AIDS Daily Summary November 19, 1993 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 Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1993, Information, Inc., Bethesda, MD "Belgian Red Cross Sued Over Contaminated Blood" Reuters (11/19/93) Brussels, Belgium--A group of Belgian hemophiliacs are suing the country's Red Cross, claiming they contracted the AIDS virus from blood transfusions, reported Belgian radio. The announcement said that 37 hemophiliacs had tested HIV-positive since 1985, and six of those had died of AIDS-related illnesses. Of the remaining 31, nine hemophiliacs are taking the issue to court. The case contends that the Red Cross should have implemented a procedure to neutralize HIV in blood earlier than it actually did. The organization began using this procedure in July 1986, but the hemophiliacs insist that the Red Cross knew about the procedure much earlier. According to the radio, this case--small in comparison to the scandals that have rocked Germany and France--is the first of its kind in Belgium. "Is Death Funny? Of Corpse Not" Washington Post (11/19/93) P. D1 (Span, Paula) With today's premiere of "Addams Family Values," writer Paul Rudnick parallels the new film to his off-center off-Broadway play about AIDS. "Can you write a comedy about AIDS? Can you write a comedy about ghouls?" queries Rudnick, who is adept at both. "I enjoy the challenge." While the Addamses are throwbacks to such ideal American clans like the Brady Bunch and the Cleavers, the embattled homosexual men in "Jeffrey" are also non-typical characters. The title character and his friends, with their wisecracking in the face of death, reject Republican conventions and theatrical traditions of earlier, more dignified AIDS productions. Rudnick recalls that, in the beginning stages of the AIDS crisis, "a certain style and a certain wit no longer seemed appropriate; it was out of keeping with the tragedy." Despite initial apprehension that audiences were not yet ready to laugh at AIDS, "Jeffrey" received rave reviews. It has settled into a long New York run and productions of it have cropped up in Los Angeles and San Francisco. "New Way to Identify HIV Sub-Viruses Found" Reuters (11/18/93) San Francisco--Researchers have developed a faster, cheaper, and simpler method of identifying subtypes of the AIDS virus, announced Stanford University Medical Center. The technique reduces the time needed to classify an HIV sub-virus from weeks to mere hours. Standard procedures for recognizing an HIV subtype require researchers to obtain the exact DNA sequence from each virus being studied. But the new method, unlike DNA sequencing, does not require radioactive materials or powerful computers. Researchers simply create a hybrid molecule by pairing a strand of DNA from an unidentified HIV subtype with a strand from a previously unknown HIV subtype. By noting how fast the molecule moves through a gel when pulled by an electric current, scientists can tell whether the strands are similar or different in DNA sequence. The new technique promises to be helpful to scientists developing AIDS vaccines. Many believe that effective vaccines will have to be tailored to counteract specific HIV subtypes. "The virus evolves so rapidly that it is a moving target for the immune system in infected people who are trying to develop therapies and vaccines," said Stanford University School of Medicine researcher Eric Delwart, who developed the technique. "Progress Reported in Understanding HIV-AIDS Link" Reuters (11/18/93) London--Australian and American researchers have made advances in understanding why HIV-infected people are attacked by their own immune systems. Autoimmune diseases, in which the immune system attacks its own tissues by developing antibodies against them, are characteristic of AIDS. Researchers speculate that while the body normally only produces antibodies against invaders, HIV patients make antibodies against their own platelet cells. "There may be some relation between changes in the immune system and the loss of platelets," said Dr. Arthur Hohmann, head of the research team. The relationship was discovered when researchers observed that a mouse antibody developed against an HIV antigen also bound to human platelets. Further experimentation revealed that the antibody bound less well to platelets of HIV-infected people, an indication that their platelets were already occupied. "This finding suggests that the antibody binding sites on the HIV-infected patients' platelets were already occupied by antibodies produced by the patients' own immune system," said researchers. They also noted that antibodies attacking the AIDS virus would eliminate platelet cells at the same time. Hohmann said the findings were important to attempts to develop an AIDS vaccine. "We don't want to give a vaccine that develops antibodies against platelets if we can avoid it," he said. "Warning Issued to Gay Sex Clubs" United Press International (11/17/93) San Francisco--Four homosexual bath clubs in San Francisco, Calif., have been threatened by health officials that they will be closed down if they continue to allow customers to participate in unprotected sex on the premises. Letters warning the clubs were mailed this week, following a five-week investigation, said Dr. Mitchell Katz, director of the San Francisco Health Department's AIDS Office. Investigators uncovered evidence that the clubs were failing to require that clients use condoms to prevent HIV transmission. "As soon as there is sufficient evidence to close them, we will do so," Katz promised. San Francisco's gay bathhouses are widely blamed for spreading the AIDS virus in the late 1970s and early 1980s before the link between promiscuous unprotected sex and AIDS was discovered. "Dec. 1 Designated as World AIDS Day" United Press International (11/18/93) Atlanta--Dec. 1 has been declared World AIDS Day by health officials across the globe. This year's theme is "Time to Act" against the AIDS pandemic, according to the Centers for Disease Control and Prevention. "Each day, an estimated 5,000 persons are newly infected," reports the World Health Organization. "By the year 2000, 40 million persons could be infected." The agency estimates that 13 million people worldwide have already been infected with the virus. "AIDS to Orphan 600,000 in Zimbabwe" Reuters (11/18/93) Harare--At least 600,000 children in Zimbabwe can expect to become orphaned by AIDS in the next six years, predicts a local health official. Orphanages are already inundated with children, reported Anslem Mukwewa, acting director in the department of social welfare, at a conference in Mutare. The director added that the government is seeking ways in which the children could be taken care of in the community at large. "Government cannot expect to continue caring for orphans in residential institutions as most of these places are full," said Mukwewa, as quoted by ZIANA news agency. Independent experts estimate that, of Zimbabwe's population of 10 million, 60,000 individuals have AIDS, and another 800,000 are HIV carriers. "News Digest: AIDS Disclosure Decision" American Medical News (11/08/93) Vol. 36, No. 42, P. 2 Arkansas dentists infected with HIV are not obliged to inform patients of their condition, ruled the state dental board. HIV-positive dentists or hygienists must, however, notify the board. Five months ago, the state medical board said the infected doctors have to tell patients before undertaking any "exposure-prone" procedure, but state health officials objected to the policy. The state medical society has now requested that health officials adopt a single set of guidelines for all practitioners. "APHA Fights Criminalization of HIV Exposure in Illinois Court" Nation's Health (11/93) Vol. 23, No. 9, P. 9 Criminalizing intentional HIV exposure is a poor weapon in the fight against AIDS and could erase the very message that can halt the spread of the virus, declared the American Public Health Association and the Illinois Public Health Association in court. The issue at hand is whether the Illinois HIV Criminal Transmission Statute is so ambiguous that it is constitutional. Under the law, which holds a five to seven-year sentence, Illinois officials have charged HIV-infected people for sneezing, coughing, biting, and scratching. It also prohibits infected individuals from "the exposure of the body of one person to a bodily fluid of another person in a manner that could result in transmission of HIV." Because it generates panic and fear, the law undermines public health efforts to fight AIDS, stops people from seeking testing and counseling, and threatens to lower the general population's vigilance in slowing the epidemic, contend health groups. Condom use may not be a defense under Illinois law, which could cause confusion in a public that needs one clear message about condom use. In addition, as long as people fear that law enforcement officials can obtain results, people will be more reluctant to get tested. The next phase of the case is oral argument in the Supreme Court of Illinois. "Cause of Death Among Persons Reported With AIDS" American Journal of Public Health (10/93) Vol. 83, No. 10, P. 1429 (Chu, Susan et al.) Because of the key role vital statistics play in molding the country's HIV policy, Chu et al. sought to describe the causes of death in AIDS patients, and to evaluate the thoroughness of reporting HIV infection or AIDS on death certificates of people with AIDS. Case reports of AIDS were matched with 32,513 death certificates with underlying causes of death available. Chu et al. found that, between 1983 and 1986, AIDS or HIV was listed as the underlying cause of death for 46 percent of patients who died. After 1987, when specific codes were designated for the virus, that number skyrocketed to 81 percent. The other most common underlying causes of death listed were conditions within the AIDS case definition, infections not included in the AIDS case definition, pneumonia, and drug abuse. Suicides, unintentional injuries, and homicides were less frequent. In concluding their study, Chu et al. emphasized the critical importance of accurately documenting HIV-related mortality on death certificates, as that data can ultimately influence the allocation of health care resources for prevention and treatment of HIV. end ------- End of Forwarded Message