over a four-year period, "elderly and poor chronically ill patients had worse physical health outcomes in HMOs than in FFS [fee-for-service] systems." "Doctor's AIDS Infection Was Labor Accident" Xinhua News Agency (10/03/96) A French court decided on Thursday that the HIV infection of a doctor while he was conducting a surgery in 1983 should be described as "a labor accident," a designation that had previously been reached by a committee of experts. The Tribunal of Social Security Affairs, under the Versaille Tribunal, said, "The recognition of the professional disease today has been made without objection." Three weeks after cutting his finger during an operation in May 1983, Doctor Patrick Cohen began to suffer from mono-nucleus infection, which is now recognized as one of the preliminary syndromes in AIDS patients. Cohen has filed a lawsuit against the French government and the hospital for failing to take proper precautions to prevent the transmission of the virus. "Japan Arrests Health Official in HIV Scandal" Reuters (10/04/96) Akihito Matsumura, former head of the Japanese Health Ministry's Biologics and Antibiotics Division, was arrested on Friday on charges of professional negligence that resulted in two deaths from HIV-contaminated blood products. Matsumura is the first government official to be arrested in the country's tainted blood scandal. He is accused of failing to order the recall of untreated blood products even though he understood that such products could be contaminated with the virus that causes AIDS. Three current and former presidents of Green Cross Corp., as well as the former head of a Health Ministry AIDS research team, have also been arrested on charges relating to the scandal. "Tanzania: Quality Control Needed for Condoms" Africa Information Afrique (10/03/96); Kasumuni, Ludger Medical and social workers are expressing concerns about the quality of condoms sold in Tanzania, because most condoms on the market there have passed their expiration date, making them prone to lost elasticity and increased breakage. Expired condoms that do not carry expiration dates, manufactured in 1992 by U.S. company Aladan Corp., have been discovered at the Centre for Education Development in Health, Arusha and the Municipal Council headquarters, raising fears that there may be a nationwide rash of unwanted pregnancies and sexually transmitted diseases. Timothy Manchester, Director of Tanzania AIDS Project (TAP), notes that his organization does not sell expired condoms, adding that every lot of condoms in any consignment is tested by the Tanzanian Bureau of Standard. TAP, which imports and buys condoms from the South African company Suitex and the Malaysian company Sagami, has sold more than 20 million condoms over the past three years. According to the National AIDS Control Program, recent data has determined that at least 800,000 people have been infected with HIV in Tanzania, which has a population of 30 million. "Malawi: Family Planning and Sex Education Not [Effective]" Africa Information Afrique (10/03/96); Livuza, Anthony New statistics on teenage pregnancy and sexually transmitted diseases in Malawi have raised concerns about the efficacy of government and Family Life education efforts. In the country, which has 11 million citizens, the rate of child mortality is 234 per 1000, and the maternal mortality rate stands at 6.2 per 1000. Moreover, in the past two years alone, sexually transmitted diseases among both men and women have increased about 20 percent a year. One million residents are thought to be infected with HIV, and some 200,000 have already died of AIDS. The trends are attributed in large part to government neglect, including the fact that sex education is still not taught in primary and secondary schools. In Malawi, only about 7 percent of the women employ family planning methods. An additional 6 percent use traditional contraceptive methods--tying a medicinal string around a woman's waist or abstinence for periods of up to a year--but health officials note that the efficacy of these techniques is not even one percent. "Or Is it the Host, Sir?" Journal of the International Association of Physicians in AIDS Care (09/96) Vol. 2, No. 9, P. 8; Mascolini, Mark Recent research suggests that the immune system's initial response to HIV infection can predict the rate of disease progression. Drs. Timothy Schacker and Lawrence Corey, from the University of Washington in Seattle, have reported that the viral set point, the level of virus reached after the immune system's initial reaction, is established about six months after infection. In addition, Dr. Giuseppe Panteleo, of the National Institute of Allergy and Infectious Diseases, has provided some clues about what happens during those first six months. At the Ninth International Symposium on Infections in the Immunocompromised Host, Pantaleo reported that disease progression in 21 newly-infected patients was linked to the patients' initial immune response. He divided the patients into three groups, depending on their immune reaction. Patients with only one kind of CD8 T cells were found to lose their CD4 T cells more quickly than patients with more diverse sets of immune cells. Other research reported at the conference included advances in using thalidomide to control levels of tumor necrosis factor alpha in people with HIV, tuberculosis (TB) or both. A study on the link between HIV and TB was also presented, as well as research on prophylaxis for Mycobacterium avium complex and other opportunistic infections. "AIDS Update" American Health (09/96) Vol. 15, No. 7, P. 14; Beim, Amy Intravenous drug use is responsible for most HIV infections in women and heterosexuals in the United States, according to the Centers for Disease Control and Prevention. The agency reported that 85 percent of AIDS cases among heterosexual men and 66 percent of cases among women reported last year were transmitted either by shared needles or through sexual contact with a drug user. The CDC also reported that, since 1991, the number of infants born in the United States infected with HIV has declined. The number peaked at 1,760 that year, and dropped to 1,630 in 1993. CDC researchers predict the number will fall even more next year, due to new guidelines that recommend HIV testing and counseling for all pregnant women.