Subject: CDC AIDS DAILY SUMMARY 12/21/93
From: "ANNE WILSON, CDC NAC" <[email-masked]>
Date: Tue, 21 Dec 1993 13:31:58 GMT

AIDS Daily Summary 
                     December 21, 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
 
"Newly Approved Drug Fights Pneumonia Related to AIDS" 
Washington Post (12/21/93) P. A4 
     The Food and Drug Administration has approved a new treatment to  
help AIDS and otherwise immunocompromised patients combat  
pneumocystis carinii (PCP), a deadly pneumonia parasite.  U.S.  
Bioscience has been given permission to market trimetrexate  
glucuronate as an alternative therapy for PCP which, as the most  
common life-threatening infection linked to AIDS disease, affects 
as much as 80 percent of the AIDS population.  The intravenous  
drug, assigned the brand name of Neutrexin, must be taken  
simultaneously with a second drug called leucovorin.  The second  
drug protects normal cells while the trimetrexate attacks the  
parasite, which invades the lungs of AIDS patients.  According to 
FDA spokesperson Arthur Whitmore, Neutrexin is "another weapon in 
the arsenal" against AIDS.  There are currently three other drugs 
to fight PCP on the market.  U.S. Bioscience said that candidates 
for Neutrexin include the estimated one-third to one-half of AIDS 
patients who must stop taking one of the other three treatments,  
trimethoprimsulfamethoxazole, because of adverse side effects.   
Patients taking the new drug must consult frequently with doctors 
and have blood counts monitored twice weekly.   Related Story:  
Philadelphia Inquirer (12/21) P. C1 
       
"HIV Patients May Get Day in Court" 
Philadelphia Inquirer (12/21/93) P. B3  (Collins, Huntly) 
     A Philadelphia court has been ordered to reconsider a  
class-action suit that charges Social Security with the improper  
denial of disability benefits to hundreds of AIDS patients.  The  
U.S. District Court had avoided the issue last year by refusing  
to allow the plaintiffs to be certified as a class.  The court  
said that the issue was moot because two of the plaintiffs had  
been awarded back benefits from Social Security following a suit  
in 1991.  In addition, the Social Security Administration in July 
issued new guidelines for disability that now include the medical 
problems of people with the AIDS virus.  But the U.S. Court of  
Appeals for the Third Circuit ruled that the district court must  
reconsider whether the plaintiffs can litigate as a class to sue  
Social Security.  Other plaintiffs may have been improperly  
denied benefits before the new regulations were established and,  
the court suggested, may still be entitled to back benefits.   
Government lawyers have indicated that as many as 3,000 people  
with HIV may be members of the class. 
       
"Modest Advances Seen With 2 AIDS Drugs" 
New York Times (12/21/93) P. C7  (Altman, Lawrence K.) 
     Researchers have reported modest advances in drug treatment of  
two common and serious complications of AIDS.  The first is an  
improvement in the oral form of the drug ganciclovir, which is  
being developed to treat cytomegalovirus (CMV) retinitis, a  
potentially blinding eye infection.  Researchers found that  
enough of the oral form of ganciclovir got into the body to  
suppress growth of CMV significantly without many adverse side  
effects.  Current drug therapy for CMV retinitis is intravenous  
only and requires the patient to keep a tube in place of a vein,  
so the oral form of the drug carries strong promise of a better  
lifestyle for these patients.  The other advancement was observed 
in fluconazole, a drug to treat invasive and superficial fungal  
infections in AIDS patients.  Most recent studies showed that  
fluconazole delayed the onset of fungal infections in AIDS  
patients with CD4 counts under 200, doing so notably better than  
another drug called clortrimazole.  The two advancements were  
reported at a scientific meeting in Washington, D.C., sponsored  
by the National Foundation for Infectious Diseases and the  
American Society for Microbiology. 
       
"FDA Sends Warning Notice Alleging Unlawful Disclosure" 
Wall Street Journal (12/21/93) P. C7 
     The Food and Drug Administration last week sent a warning letter  
to Epitope Inc. of Beaverton, Ore., alleging that the company  
violated federal regulations during the development of an oral  
specimen-collection device for detection of the AIDS virus.  The  
agency cited four occasions in which Epitope allegedly violated  
the Food, Drug and Cosmetic Act by disclosing information about  
the expected performance, or pricing, of the specimen-collection  
device known as OraSure.  The regulations aim to prevent  
companies from promoting products before they receive FDA  
approval to be marketed.  Epitope said it does not expect the  
letter to slow or alter FDA review of the company's application  
for premarket approval of OraSure.  The firm says it will respond 
to the FDA letter shortly. 
       
"Cryopharm Demonstrates Potent Viral Decontamination of Blood  
Products" 
Business Wire (12/17/93) 
     Pasadena, Calif.--CP-38, the proprietary psoralen molecule of  
Cryopharm Corp., has demonstrated its ability to eliminate  
platelets, which are critical human blood components of viral  
contaminants--including HIV.  When added to human platelet  
concentrates, CP-38 reduced model viruses by as much as 1  
million-fold compared to untreated samples.  There was little  
effect on the function of platelets, which are essential to  
clotting.  Psoralens are naturally occurring molecules that  
insert themselves into viral nucleic acids, a fundamental  
component of all viruses.  Because red blood cells and platelets  
do not contain nuclear DNA, they are virtually unaffected by  
CP-38.  Once the compound is entwined in the nucleic acid  
backbone of the DNA helix and exposed to ultraviolet light, a  
chemical reaction occurs that breaks the two backbones of the  
helix, thus completely inactivating the virus while sparing the  
surrounding blood cells.  Studies have shown the compound to be  
non-toxic at sufficient levels to achieve maximum viral  
inactivation.  "Given the growing international concern about the 
safety of human blood products, we believe that Cryopharm's viral 
inactivation technologies may offer a simple, efficient, and  
cost-effective method to significantly increase the safety of  
these products from blood-borne viruses such as HIV and  
hepatitis," said Carl E. Brooks, president and chief executive  
officer of Cryopharm. 
       
"Africa Urged to Make AIDS Fight National Priority" 
Reuters (12/17/93)  (Williams, Jack) 
     Marrakesh, Morocco--Participants attending the 8th African  
conference on AIDS have appealed to the continent's governments  
to combat the disease and help prevent hundreds of thousands of  
deaths each year by giving the issue the urgency and priority it  
needs.  In what was dubbed the "Marrakesh appeal," the conference 
outlined a strategy to fight AIDS.  It urged African governments  
and health authorities to consider HIV infection "as a chronic  
affliction that can be prevented" by kicking off education  
programs targeting children, adolescents, and adults.   
"Prevention is the only way to stem the propagation of AIDS in  
Africa," it said.  The appeal called for a ban on discrimination  
against HIV-infected persons, voluntary but not compulsory  
testing for the virus, and free medical treatment.  "We demand a  
commitment from politicians, religious leaders, and scientists to 
give the fight against AIDS the dimension it deserves and make it 
a national priority," it declared.  In conclusion, the conference 
pleaded for "maximum international cooperation and solidarity to  
deal with the epidemic and its consequences." 
       
"Portugal to Help Combat AIDS in Africa" 
Reuters (12/20/93)  (Pozniak, Helena) 
     Lisbon--Portugal is prepared to contribute money and help with  
education programs to help combat the spread of AIDS in its  
former African colonies, announced Michael Merson, director of  
the World Health Organization's program on AIDS.  Odete Ferreira, 
head of Portugal's AIDS commission, said the country would give  
cash, but that the amount was still undetermined.  Details will  
be firmed up next year, she said.  Merson said that WHO plans to  
open four centers in Uganda, Thailand, Rwanda, and Brazil for  
testing experimental AIDS vaccines.  "I'm not hopeful a vaccine  
will be ready by the year 2,000," he said.  "But we can't wait  
until then, education must be our vaccine." 
       
"Theft at Home for AIDS Kids Turns Into a Blessing" 
Chicago Tribune (12/20/93) P. 1-4 
     A detective investigating the theft of more than $500 worth of  
gifts from a New Jersey home for children with AIDS called the  
incident "a blessing in disguise."  That's because the public  
responded to the robbery with true Christmas compassion, donating 
presents and more than enough money to replace the stolen  
merchandise.  Two men broke into St. Clare's House on Thursday  
evening and locked the two health care workers in the basement,  
according to Dr. Terry Zealand, director of the AIDS Research  
Foundation for Children, which runs the home.  Then, as the five  
children slept on the second floor, the intruders stole a TV,  
VCR, and every gift under the Christmas tree, as well as some  
hidden in a closet.  Many of the presents were intended for some  
40 Jersey City families that receive support from the home.  Now, 
thanks to the overwhelming amount of money and gift donations,  
St. Clare's House will be able to help those families and more.   
"We have people coming in from all over the state with toys, and  
the phones start to ring off the hook every time it [the story]  
is aired," said Det. Martin D'Angelo.  "We've taken approximately 
$400 so far just from police officers here in Jersey City, and  
people are wiring in checks to the station made out to the home." 
       
"CDC to Launch New HIV Prevention Initiatives" 
American Medical News (12/13/93) Vol, 36, No. 46, P. 10  (Staver, 
Sari) 
     The Centers for Disease Control and Prevention, in response to an 
independent panel's critical review of HIV-prevention programs  
administered by the federal agency, announced several new  
initiatives.  The first is a new public-information campaign  
called a "prevention marketing initiative" that will target  
people under age 25 who are practicing unsafe sex.  The program,  
set to kick off before the end of the year, will include a  
national media campaign and demonstration projects conducted  
jointly with local groups.  In addition, a new public-service  
campaign will be launched.  This initiative will feature explicit 
messages about preventing sexual transmission of HIV, which are  
scheduled for broadcast at the beginning of next year.  The third 
initiative, effective as of Jan. 1, involves proposed new  
procedures for review of federally funded AIDS-prevention  
materials.  Under the policy, recipients of CDC money to produce  
or distribute such material will be able to designate local  
groups to review them.  It will, therefore, no longer be  
necessary to have materials reviewed by government-appointed  
groups, which has been an instrumental factor in blocking the  
distribution of sexually explicit materials. 
       
"A Prospective Study of Diarrhea and HIV-1 Infection Among 429  
Zairian Infants" 
New England Journal of Medicine (12/02/93) Vol. 329, No. 23, P.  
1697  (Thea, Donald M. et al.) 
     AIDS is often characterized by persistent diarrhea in adults, but 
the cause and its effect on HIV-infected children is still  
largely unknown--especially in Africa, where it is the leading  
cause of mortality among children with HIV.  Thea et al.  
conducted a study of 429 infants in Zaire born to both  
HIV-positive and HIV-negative mothers to determine the incidence  
of persistent diarrhea.  HIV-infected infants, compared to  
uninfected babies, had greater incidence rates for acute,  
recurrent, and persistent diarrhea.  Persistent diarrhea  
developed in 11 infected babies, all but one of whom died.  It  
also developed in 19 uninfected infants, all but one of whom  
survived.  Using a multivariate model, Thea et al. found that  
persistent diarrhea was independently linked with symptomatic HIV 
infection in the mother.  The incidence of persistent diarrhea in 
uninfected babies born to HIV-positive mothers was nearly double  
that of uninfected infants born to HIV-negative mothers, and the  
risk increased if the mother died, even among uninfected  
offspring.  Notable growth impairment, bouts of acute diarrhea,  
and severe immunosuppression often preceded the onset of  
persistent diarrhea.  The data indicates that maternal health is  
an important risk factor for diarrheal morbidity in infants.   
Thea et al. propose that diarrheal morbidity was associated with  
the ability of the mother to care for her baby and maintain  
infant hygiene and nutrition.  The implication, say the  
researchers, is very important considering the estimated 5.5  
million AIDS orphans that will be living in Africa by the turn of 
the century.