>From: "ANNE WILSON, CDC NAC" >Subject: CDC AIDS DAILY SUMMARY 12/17/93 >Date: Fri, 17 Dec 1993 13:17:25 GMT AIDS Daily Summary December 17, 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 "Drug-Resistant Strains of H.I.V. Linked to Tripling of AIDS Deaths" New York Times (12/17/93) P. A28 (Altman, Lawrence K.) A study of 170 strains of the AIDS virus showed that 15 percent of the strains were highly drug-resistant, and that patients infected with these strains were three times more likely to die in a given period than those with other strains. Scientists were aware of the presence of HIV strains that demonstrated resistance to AZT--the disease's main treatment--but had no proof of clinical ramifications. "Now we know it is clinically important," said Dr. Clyde S. Crumpacker of Beth Israel Hospital in Boston, head of the research team that made the discovery. He added that the team viewed resistant strains as an indicator not of death, but rather of disease progression. When AZT-resistant strains are detected in an AIDS patient, doctors could possibly replace AZT with another drug, or simply add another drug to the treatment regimen. Researchers now hope to develop a test for this purpose that can be used in everyday medical practice. A "pressing problem" is the need to develop a quicker and easier version of the existing test that can be done by commercial laboratories, so that physicians can use it in their care of HIV-infected patients, said Crumpacker. "Celgene to Boost Work on Immune Therapies" Journal of Commerce (12/17/93) P. 6B Celgene Corp. plans to expand immune therapeutics research based on the modulation of tumor necrosis factor alpha (TNFa), a hormone-like protein that performs several important cellular functions. High levels of TNFa are linked to many of the debilitating symptoms of diseases such as cancer, autoimmune disorders, and AIDS-related opportunistic infections. The company's expanded research program will capitalize on its proprietary chemical and biological technologies, as well as clinical data indicating that thalidomide may be an effective modulator of TNFa. Celgene will launch the expansion with human clinical trials of Synovir (thalidomide) in AIDS patients and the development of new analogs for evaluation in AIDS and other illnesses. "CDC: AIDS Guidelines Won't Be Changed" United Press International (12/16/93) Atlanta--Despite two recent, separate accounts of a child and an adolescent who transmitted the AIDS virus to other members of their households, the Centers for Disease Control and Prevention has announced that it will not make any revisions to its 1985 guidelines concerning school attendance, foster care, or day care. Transmissions in such settings and in homes are "extremely rare," and can be avoided by precautions to prevent exposure to blood, the federal agency said. "In 17 studies involving over 1,100 persons who lived in the same households with HIV-infected persons, none became infected," reassured health officials. "Nutrition Key in Preventing AIDS Deaths" Business Wire (12/16/93) Malnutrition, not AIDS, is killing HIV-positive patients, contend the creators of "The HIV+ Survival Guide" video, the first step-by-step nutritional guide for infected persons. The video asserts that if AIDS patients simply meet their special nutritional needs, they can and should live long, healthy lives. Many people who have died as a result of AIDS actually died of malnutrition, a condition that can be treated and often can be prevented, according to the Physicians Association for AIDS Care (PAAC). Studies indicate that all HIV patients become hypermetabolic. Symptoms generally associated with disease progression, research suggests, are in fact caused by an increased need for nutrients that leads to malnutrition and, finally, death. The nutritional information offered in the video has been confirmed by top AIDS medical practitioners and shows that good nutrition can help delay the advance of AIDS in HIV patients. "Providing the HIV-positive individual becomes proactive in their health maintenance and addresses their unique nutritional needs, HIV infection can be limited to a chronic and manageable disease," proclaims Steve Frankel, the HIV-positive creator and narrator of "The HIV+ Survival Guide" video. "Religious Taboos Hamper African Anti-AIDS Drive" Reuters (12/15/93) (Williams, Jack) Marrakesh, Morocco--Religion-based reluctance to use condoms is hindering the African campaign to curb the spread of AIDS, said attendees at the eighth annual African AIDS conference. Moroccan anti-AIDS campaigner Souad Hanafi noted that women in rural areas rejected condom use even more often than did men. "Most Moroccan women think of sex as a means of procreation," she said. "They want to have children." Parents also were not efficient in informing their offspring about sexual matters considered taboo, Hanafi added. Mohamed Idrissi Kaitouni, director of the Moroccan daily newspaper L'Opinion, said in an editorial that anti-AIDS campaigns placed too much emphasis on the use of condoms for extra-marital sex, and ignored the most important factors, which he cited as abstinence and fidelity. "In a Moslem country...the accent should be on the causes and the danger facing all those exposed to it, instead of inciting people to debauchery, declining morals, and infidelity," he argued. Kaitouni called on the Islamic Affairs Ministry to organize radio, television, and mosque sermons that would preach marital fidelity and abstinence as they are prescribed by the Koran. Finally, professor Abdallah Bensliman pointed to Pope John Paul II's visit to Rwanda, where AIDS is endemic. The Pope urged people there not to use artificial contraception, an act that "to my mind...was a crime," said Bensliman. "AIDS Test" Associated Press (12/15/93) Washington--In a move that would help doctors detect and diagnose AIDS infections earlier, and better monitor the effects of treatment, researchers are trying to develop widely available blood tests that would indicate how much AIDS virus patients have in their bodies. Current tests reveal only the presence of AIDS antibodies. Two new generations of tests are under development, both of which are greatly based on versions of polymerase chain reaction (PCR), a sophisticated lab technique that expands tiny amounts of genetic material so that it can be easily detected. Most advanced are tests that identify viral genes that have been converted by the AIDS virus from RNA to DNA, then stitched into the genetic material of infected blood cells. These tests, which search for viral DNA, do reveal whether a patient is infected, but do not disclose how much of the virus is actually within the cells. The most recent innovation is a test that reveals viral RNA. These tests will detect genes that are inside the virus but are not part of the cells' genetic material, a technique that developers say will allow them to determine the quantity of individual viruses in the body. Both the DNA and RNA tests may be useful in diagnosing infections in the earliest stages, for instance, after accidental exposures such as hospital needle injuries. They may also be helpful in determining the HIV status of infants born to infected mothers. "Trinity Biotech Announces Pre-Clinical Trial Results of SalivaCard and SeroCard HIV-1/2" PR Newswire (12/14/93) Dublin, Ireland--Trinity Biotech, an Ireland-based diagnostics company, has completed initial pre-clinical trials of HIV-1/2 SeroCard and HIV-1/2 SalivaCard, both with favorable outcomes. The results, collected from 10 centers in Italy, Sweden, Mexico, Bangladesh, Thailand, India, and Ireland, demonstrated 99.81 percent sensitivity with HIV-1, 100 percent sensitivity with HIV-2, and 99.59 percent specificity with HIV-1/2. The trials included 483 HIV-negative and 533 HIV-positive patients, 19 of whom were HIV-2 positive. Another trial compared the blood-based SeroCard test with the saliva-based SalivaCard test, and yielded 100 percent concordance. "We are delighted that the tests have proved so reliable in such a wide variety of clinical sites," said Dr. Anthony Nicholls, Trinity chairman and CEO. "The results reinforce our belief that the tests are both accurate and easy to use." Trials continue in India, Africa, Italy, and at the World Health Organization Collaborating Laboratories, which are expected to report further results by the end of January. "Gilead Sciences' GS 393 Associated With Evidence of Antiviral Activity; Initial Phase I/II Results Presented at First National Conference on Human Retroviruses and Related Infections" HealthWire (12/15/93) Preliminary findings from the Phase I/II clinical trials of an HIV therapy indicate that administration of the drug is linked to decreased p24 antigens and increased CD4 counts. The purpose of the studies of GS 393, or PMEA, is to determine evidence of dose-limiting toxicity, antiviral activity, and pharmacokinetics of the drug. Among the 28 HIV-positive patients enrolled in the study, the GS 393 was generally well-tolerated, although some dose-limiting side effects were observed. In response to these results, Gilead Science--the manufacturer of GS 393--will pursue additional studies, including different routes of administration, lower doses, and compatibility with AZT. The preliminary results of the trials were presented at the University of Washington during the First National Conference on Human Retroviruses and Related Infections. "Serving HIV-Infected Poor Families" Focus (11/93) Vol. 8, No. 12, P. 1 (Tufel, Robert and Brooks, Geri) Epidemiological data indicates that the fastest-growing groups in the AIDS epidemic are women, children, adolescents, blacks, Latinos, and those infected by heterosexual contact. The majority of these cases occur in poor, urban households where one or more family members carry the virus. HIV increases the burden of poverty, and affected families confront a variety of obstacles. Housing is of the utmost importance to HIV families. Homelessness or lack of stable housing increases vulnerability to medical problems, such as upper respiratory infections; ear, gastrointestinal, or chronic physical disorders; and fatigue. It also makes it difficult for HIV families to benefit from the services of AIDS organizations. Stigma has a major impact on these families as well. HIV families still hide AIDS infection, and continue to ostracize infected family members out of fear that they might contract the virus. Stigma affects the entire clan no matter who is infected. Just watching an infected relative fight fear, misunderstanding, and hatred contributes to the feelings of shame and isolation. Planning for change, too, is stressful, and families must make financial preparation as well as psychological preparation for children who will experience rejection, abandonment, grief, isolation, and fear upon the death of a parent. Many HIV families must also deal with substance abuse, which quickens disease progression and makes it more difficult for parents to care for their children. "HIV and an Editor Equals Plus" Advocate (12/14/93) No. 644, P. 36 (Clarkin, Michelle) This month will witness the premiere issue of "Plus: The Magazine About Living & HIV." According to editor Brett Grodeck, the publication will focus on lifestyle issues--the daily concerns and tribulations that he finds are not addressed in medical and clinical journals and textbooks. The bimonthly, four-color glossy will explore career decisions, dating and intimacy, family interactions, safe-sex, and unconventional approaches to staying healthy. It will also include features, departments, and profiles of active participants in the AIDS movement. Grodeck found the need for such a publication when he discovered his own HIV-positive status in 1987. He says the public still has a fear of AIDS, "and everyone has to understand these fears. But people have fears because the information is not there and they've not been educated." Grodeck was able to start up Plus and achieve national distribution through the pooled resources of AIDS service organizations in Chicago, grants, and the guidance of his former boss, publisher Joe Crump. Although much of his support flows from the homosexual community, the editor says Plus will not speak only to gays and lesbians. He has planned the columns so that all people affected by AIDS--blacks, Hispanics, women, drug addicts, families, and bisexuals--have a voice. "Each community needs to be able to identify with what's on Plus' pages," Grodeck reasons. "We are all part of this together. We are not disconnected populations." --- End of forwarded mail from minerva@netcom.com (Minerva) -- ------ Darci L. Chapman Northwest Natural Gas Portland, OR \ --/--- work: dlc@gasco.com play: dlc@nehalem.rain.com \ \/ / \/\ / Civil Rights are NOT "Special Rights". \/ (I do not speak for the Gas Company, and They do not speak for Me)