From: "ANNE WILSON, CDC NAC" Subject: CDC AIDS DAILY SUMMARY 12/21/93 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.