Date: Mon, 17 Apr 1995 14:01:02 +0500
From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com
Subject: CDC Nat. AIDS Hotline Training Bul. #134


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

March 30, 1995                                              #134

This is a statement from the National Institutes of Health (NIH)
concerning the renewal of an HIV/AIDS Study in Homosexual Men.

The Multicenter AIDS Cohort Study (MACS), a long-term study of
HIV and AIDS in more than 5,000 gay and bisexual men, will
receive funds from the National Institute of Allergy and
Infectious Diseases (NIAID) on April 1, 1995, to establish two
state-of-the-art laboratories and renew the four clinical sites
and data center.  First- year funding of the four-year grants
together totals $6.2 million.

"The MACS is one of the longest and most rigorous epidemiologic
studies of HIV infection in the world," says Anthony S. Fauci,
M.D., director of NIAID.  "The MACS biological specimens and
database, with more than a decade of valuable HIV-related
information, are exceptional resources for advancing HIV and AIDS
treatment and prevention strategies worldwide."

The new laboratories will bring together scientists with
expertise in immunology, virology, and molecular biology to study
the factors that contribute to the progression of HIV disease and
destruction of the immune system as well as those factors that
may prevent or protect against HIV disease progression, notes
Lewis K. Schrager, M.D., the project officer of MACS.  Dr.
Schrager is the chief of the Epidemiology Branch of the Basic
Sciences Program in the NIAID Division of AIDS.

MACS directors and the four clinical sites are:  Alfred Saah,
M.D., M.P.H., at the Johns Hopkins School of Public Health in
Baltimore; John Phair, M.D., at the Howard Brown Memorial
Clinic/Northwestern University in Chicago; Roger Detels, M.D.,
M.S., at the University of California, Los Angeles (UCLA); and
Charles Rinaldo, Ph.D., at the University of Pittsburgh.

The new MACS pathogenesis research laboratories are at Johns
Hopkins, directed by Joseph Margolick, M.D., Ph.D., and at UCLA,
directed by Janis Giorgi, Ph.D.  The Center for the Analysis and
Management of MACS Data, at Johns Hopkins, is directed by Alvaro
Munoz, Ph.D.

MACS focuses on HIV disease and related infections, immune
responses to the virus, and the impact of anti-HIV treatments.
MACS accomplishments and findings include the following:

~    Identification of more than 60 HIV-infected men who are
     long-term non-progressors, many of whom have served as
     critical sources of information on this phenomenon in
     studies conducted at several U.S. laboratories.

~    Prevention of Pneumocystis carinii pneumonia can delay
     the first AIDS-defining illness by six to 12 months.

~    Zidovudine (AZT) therapy given with acyclovir may
     significantly increase survival of AIDS patients.

~    The response of CD4+ T cells to AZT predicts AIDS-free
     time and survival among HIV-infected patients.  For
     example, increases in CD4+ T cell counts after patients
     begin AZT therapy correlate to longer times to AIDS and
     death.

~    Risk factors for AIDS-related dementia include anemia,
     lower body mass, older age, and having such symptoms as
     fever, fatigue, diarrhea, or thrush before an AIDS
     diagnosis.

~    Symptoms of depression do not independently predict
     poorer outcomes to HIV infection.

Begun in 1983, MACS enrolled its first participants in 1984.  Of
the 5,579 men who entered the study, 2,191 were infected with
HIV.  During the study, 488 men have become HIV infected.  The
men come to the clinical sites twice a year for exams and
laboratory testing as well as to answer questions about any
preventive and treatment medications they take.  Since
enrollment, 1,362 men have developed AIDS, of whom 1,158 have
died.  Another 101 HIV-infected men died, but before they
developed AIDS.

At enrollment, MACS men included 83.1 percent whites, 10.1
percent African-Americans, 5.3 percent Hispanics, while the rest
were from other or unknown racial groups.  The men ranged in age
from 18 to 70 and more than half had college degrees when they
entered the study.

MACS collaborations with the National Cancer Institute (NCI) and
the Agency for Health Care Policy and Research (AHCPR) have
supported studies on HIV-related cancers and the impact of
treatments on patients' use of health services.

NIAID and NCI are components of the National Institutes of Health
(NIH) and support investigators and scientific studies at
universities, medical schools, hospitals, and research
institutions in  the United States and abroad.  NIH and AHCPR are
agencies of the U.S. Public Health Service, part of the U.S.
Department of Health and Human Services.