Date: Tue, 8 Mar 1994 22:51:19 -0800 From: jfh@netcom.com (Jack Hamilton) Subject: AIDS Treatment News #193 Date: Feb 18 1994 (764 lines) &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& J O H N J A M E S writes on A I D S &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& Copyright 1994 by John S. James; permission granted for non-commercial use. AIDS TREATMENT NEWS #193, February 18, 1994 phone 800/TREAT-1-2, or 415/255-0588 CONTENTS: [items are separated by "*****" for this display] National Task Force Appointed Major Proteinase Inhibitor Trials to Begin San Francisco: Phase I Trial of Bucast (Castanospermine Analog) Recruiting Office of AIDS Research -- Director Appointed Rheumatoid Arthritis Advance May Be Relevant to AIDS "Living Benefits" -- Options and Resources Correction -- California AIDS Drug Assistance Program List ***** National Task Force Appointed by John S. James On February 4, Health and Human Services Secretary Donna E. Shalala named the members of the National Task Force on AIDS Drug Development -- the new high-level panel to look at all aspects of AIDS medical research, and implement or recommend improvements in both government and private programs to speed the discovery and testing of important treatment advances. The first meeting is planned for late March, but the all-important work by professional staff at the FDA, NIH, and other government agencies, has already begun. (For background on this Task Force, see AIDS TREATMENT NEWS #188, December 3, 1993.) This Task Force, which reports directly to Secretary Shalala in President Clinton's Cabinet, differs from previous efforts in that it can bridge the gap between the detailed knowledge of what happens in medical research (needed to understand the problems), and the high-level attention and authority, missing until now, which is often needed to resolve them. For example, on the government side, the Task Force includes the Director of the National Institutes of Health, the Commissioner of the Food and Drug Administration, and, above them, the Assistant Secretary for Health. From industry, it includes the president of Merck Research, the vice president for clinical research of Bristol- Myers Squibb, and the CEO of Genentech. The 18 members, chosen to represent "government, academia, the pharmaceutical industry, medicine, and the AIDS-affected communities," are: * Moises Agosto, Research and Treatment Advocacy Manager, National Minority AIDS Council, Washington, D. C. ; * Arthur Ammann, M. D., Director, Ariel Project, Pediatric AIDS Foundation, Novato, California; * Stephen K. Carter, M. D., Senior Vice President, Worldwide Clinical Research and Development, Bristol-Myers Squibb, Princeton, New Jersey; * Ben Cheng, Information and Advocacy Associate, Project Inform, San Francisco, California; * Deborah J. Cotton, M. D., M. P. H., Assistant Professor of Medicine, Harvard Medical School, Boston, Massachusetts; * Mindy Fullilove, M. D., Research Psychiatrist, HIV Center, New York State Psychiatric Institute, New York, New York; * David Ho, M. D., Director, Aaron Diamond AIDS Research Center, New York, New York; * Daniel Hoth, M. D., Senior Vice President, Cell Genesys, Foster City, California; * David A. Kessler, M. D., Commissioner, U. S. Food and Drug Administration; * Philip R. Lee, M. D., Assistant Secretary for Health, U. S. Department of Health and Human Services; * Theresa McGovern, Director, HIV Law Project, New York, New York; * Charles Nelson, Sisterlove Women's AIDS Project, Atlanta, Georgia; * G. Kirk Raab, CEO, Genentech, South San Francisco, California; * Robert Schooley, M. D., Director, Colorado ACTU, University of Colorado, Denver, Colorado; * Edward Scolnick, M. D., President, Merck Research Laboratories, Rahway, New Jersey; * Peter Staley, Founding Director, Treatment Action Group, New York, New York; * Harold Varmus, M. D., Director, U. S. National Institutes of Health; * Flossie Wong-Staal, Ph.D., Professor of Medicine and Biology, University of California, San Diego, California. Comment This task force has three basic ways to make changes: * The group includes persons who can "commit at the table" to implement much of what needs to be done to develop a more coordinated and productive approach to drug development. These leaders, brought into close coordination for the first time, should be able to solve a number of problems directly, by their own decisions and agreements, instead of filing a report and hoping that someone else takes action. * When cooperation is needed from other organizations, such as other pharmaceutical companies, the Task Force should be influential enough, and realistic enough in what it asks for, to have a good chance of obtaining the cooperation needed to address other problems which the members cannot resolve on their own. (Dr. Scolnick of Merck can be especially helpful here, because of his role in the Inter-Company Collaboration for AIDS Drug Development, a pharmaceutical-industry association which is improving coordination among companies engaged in AIDS research.) * Finally, when government action is needed, the Task Force can make recommendations to Health and Human Services Secretary Shalala. If legislation is necessary, the Administration can go to Congress -- although usually this is a last resort, since legislation takes much longer than administrative action by government agencies or private organizations. What do we hope to see from the Task Force? We believe that the central problem in medical research is that some of the most promising leads -- individual treatments and overall research directions -- are left in limbo for years, not for any medical, scientific, or even economic reason, but because they have not yet amassed the commercial and political clout required to push through the jumble of roadblocks and hurdles which impede any medical research today. Somewhere among government, industry, academia, foundations, etc., the intellect and energy must be found to give a few well-chosen areas the strategic push they need to quickly prove themselves and acquire the stature to proceed on their own. Also, the Task Force will discover endless correctable problems if it listens to working scientists describe what they do every day, and explain the obstacles and frustrations, such as mindless red tape, that impede their work. Hopefully the scientists will recognize that these problems can now be addressed, and will be able to articulate requests that would have been useless before, even after years of doing things the wrong way when that was how the world worked, when they had no choice. Hopefully, also, the scientists will not blow this opportunity by using it only to ask for more money -- always the easiest request to make, but sometimes the hardest to fulfill. Certainly more money is needed for medical research; but the way to get it is to produce the major practical advances that save lives and save resources as well. ***** Major Proteinase Inhibitor Trials to Begin by John S. James Two large-scale trials of the Hoffmann-La Roche proteinase inhibitor Ro 31-8959 -- seeking 1200 volunteers for a U. S. study, and approximately 1800 others for a separate international study -- are now beginning. Proteinase inhibitors are a new kind of anti-HIV drug, fundamentally different from AZT, ddI, ddC, d4T, etc., because they target a different step in the HIV life cycle. Ro 31-8959 is the proteinase inhibitor which is furthest ahead in human trials; it was tested in people in small studies last year. The new trials will be the first large human studies of a proteinase inhibitor. [Note on terminology: The words "protease" and "proteinase" are interchangeable; "protease" seems to have slightly more common usage, and is generally the form preferred in AIDS TREATMENT NEWS. But Hoffmann-La Roche consistently uses "proteinase"; we followed its usage here, because this article refers only to the Roche drug.] Of the two trials now beginning, one is in the U. S., and the other is international, including the U. S. The U. S. trial, which will take place in 40 sites throughout the country, is now open at a number of those sites. Volunteers must have used AZT previously, but no other antiretroviral, and currently have a T-helper count between 50 and 300. They will be randomly assigned to one of four treatment arms: Ro 31-8959 alone, ddC (HIVID) alone, and combination treatment combining Ro 31-8959 (at two dose levels) and HIVID. This study will last for at least 12 months of treatment, and will compare the treatment regimens by using "clinical endpoints" of disease progression and survival; it will also investigate possible resistance to Ro 31-8959, and try to validate the usefulness of laboratory markers (certain blood tests) for measuring disease progression and the possible benefits of treatment. The international study, due to begin in late February or in March, will seek 1,800 volunteers, at sites in North America, South America, Europe, and Australia; 600 of the 1800 will be in the U. S. Volunteers must have T-helper counts between 50 and 300; but, opposite to the U. S. study, they must not have previously used AZT (or any other antiretroviral treatment). This study will also assign patients at random to one of four treatment regimens, but it will compare the proteinase inhibitor with AZT, not with ddC. (The four arms are Ro 31-8959 alone, AZT alone, and Ro 31-8959 (two doses) in combination with AZT.) This study will last for at least 18 months of treatment. A total of 90 sites (for both the U. S. and the international study) will be enrolling volunteers. Comment Ro 31-8959 is considered one of the leading proteinase inhibitors at this time. Its unique advantage is that it is further along in clinical trials than the other proteinase inhibitors, and it appears to be well tolerated and to have antiviral activity in humans. Its major disadvantage is that it is difficult and expensive to manufacture. This trial may be difficult to fill, because the restrictions on prior antiretroviral treatment will exclude many volunteers. (This is especially true for the international trial, which is seeking 600 U. S. volunteers with T-helper count between 50 and 300 who have not taken any antiretroviral treatment so far -- and who are willing to take AZT as well as the experimental drug in this trial.) A common issue in clinical trials (including early trials of Ro 31-8959) concerns continued access to the drug after the trial has ended. According to Roche spokesperson Gail Levinson, if the drug is found to be safe and active it will be provided to patients in these phase III trials (and also to those in the phase II trial ACTG 229, which has tested Ro 31-8959 in combination with other drugs, and is now ending). Roche has not stated this in writing, however. Proteinase inhibitors will be in the news during 1994 and 1995, as more clinical trials get underway. These drugs work very well in laboratory tests, but only the earliest human data is available. Concerning Ro 31-8959, early human results reported last summer, at the International Conference in Berlin, showed significant but not spectacular antiviral activity, without serious side effects. We will know more when the results of ACTG 229 are released, probably in the second quarter of 1994; this study tested Ro 31-8959 in various combinations with other antiretrovirals, in 300 volunteers. For more information on either trial, including contact information for a site in your area, call Hoffmann-La Roche at 800/526-6367. ***** San Francisco: Phase I Trial of Bucast (Castanospermine Analog) Recruiting by John S. James A new trial in San Francisco will begin the human testing of Bucast, an anti-HIV compound which has been studied in laboratory tests and in animals for several years. This phase I study seeks 40 to 60 volunteers, who must have a T-helper count over 500, and be willing to spend some time at HIVCare at St. Francis Memorial Hospital -- the only site where this early study is being conducted. Bucast (also called 6-0-butanoylcastanospermine) is a chemical derivative of castanospermine, an antiviral found in an Australian tree, Castanospermum australe. Bucast is at least several times more potent as an antiviral than the natural castanospermine in laboratory cell cultures. Bucast (and castanospermine) are glycosylation inhibitors -- they interfere with an enzyme required by HIV for processing glycoproteins (chemicals composed of both proteins and sugars). Laboratory studies suggest that these glycosylation inhibitors will make the virus more susceptible to attack by the immune system, and also prevent the formation of syncytia -- giant cells formed when T-helper cells join together abnormally and die. (A different glycosylation inhibitor, butyl-DNJ, is already in human trials.) Bucast has shown antiviral activity in animals, as well as in laboratory cultures. Also, castanospermine has been found to be synergistic with AZT in laboratory cell cultures, meaning that the two work better together than would be expected by adding their separate antiviral activities. The Trial There will be two parts of this trial, which will be placebo controlled. Part A will test a single dose of bucast. Part B will test daily doses given for 14 days. The drug is taken orally. The aim of this study is to find the maximum tolerated dose. Persons can volunteer for either part A, or part B, or for both. Part A requires one 36-hour stay in the hospital, and daily visits of up to two hours each morning, for the following seven days. Part B requires 36 hours in the hospital, daily visits for 13 days, then another 36 hours in the hospital. Volunteers should realize that they cannot expect personal medical benefit from participation in a phase I study; the main motive for enrolling in this trial will be altruistic. Because no medical benefit is expected, participants who complete the study will receive monetary compensation for their time. And they will not be excluded from phase II trials of Bucast. Comment There is always a risk in a clinical trial which gives a new drug to people for the first time. This risk is minimized by careful animal studies, in which animals are given much larger doses than any human volunteers will receive; the FDA requires these studies before the drug can be given to humans. This trial is important, because of the great need for new AIDS treatments. For More Information For more information, call Mark Bowers, Client Coordinator, HIVCare, St. Francis Memorial Hospital, 415/353-6215. ***** Office of AIDS Research Director Appointed On February 17, the U. S. National Institutes of Health announced the appointment of William Paul, M. D., as director of the new Office of AIDS Research (OAR) at NIH. Dr. Paul, an immunologist, has been chief of the Laboratory of Immunology at the U. S. Institute of Allergy and Infectious Diseases (NIAID, part of NIH) since 1970. He is an expert in cytokines, and has authored over 400 scientific papers. The OAR's responsibilities will include setting directions for the entire AIDS research effort at NIH, and allocating funds to the different components of NIH, according to a comprehensive strategic plan. Also, the OAR will establish coordinating groups for: natural history and epidemiology; etiology and pathogenesis; therapeutics; vaccines; and behavioral research. Dr. Paul will also administer a discretionary fund to take advantage of unanticipated scientific opportunities as they occur, and will oversee a new national advisory council on AIDS research. The Treatment Action Group (TAG), the activist organization which has been heavily involved in AIDS research reform, welcomed Dr. Paul's appointment, and the increasing emphasis on immunology in AIDS treatment research. ***** Rheumatoid Arthritis Advance May Be Relevant to AIDS by John S. James Researchers in London have reported impressive results in treating rheumatoid arthritis with a monoclonal antibody against tumor necrosis factor (TNF). Initial results of the trial, conducted by T. Miani and M. Feldman, were published in the February issue of Arthritis and Rheumatism. We could not obtain the article by press time, but according to media reports, patients received only two weeks of treatment and consistently experienced improvement for three to five months. Continuing treatment appears to be successful so far. One of the researchers provided current information in a recent radio interview on the BBC (British Broadcasting Corporation). About 50 volunteers have now been treated, apparently with success in every case. All of them had failed standard treatments for rheumatoid arthritis, in order to be eligible for the study. The researchers had been concerned that the patients might become more susceptible to infections, since TNF has a normal role in immune defenses; but no such problem was found. How is this relevant to AIDS? Tumor necrosis factor (TNF), which is found naturally in the body, is often too high in people with HIV or AIDS. It is believed to be an important cause of wasting syndrome. Also, it can stimulate HIV growth directly; for example, in our article on LTR inhibitors (AIDS TREATMENT NEWS #192, February 4, 1994), TNF was the agent used in the laboratory to stimulate the HIV LTR, in order to screen for potential LTR inhibitors. Two drugs currently being tested as a potential AIDS treatment -- pentoxifylline, and thalidomide -- reduce the levels of TNF in the body. The monoclonal antibody (which is produced by Centocor, a Philadelphia company, although it was tested in the UK) may be a highly effective way to block TNF. While this particular drug will not be widely available for some time, the dramatic results in the arthritis study, if confirmed, may advance the research on other drugs with a similar mechanism of action. ***** "Living Benefits" -- Options and Resources by Thomas P. McCormack [Note: Thomas P. McCormack, a leading expert on AIDS insurance and entitlement issues, is the author of The AIDS Benefits Handbook (Yale University Press, 1990). He has served as benefits policy specialist with the U. S. Department of Health and Human Services, and with the National Association of People with AIDS (NAPWA). He is currently an HIV-benefits correspondent for PAACNOTES (published by the Physicians' Association for AIDS Care), and is on the advisory board of Affording Care, Inc., a non-profit organization which promotes insurance and entitlement education for seriously ill people. [Mr. McCormack and Yale University Press may revise The AIDS Benefits Handbook once the outcome of health-care reform becomes more clear. Meanwhile, he is publishing articles in newsletters, including AIDS TREATMENT NEWS, to get important benefits information quickly to those who need it. [The article below may be useful even for persons without life insurance. It explains that in certain cases, persons with AIDS who do not have life insurance can legally obtain it, then sell the policy for cash to live on or to pay medical expenses. [More importantly, it explains that "viatication" -- the sale of a life insurance policy to investors -- is often not the best way to obtain cash from the policy. Often the best way is a loan from close friends or relatives, whose interests are protected by naming them as beneficiary of the policy; this can be done even if the lenders have property but not cash, through a special "reverse mortgage" program run by the Federal Government. [This article is unusual for AIDS TREATMENT NEWS, which focuses on increasing one's chances of surviving the epidemic, and therefore has had little coverage on "living benefits," or ways to obtain life-insurance payments before instead of after death. But when we mentioned living benefits in Issue #173 (April 23, 1993), over 100 readers called the numbers provided for more information. Clearly many people want to know what their options are, whether or not they have decided to obtain money from their policy. Much of the information below is not well known, and it is important that it be more widely available. [Mr. McCormack is currently working on another article for AIDS TREATMENT NEWS, on state AIDS drug assistance programs. JSJ] The "living benefits" movement for realizing cash from life insurance for terminally ill patients -- especially people with AIDS -- continues to grow. There are three major ways to obtain cash from a life-insurance policy; yet most people know about only one, called "viatical settlement" or "viatication" -- which means the sale of one's life insurance policy at a discount to an investor, who then becomes the beneficiary and collects at one's death. This method, which usually should be the last choice if one of the others is available, is well known because it is heavily advertised, by dozens of viatical companies, in gay and AIDS publications. The preferred methods consists of a private loan against the policy from a relative or close friend, if that is possible; or accelerated benefits, if one's insurance company provides that option. Living Benefits Through Private Loans Private loans can be made by close friends or relatives in exchange for being named beneficiaries of one's life insurance. Since life insurance firms allow policy holders to continue to change beneficiaries right up until death, such "collateral" obviously would not be honored in a bank loan, for example. But many loved ones of the dying would trust them not to later change beneficiaries, making the beneficiary-naming a reliable surety between trusted intimates. Such loans therefore avoid the viatical firms' discounting and can make the full benefit amount available. Another very important advantage of this private-loan method is that loans are not taxable. But viatical settlements are taxed under Federal and most state laws. (These laws need to be reformed, because they tax viatical payments to terminally ill patients who need the money for living expenses and medical care, when they would not tax the same money if paid after death.) If your relatives do not have the cash for a loan, but do have equity in their house, they can take out a special "reverse mortgage," sponsored by the U. S. Department of Housing and Urban Development. This special mortgage differs from a regular one in that there is no monthly payment. Also, the loan is not due until the property owner, their spouse, their minor children, and adult handicapped children, no longer live in the house. Normally, of course, the loan could be repaid from the proceeds of the life-insurance policy, after the borrower's death. For more information about reverse mortgages, contact the National Center for Home Equity Conversion, 612/953-4474; or obtain a copy of Retirement Income on the House, from Bookmaster, 800/247- 6553, $29.45. Accelerated Benefits A second advantageous way to get money from insurance is through "accelerated benefits" -- riders already in, or sometimes added to, one's policy by the insurance company itself. Here, one must submit medical evidence of an expected death within six months, or one year at most. (If one's life expectancy is longer, one must use a private loan, or viatication, to obtain money from the policy.) If the company is satisfied with the proof, one receives part or all of the policy death benefit -- with the remainder, if any, paid to one's beneficiaries. To find out whether one's insurance company offers "accelerated benefits," see the "Annual Survey of Accelerated Benefits," which appeared in Life Association News, February 1993. Check with a business college library for a copy, or order one from the National Association of Life Underwriters, 1922 F Street NW, Washington, D. C. 20006, 202/331-6000, $6.00. For more recent information, consult the mid-March, 1994, Source Issue of Selling Life Insurance magazine; it is available at business libraries, or can be ordered from Commerce Publishing Company, 330 North 4th Street, St. Louis, MO 63702, 314/421-5445, $3.00. These surveys are, however, only a starting point and should not be taken as the final word, since company rules change constantly. Have your attorney, insurance agent, financial planner, or social worker call the national headquarters of your insurance company for the latest details. Viatication -- Choosing a Company Viatication -- selling one's policy at discount to an investor firm -- still seems to be the most widely-known way, even if the least advantageous, of raising funds from life insurance. There are at least 54 viatication firms in business today, and they advertise heavily in the gay and AIDS media; many claim to feel a special social service or gay rights calling, and some even say they are solely "sellers' agents." Affording Care, Inc., provides a listing of the viatical firms and additional consumer information; send a self-addressed stamped envelope to: Affording Care, Inc., 429 E. 52nd Street, New York, NY 10022, 212/371-4741. This list shows which firms have sought or secured licensure to do business in California -- which provides some protection, even if both you and the viatical company are located outside of California, since it means that someone has at least examined the paperwork of the business. (In most states, viatical firms are not regulated at all; Kansas, New Mexico and New York require licensure, but their standards are not widely applied, or have only recently gone into effect.) The National Association of Insurance Commissioners (NAIC) recently adopted a model regulation for states to use in regulating viatication; for a copy, contact NAIC at Suite 1100, 120 West 12th Street, Kansas City, MO 64105, 816/842-3600. The National Viatical Association -- a trade group -- offers some information as well; contact them at 6614 Sanger Avenue, Suite 3, Waco, TX 76710, 817/741-9465. What percentage of the benefit should you expect to sacrifice as the discount for the investor? According to David Petersen of Affording Care, "There are not set prices. Selling and buying a policy is like selling and buying a used car. You have to shop around and negotiate. Offers and bargains vary widely." Non-Profit Viatication Funding Sought Some consumer advocates have concluded that a non-profit viatical firm might well offer more generous payouts to the terminally ill by eliminating the profit motive and other high costs in the for-profit industry; to this end, start-up funding and assistance is now being sought by The Morpheus Fund. To support this initiative contact Robert Roehr, P. O. Box 12199, Washington D. C. 20005, 202/234-8172. Taxation of Money from Life Insurance The Internal Revenue Service -- plus all state income and capital gains tax systems, except those of California and New York -- considers funds received from accelerated benefits and viatication to be taxable (loans, already the most advantageous to clients anyway, are not taxable). But on December 15, 1992 the IRS proposed regulations to exempt most accelerated benefits -- but not viatical payments -- from federal taxation; it has yet to finalize this proposal. To obtain a copy, consult that date's Federal Register in any law library. New Studies of Living Benefits Congress has called for a study of living benefits' effect on SSI and Medicaid by the Health Care Financing Administration (HCFA) in fiscal year 1994; this study might focus on issues like "welfare fraud." (Receiving money from insurance while on SSI, Medicaid -- MediCal in California -- or any other needs-based program makes one ineligible, and concealing it is illegal. Social Security Disability Insurance (SSDI) and Medicare are not affected, because one's wealth does not affect eligibility for them, as it does for SSI and Medicaid.) The American Association of Retired Persons has just let a contract to study living benefits. The AARP study is likely to center on consumer issues (such as payout amounts, or sales tactics). The National Viatical Association is considering a survey on the extent to which viatication has kept people off needs-based programs, as an important argument in the struggle to free viatical money from taxation. It will be months -- if not a year or more -- before these studies bear fruit. Meanwhile, the SSI and Medicaid eligibility rules for accelerated benefits and viatication appear in Social Security's POMS manual, Section SI 01130.300 C and D and in SSI Program Instruction No. 03-91-OSSI of August 22, 1991; both are available at any Social Security office. Getting Insurance While HIV Positive Contrary to received wisdom, it is sometimes possible for HIV-positive persons to secure life insurance. For example, most employers offer group life insurance, without medical tests or questions to their employees, in amounts at least equal to annual salary levels. What is not widely known is that these group policies -- once the group coverage goes into effect -- are almost always convertible, for those leaving the job, to an individual life policy without medical questions. One must invoke the conversion right within thirty days of departure and pay private, "community-rated" premiums oneself, but policies so secured can sometimes be "accelerated" or -- with careful technical assistance from professional advisers -- viaticated. When job searching, be careful to make general, non-suspicious inquiries about fringe benefits to find out about life insurance coverage; once it is in force (and it may not have a waiting period like some health plans do) one can resign and convert at any time. Staff in payroll offices can be notoriously ignorant and obstructive about life insurance conversions; get the name of the insurance agent who sold the firm the group life plan and contact her or him to resolve problems. Insurance Access Advisors offers modest-fee advice about securing job-based, convertible life insurance of over $100,000 to HIV-positive clients who are and appear work ready, preferably under 35 and/or with good office or word-processing skills, and who are able to relocate, at least temporarily. Call 212/734- 0941 for details. A few insurance agencies, among them Guarantee Insurance Services of Richmond, Virginia, 800/245-6968, sell "guaranteed issue" and "graded life" policies to those who might be uninsurable on an individual basis because of poor health. Often, however, there are two-year or three-year waiting periods for policies to go into force. While these policies can then be paid out in full in the case of death -- or be viaticated -- they generally offer no accelerated benefits payouts. Mutual of Omaha and several television-advertising "veterans" or "over-age-45" life insurance firms also offer similar policies -- sometimes even without the waiting periods. Face amounts are generally limited under all these offerings to $10,000 or $20,000. Note A basic introduction to living benefits -- especially viatication and its effects on taxes and on eligibility for need-based programs -- appeared in Clearinghouse Review magazine, April 1991. It is available at any law library, or from the National Clearinghouse for Legal Services, 205 West Monroe, Chicago, IL 60606, 312/263-3830, $15. ***** Correction: California AIDS Drug Assistance List Our list of drugs in the California AIDS Drug Assistance Program (AIDS TREATMENT NEWS #192, February 4, 1994) erroneously listed 5-fluorouracil as one of the drugs provided. The drug flucytosine should have been listed instead. The correct list is: acyclovir, amphotericin B, atovaquone, azithromycin, AZT, clarithromycin, clindamycin, clofazimine, clotrimazole, dapsone, ddC, ddI, ethambutol, fluconazole, flucytosine, foscarnet, ganciclovir, ketoconazole, nystatin, paromomycin, pentamidine (aerosol), pentamidine (intravenous), pyrimethamine, rifabutin, sulfadiazine, and trimethoprim- sulfamethoxazole. ***** AIDS TREATMENT NEWS Published twice monthly Subscription and Editorial Office: P. O. Box 411256 San Francisco, CA 94141 800/TREAT-1-2 toll-free U. S. and Canada 415/255-0588 regular office number fax: 415/255-4659 Internet: aidsnews.igc.apc.org Editor and Publisher: John S. James Reader Services and Business: David Keith Thom Fontaine Tadd Tobias Rae Trewartha Statement of Purpose: AIDS TREATMENT NEWS reports on experimental and standard treatments, especially those available now. We interview physicians, scientists, other health professionals, and persons with AIDS or HIV; we also collect information from meetings and conferences, medical journals, and computer databases. Long-term survivors have usually tried many different treatments, and found combinations which work for them. AIDS Treatment News does not recommend particular therapies, but seeks to increase the options available. Subscription Information: Call 800/TREAT-1-2 Businesses, Institutions, Professionals: $230/year. Nonprofit organizations: $115/year. Individuals: $100/year, or $60 for six months. Special discount for persons with financial difficulties: $45/year, or $24 for six months. If you cannot afford a subscription, please write or call. Outside North, Central, or South America, add air mail postage: $20/year, $10 for six months. Back issues available. Fax subscriptions, bulk rates, and multiple subscriptions are available; contact our office for details. Please send U. S. funds: personal check or bank draft, international postal money order, or travelers checks. VISA, Mastercard, and purchase orders also accepted. ISSN # 1052-4207 Copyright 1994 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used. &&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&&& End of display [Copyright Ben Gardiner, 1994, for AIDS Info BBS, San Francisco, California, U.S.A., 1-415-626-1246, source of this file. Only non-commercial reproduction is permitted.]