AIDS Daily Summary December 14, 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 "AIDS Epidemic Increasing Slowly in U.S. Population, New Survey Suggests" Baltimore Sun (12/14/93) P. 8A The first nationwide survey of AIDS infection conservatively concludes that about 550,000 Americans are infected with the virus--an estimate that is considerably lower than earlier government estimates. The new figures, released yesterday by Dr. Geraldine McQuillan of the National Center for Health Statistics, represent the first effort to estimate the scope of AIDS through direct testing of the general population. The data was based on a random sample of 7,992 households, but the researchers concede that it is a conservative estimate because the survey covered only those Americans living at home. It failed to include prisoners, homeless people, and hospitalized patients. In addition, young men in the study were slightly more reluctant than other participants to be tested for AIDS, which may have contributed to the lower estimate of infections. The most widely accepted estimate of AIDS infection, compiled by the Centers for Disease Control and Prevention, dictates that about 1 million Americans carry the virus--a number that has remained stable since the mid-1980s. McQuillan speculates that the CDC previously may have overestimated the extent of the epidemic, but the projection is probably fairly accurate at this time. The new study, she said, "implies the epidemic is slowly increasing in the general population. It is not exploding." Related Stories: Washington Post (12/14) P. A13; Philadelphia Inquirer (12/14) P. A10; Washington Times (12/14) P. A5; and USA Today (12/14) P. 1D "EU Moves to Limit Tainted Blood Supplies" Journal of Commerce (12/14/93) P. 7A The European Union has approved a plan to improve blood testing for the AIDS virus that calls for discontinued use of imported blood. Because half of the affected plasma products come from America, the move would cripple the U.S. medical industry. EC Health Commissioner Padraig Flynn recommended the tighter regulations after investigations yielded evidence that a German company distributed HIV-contaminated blood products. Flynn attributed the inadequacy of blood products to conflicting legislation in EU nations, which bans some members from exporting blood to other member states and allows others to export outside of the EC. The EU should become self-sufficient in blood provisions, said Flynn. "'Natural' Interferon Joins the AIDS Battle" Wall Street Journal (12/14/93) P. B1 Interferon, a substance produced by white blood cells as part of the body's immune defense against disease, once showed promise as an AIDS treatment. Although laboratory and human studies showed that alpha interferon was able to block HIV replication, the substance was problematic in that it caused debilitating flu-like symptoms and had to be administered intravenously, a obstacle to daily use. For years, however, Interferon Sciences in New Jersey has argued that its "natural" interferon manufactured from donated blood is more potent and less toxic than the alpha interferon sold by Schering-Plough and Roche Holding. The company says its Alferon product is a cocktail of 14 alpha interferon subtypes, while the other products are a combination of just two subtypes. It also maintains that one of the subtypes, which is found in its "natural" interferon but not in that of the drug companies, is especially active against the AIDS virus. According to a new report, researchers at the Walter Reed Army Institute claim that the Alferon mixture is, in fact, 100 to 1,000 times more potent than other versions. A test of Alferon in patients also demonstrated fewer side effects than expected. "Carjackers Got a Load of HIV-Positive Blood" Baltimore Sun (12/14/93) P. 2B Two carjackers who hit and bit a man as he was getting into a state-owned vehicle ended up with a car-load full of HIV-positive blood. The 150 test tubes of blood were en route to be tested for the AIDS virus at laboratories in Baltimore and Cheverly, Md. Some of the blood was already known to be infected with the virus because it was taken from HIV-infected patients, said Lynn Frank, director of communicable diseases for the Montgomery County Health Department. Although the stolen car was recovered with all of the specimens intact, the samples are now useless after so much time away from a lab setting because HIV doesn't survive long outside of the body, she noted. Frank said that the patients' blood would have to be redrawn and the old specimens specially disposed of as medical waste. "German Firm Sold AIDS-Tainted Blood--Investigators" Reuters (12/10/93) Frankfurt, Germany--The German HIV scandal continued to snowball Friday when investigators reported that a pharmaceutical firm sold blood taken from a donor known to be infected with the AIDS virus. Three companies have been closed under suspicion that they neglected to ensure their blood products were free of HIV. One of those firms, Haemoplas, received five batches of contaminated plasma in November 1987 from a company called Plasmadienst Offenbach, said Hesse state health ministry. The batches came from a single donor who had tested positive for HIV in January of that year. Two of the batches were seized, but five entered the market 11 months later. The Hesse health ministry found no evidence that Plasmadienst Offenbach may have warned Haemoplas, said officials. Haemoplas then sold the plasma to hospitals in Mannheim, Munich, and Hanau, where local authorities are now recommending that patients who received treatment with the tainted blood products undergo AIDS testing. "EXP--Female Condom--FDA" Associated Press (12/13/93) (Raeburn, Paul) New York--The lack of demand for Reality's female condom may be due to the conclusion of the Food and Drug Administration that the device has a failure rate of 26 percent. James Trussell of Princeton University, however, found the female condom to be about as effective as the male condom and the diaphragm. Furthermore, he says, it may be ideal for men and women who dislike male condoms. "It's the only method that prevents both pregnancy and sexually transmitted diseases that is under the control of the woman," notes Trussell, a Reality consultant. "There wouldn't be a need for the female condom if males used condoms at every act of intercourse." Plus, says Mary Ann Leeper, who directed development of the device at Wisconsin Pharmacal, the polyurethane from which it is made is less likely to rip or tear than latex male condoms. "We know that the HIV virus can't get through the sheath," she said. "Logic says you're going to be protected." Trussell says that 21 percent, not 26, of women using the female condom would become pregnant during one year of "typical use," meaning sometimes using it, sometimes not. Typical use of the male condom is thought to have a failure rate of 15 percent. With perfect use--with each act of intercourse--the female condom has a failure rate of only 5 percent, compared to 3 percent for the male condom, says Trussell. But Dr. Lillian Yin of the FDA says that there is not yet solid data on the device. She said the female condom was approved on the basis of a six-month study, rather than the usual year-long study, because of the condom's value to AIDS prevention. That meant that the female condom could be approved more quickly, but that the FDA was less sure of its effectiveness. "Numbers Paint Somber Picture of AIDS in Md." Baltimore Sun (12/12/93) P. 1B (Selby, Holly) Grim statistics compiled by the Centers for Disease Control and Prevention suggest that Maryland may be one of the states hardest hit by the AIDS epidemic. Although only 19th in population, the state ranks among the top 10 for two significant AIDS indicators: number of AIDS cases since 1981, and the number of infections per 100,000 people. Maryland is ninth in the nation in terms of total cases since 1981, with 7,420 residents diagnosed with the deadly virus. The state has the country's eighth-highest rate of infection, with 47.6 documented cases for each 100,000 residents. The nation is led by New York, which has diagnosed 64,981 cases of AIDS, and the District of Columbia, which has a rate of 232.2 cases per 100,000 people. Other top-ranking states are California, Massachusetts, New Jersey, and Florida. Factors linked to the spread of AIDS, including urbanization and intravenous drug use, have contributed to Maryland's relatively high rate. The same factors apply from Washington, D.C. to Boston, making the Northeast Corridor the highest concentration of AIDS cases in the nation. "Probation Revoked in AIDS/Marijuana Case" United Press International (12/10/93) San Diego--A San Diego judge has revoked probation for a man infected with the AIDS virus who claims he is unable to survive without the marijuana he was growing. In October, jurors accepted "medical necessity" as Samuel Skipper's defense for cultivating marijuana and acquitted him. Skipper, 39, of La Mesa, said that he needed the drug to stave off the symptoms of AIDS, which killed his lover. Skipper then sought to terminate probation conditions from a case in 1991 in which he pleaded guilty. Municipal Court Judge Charles Rogers agreed to modify the terms of Skipper's probation. The judge exempted Skipper's house from search and seizure requirements, but left his person and vehicle open to search. But Skipper argues that his cultivation tools had been seized, and now he cannot use his car to transport drug equipment for fear of violating probation, or facing new charges. "I have no choice but to do what I'm doing," said Skipper. "They won't give me the tools. They're saying, 'Go home and die.'" Rogers allowed Skipper to remain free on his own recognizance until sentencing Jan. 13, when he faces up to three years in jail. "Haitians Escape Guantanamo, Not HIV Shadow" Los Angeles Times--Washington Edition (12/12/93) P. A2 (Sewell, Dan) After the ousting of Jean-Bertrand Aristide from the Haitian government in September 1991, 40,000 Haitians fled from their island. Guantanamo Bay, the U.S. Navy base at the southern tip of Cuba, became a conveniently located detention camp. Three-quarters were sent back, and the camp dwindled down to about 200 Haitians, all of whom had tested HIV-positive. Although they provided sufficient evidence of political persecution in their homeland to qualify for entry to the States, they were prevented from doing so by America's policy against admitting immigrants infected with the AIDS virus. Although unfriendly U.S. policy towards Haitians is common, the indefinite detention of people with medical conditions in such a camp prompted public outrage. U.S. District Judge Sterling Johnson Jr. responded in March by ordering that the 50 Haitians who had developed AIDS be taken to the United States for medical treatment. In June, calling Guantanamo "nothing more than an HIV prison camp," Johnson ordered it shut down. The remaining 142 Haitians were flown to America, where various organizations worked to cut red tape and swiftly arrange housing, medical care, and other aid. Despite these efforts, many Haitians still have problems finding or keeping jobs. The transition has also taken its toll on the psychological state of the immigrants, who are shadowed by a deadly virus in a new culture that has made them feel unwanted and suspicious. "Becton Dickinson Immunocytometry Systems Files 510(K) for FDA Clearance of FACSCount, a Complete System for Monitoring Patients With HIV Infection; New Product Provides Precision, Accessibility and Ease-Of-Use in Monitoring the Progression of the HIV Infection" PR Newswire (12/10/93) San Jose, Calif.--Becton Dickinson Immunocytometry Systems (BDIS) has applied for clearance from the Food and Drug Administration to sell its FACSCount system for monitoring HIV patients in the United States. FACSCount, the first of its kind dedicated to obtaining absolute counts of CD4, CD8, and CD3 T lymphocytes, has been available on the international market since April. The device offers improved precision and accessibility of CD4 testing, which is critical in monitoring the progression of AIDS. The system is self-contained, eliminating the need for other instrumentation and simplifying the sample preparation process. And use of whole blood samples--which require minimal preparation and handling--reduces the risk of human error. Once a blood sample is analyzed, a built-in printer yields a summary printout of the absolute numbers of CD4, CD8, and CD3 T lymphocytes and a helper/suppresser ratio. "Cost effectiveness and ease-of-use of the FACSCount system will make more accurate, reproducible testing for CD4, CD8, and CD3 counts more convenient and readily accessible to patients, including those in lesser-developed countries, afflicted with the HIV virus," explained Kate Mulligan, BDIS marketing manager, Worldwide AIDS Program. "Because smaller laboratories, hospitals, and physician groups will now be able to afford and use an accurate cell counting system, patients will receive the benefit of having local clinics monitor their immune cell levels."