Date: Wed, 21 Jun 1995 19:58:01 +0500 Reply-To: aidsnews@aspensys.com Subject: CDC National AIDS Hotline Training Bulle CENTERS FOR DISEASE CONTROL AND PREVENTION HIV/AIDS PREVENTION CDC NATIONAL AIDS HOTLINE TRAINING BULLETIN ................................................................. June 16, 1995 INFORMATION ALERT: HIV/AIDS Treatment Information Service The HIV/AIDS Treatment Information Service (ATIS) is a free telephone service that provides timely, accurate treatment information on HIV and AIDS. The service was developed through a coordinated Public Health Service effort and is offered through the CDC National AIDS Clearinghouse. The service opened on October 31, 1994 and in the first six months of operation, received over 5,700 calls. ATIS answers callers' questions about federally approved treatment of HIV disease and provides copies of federally approved HIV/AIDS treatment guidelines. The staff can also provide referrals to other information resources through a comprehensive treatment information referral network, including the CDC National AIDS Hotline. The service is staffed by health professionals who answer questions using several different databases including the National Library of Medicine's HSTAT electronic resource of information. The HSTAT(Health Services/Technology Assessment Text) contains the full-text of clinical practice guidelines, quick-reference guides for clinicians, and consumer brochures developed under the auspices of the Agency for Health Care Policy and Research (AHCPR); National Institutes of Health (NIH) consensus development conference and technology assessment reports; MMWRs; and the U.S. Preventive Services Task Force Guide to Clinical Preventive Services. Additional database resources available to the ATIS staff are: * HIV/AIDS Drug Database: contains information about over 200 drugs listed in approved and experimental protocols. * PDR ONLINE: a searchable database which provides a listing of FDA- approved drugs. * APRS database: contains relevant HIV/AIDS federal press release information. * Medline Searches: a part-time librarian is available to health care providers that call with requests for specific scientific searches. The ATIS staff field complex questions from callers that require a great deal of indepth subject knowledge. Listed below are examples of the actual questions that ATIS receives and the responses given by the staff: Question via Internet: Hi...I'm new at this. Forgive me if I make a mistake. I need info on the effect of splenectomy on CD4 counts. Our patient had a splenectomy prior to HIV. His CD4s are about 600 but he seems in worse shape than his numbers. We chose to prophylax him for PCP even with his high CD4 count. Got any info on this? Answer via Internet: Your request for information on CD4 counts being affected by splenectomy in someone with HIV has been forwarded to me at the HIV/AIDS Treatment Information Service (ATIS). After searching our database of federally approved treament information, which did not address splenectomy, I resorted to a medical text. In the third edition (1994) of Clinical Approach to Infection in the Compromised Host, (Rubin and Young) the chapter on Pathogenesis and Clinical Manifestations of HIV-1 states: "CD4 cells rise significantly in the peripheral blood following splenectomy, but an HIV-infected, splenectomized individual is much more immunocompromised than is reflected by peripheral CD4 cell enumeration. Indeed, in this setting, it is appropriate to initiate P. carinii prophylaxis at levels of 500-800 CD4 cells." The author of this chapter is Robert T Schooley of the Division of Infectious Diseases, Department of Medicine, University of Colorado Health Sciences Center. In addition, you may want to contact the HIV Telephone Consulting Service for Health Care Providers. It is a "Warmline" staffed by clinicians at San Fransisco General Hospital who offer case consultation. Their hours of operation are 7:30 a.m. to 5:00 p.m. pacific time. They will return your call if you need to leave a message 24 hours. The number is 1-800-933-3413. I hope this is useful. Please don't hesitate to use our services. We can be reached at 1-800-HIV-0440 for information on federally approved treatment for HIV/AIDS or at 1-800-TRIALS-A for HIV/AIDS clinical trials information. Our phone hours are 9:00 a.m.-7:00 p.m. eastern time. Phone request Q. I just found out that someone I had sex with three years ago now has AIDS. Where can I get tested anonymously? A. The best place to get an answer to that question is from your state AIDS Hotline, or the National AIDS Hotline. Our service answers questions on approved and investigational treatment options after someone has been diagnosed with HIV. Where are you calling from? [Kentucky] The number for the CDC National AIDS Hotline is 1-800-342-AIDS. I can transfer you directly if you hold for a moment. Phone request Q. My doctor's office called and said my most recent lab work shows a drop in my CD4+ count; it is now 187. They scheduled an appointment for me to talk about PCP prophylaxis. What is that and what can I expect when I go for my appointment? A. Prophylaxis means medication to prevent an illness. You and your doctor will talk about what is best for your medical condition right now. Since we are not doctors, and treatment decisions are very individual, we cannot recommend any particular treatment, but I can share with you what the CDC recommends for preventing illness in people whose CD4+ count has dropped below 200. Studies of people with HIV have shown that most people are at increased risk for illnesses such as Pneumocystis carinii pneumonia (PCP) when their CD4+ count falls below 200. There are several options of drug therapies that can help prevent PCP; the most common is Bactrim or Septra. Some people are allergic to these drugs, though, and need to try other available drugs for prophylaxis. When you see your doctor, you may want to ask about other infections that you may be at risk for developing. I would be happy to send you the CDC recommendations on PCP prophylaxis as well as some publications about illnesses that are associated with HIV infection and ways to avoid them. Disclaimer: CDC Hotline Training Bulletins The information in the "CDC Hotline Training Bulletins" is provided by CDC and NIH for use by the CDC National AIDS Hotline in responding to general questions from the public about HIV and AIDS. The bulletins are not intended to be comprehensive discussions of the subject areas. Treatment and drug therapy options change as new research and clinical experiences broaden scientific knowledge. Therefore, persons seeking information on drug therapy should refer to the product information sheet included in all drug packages for the most current and accurate information about a particular drug, especially if the drug is new or infrequently used. HIV-infected individuals should consult their personal physician for specific concerns about their health. For persons desiring more information on a specific topic, public, medical, and university libraries can provide excellent references. The AIDS Clinical Trials Information Service (800-874-2572) can provide information about ongoing HIV/AIDS clinical trials; the HIV/AIDS Treatment Information Service (800-448-0440) can assist with information about the latest treatments for persons with HIV infection or AIDS.