Date: Mon, 17 Apr 1995 13:23:39 +0500
From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com
Subject: CDC Nat. AIDS Hotline Training Bul. #132


           CENTERS FOR DISEASE CONTROL AND PREVENTION
                       HIV/AIDS PREVENTION
           CDC NATIONAL AIDS HOTLINE TRAINING BULLETIN
.................................................................

March 16, 1995                                              #132

This is a statement from the National Institutes of Health (NIH)
concerning two studies of therapies for AIDS-related infections.

Two studies, done by the AIDS Clinical Trials Group (ACTG) of the
National Institute of Allergy and Infectious Diseases (NIAID), of
therapies for AIDS-related infections appear in the March 16
issue of The New England Journal of Medicine.

Three Therapies Prevent Pneumonia  (ACTG 081)

In patients with advanced HIV infection, three treatments have
similar effectiveness in preventing Pneumocystis carinii
pneumonia (PCP).  Investigators assessed the risks for developing
PCP during 36 months of therapy among more than 800 patients with
HIV and 200 or fewer CD4+ T cells per cubic millimeter of blood.
CD4+ T cells are the infection-fighting cells targeted by HIV.
The risk for developing PCP was 18 percent among patients taking
trimethoprim-sulfamethoxazole (TMP/SMX), 17 percent for those
receiving dapsone, and 21 percent for those on aerosolized
pentamidine therapy.  For patients with fewer than 100 CD4+ T
cells, therapies that start with TMP/SMX or high dose dapsone are
superior to treatments beginning with pentamidine.  Authors note,
however, that the greatest gains in preventing PCP will likely
come from identifying more people at risk of the disease, rather
than optimizing therapy for patients already receiving care.

Fluconazole Prevents Fungal Infections (ACTG 981)

Fluconazole was more effective than clotrimazole in preventing
fungal infections in patients with advanced HIV infection,
particularly those with 50 or fewer CD4+ T cells.  In a substudy
of ACTG 081 patients, researchers found that fluconazole reduced
the frequency of cryptococcal meningitis and esophageal
candidiasis, as well as superficial fungal infections.