From CLEARINGHOUS@delphi.com Mon Apr 11 09:30:17 1994 AIDS Daily Summary April 11, 1994 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 1994, Information, Inc., Bethesda, MD "Wellcome Disputes AZT Study Results" Journal of Commerce (04/11/94) P. 6B Great Britain's Wellcome PLC on Friday rejected the findings of a major study, which concluded that AZT does not help delay the onset of full-blown AIDS. Although it has been shown that the drug prolongs life in patients who have symptoms of AIDS, doubts about its benefits for asymptomatic HIV patients have damaged Wellcome. Generally known as zidovudine and marketed by Wellcome under the brand name Retrovir, AZT accounts for more than 10 percent of group revenues at Wellcome and is the company's second-biggest selling drug. Sales have fallen, however, since the release of a preliminary report on the Anglo-French Concorde trials a year ago. The final report states clearly that early use of AZT is not recommended. "WHO Urges Work on Aids Vaccine" Financial Times (04/11/94) P. 4; Green, Daniel Pharmaceutical companies should focus on developing an AIDS vaccine--which would immunize before infection--instead of concentrating on AIDS treatments like Wellcome's AZT, the World Health Organization said yesterday. The shift in focus to vaccines should occur even though "pharmaceutical and biotechnology companies have been reluctant to become fully committed to the development of an HIV vaccine," said Dr. Peter Piot, WHO's director of research and intervention development. Piot punctuated his message with the agency's latest statistics, which placed the number of HIV-infected adults at 14 million and the number of HIV-infected babies at 1 million. As of December 31, 1993, there were more than 850,000 reported cases of AIDS, according to WHO. The agency's push toward vaccine work was boosted by a study released last week which indicated that the leading AIDS drug AZT is of little value to people who are HIV-positive, but have no symptoms of the disease. "AIDS Research Takes Off in Houston, Galveston Area" Houston Chronicle (04/08/94) P. 1A; SoRelle, Ruth AIDS research in Houston was stagnant seven years ago, but the past two years have seen a dramatic increase in research programs and studies in the Houston and Galveston areas. Dr. Richard Pollard received federal funding in 1992 for a drug studies program at the University of Texas Medical Branch in Galveston and, today, his clinic is the only AIDS drug center funded by the National Institutes of Health between St. Louis and Denver. Pollard has gained national recognition and next year will head the adult AIDS immunology committee at the National Institutes of Allergy and Infectious Diseases. Dr. William T. Shearer, director of a federally funded pediatric AIDS clinical trial unit in Houston, heads a similar committee for children. And Dr. Janis Butel, chief of virology at Baylor College of Medicine, recently received a grant to establish a Center for AIDS Research that will specialize in basic research into halting the disease. This recent flurry of activity may give Houston more prominence in the AIDS field, predicts Chris Jimmerson, head of the Research Network, a nonprofit community group that is conducting 12 of the 44 trials listed on Houston's 1994 AIDS trial directory. "AIDS Quarantine" Associated Press (04/08/94) AIDS activists and the Democratic party in Texas criticized a Galveston County Republican group for passing a resolution calling for the quarantine of people infected with HIV. The measure recommends the isolation and quarantine of HIV patients, as well as identification of carriers of the virus. "In my opinion, the whole resolution is filled with rhetoric, innuendo and misinformation," said Maurisa Bylerly, coordinator of the AIDS Coalition of Coastal Texas. "To put forward such a resolution is merely giving voice to fear rather than taking constructive action to address the pandemic." Republican D.D. Haney disagreed. "I think the intent of it was to stress the importance and seriousness of AIDS so that people will recognize that action needs to be taken," he said. "It seems like overkill, but it's a way of getting their attention." David Jameson, chairman of the Galveston County Democrats, compared the resolution to opening a concentration camp. "It sounds like Hitler doctrine is alive and well and apparently in the majority of the Galveston County Republican Party," he said. Related Story: Houston Chronicle (04/11) P. 6A "France--AIDS Telethon" Associated Press (04/08/94) Two in three French citizens viewed the celebrity-studded AIDS telethon simultaneously broadcast Thursday on the country's six major television networks. About 33,185,000 of France's 57 million people watched at least part of the six-hour program--a ratings record, organizers said. Viewers alone pledged more than $8.7 million to benefit AIDS research, in addition to the donations made by mail and through city halls throughout the country. Entertainers joined government ministers, scientists, and AIDS patients to raise consciousness about the disease in Europe's most badly affected nation. France has 150,000 HIV-infected people. More than 32,000 have developed AIDS, with an average of 15 people dying each day from the disease. "Elders Stirs Crowd at AIDS Conference" Boston Globe (04/09/94) P. 19; Saltus, Richard This past weekend's AIDS conference, "Breaking the Silence: Voices of HIV-Positive Women of Color Living the Reality," was highlighted by keynote speaker U.S. Surgeon General Joycelyn Elders, who roused the crowd of about 250 to elicit a revival-like response. Elders stressed that "we don't have a magic shot or a vaccine--the only vaccine we've got is education," but she noted that under 1 percent of the nation's $940 billion health care funding is allocated to preventive AIDS services. Women have been "underdiagnosed, underresearched, and underserved" by the medical establishment, added Anita Gupta, a former Department of Health employee who is currently attending Harvard Medical School. The conference also included workshops on a variety of topics, including HIV-positive female inmates, education about HIV and AIDS, grieving, family policy, and sexuality. The two-day summit, supported by a coalition of community groups and government agencies, was the first public event in the United States to focus on the special concerns of minority women, said representatives of the Women of Color AIDS Council, which sponsored the conference. "Red Cross Delayed Closing Clinic" Toronto Globe and Mail (04/08/94) P. A10; Mickleburgh, Rod The Canadian Red Cross continued to operate a blood donor clinic in the center of Vancouver's gay community several years after its American counterpart ceased similar practices, a former head of the British Columbia Red Cross told the Krever blood inquiry last week. The American policy was implemented in the early 1980s amid fears that HIV could be spread through blood donations, but the Red Cross in Vancouver did not shut down its blood donor clinic in the city's largely gay West End until the "1985-86 era," disclosed Noel Buskard. He said the agency feared "consternation" and an adverse effect on the organization if the clinic closed, and that Red Cross nurses took their own measures to prevent use of blood donated by gay men. The practice of tagging and destroying suspect blood began in the fall of 1982, and was not publicized. It was based on the discretion and clinical judgment of the nurses, because individual donors were not asked for sexual histories. Buskard also acknowledged that the Red Cross gave "no serious consideration" to the issue of a statement of regret to patients who became infected with HIV through contaminated blood. "I don't recall that we ever considered it," he said. "In hindsight, that was probably wrong." "Medical Briefs: Good News About AZT and DDI" Advocate (04/05/94) No. 652, P. 32 Recent studies demonstrate that combination therapy with AZT and ddI improves anti-viral activity both in the laboratory and in humans. Dr. Robert Yarchoan of the National Cancer Institute tested simultaneous and alternating regimens of the two drugs. Simultaneous dosing resulted in an increased number of CD4 cells and weight gain. And a recent study by Antonelli et al. showed that AZT and ddI work synergistically, reducing the chances that resistant strains will develop. "Inmate Peer Education Program Focuses on Confronting Denial" AIDS Alert (03/94) Vol. 9, No. 3, P. 47 In 1986, the goal of the AIDS education program at California State Prison in San Quentin was to teach inmates approaching their release date how to avoid HIV transmission. Today, the HIV-Positive Inmate Peer Education Program at the maximum security facility uses infected prisoners to not only educate about how the disease is transmitted, but to debunk myths about AIDS and to try to alter risky behavior. "Many of the prisoners going through the program today understand how AIDS is transmitted, but they remain in a state of denial," says Barry Zack, director of education and research at the Marin AIDS Project in San Rafael, Calif., which oversees the peer education program at San Quentin. "They don't see themselves at risk." The inmate-instructors receive five days of training, learning a great deal from AIDS researchers from the San Francisco area and also learning how to pass the message along to fellow prisoners. "We use focus groups to figure out what skills the HIV-infected inmates need," explains Zack. "We cover everything from the epidemiology of the disease to the statistics. We also spend a lot of time on alcohol and drug use." During the classes, the instructors target the denial fostered by inmates by pointing out that 25 percent of all inmates have injected drugs. They question the group, usually consisting of 10 to 30 men, whether they have participated in risky sexual behavior or been in situations that could lead to unprotected sex. "The whole goal of this is to increase the perceived risk of everybody in the audience," says Zack. "People still feel that it is 'them,' not 'me.'" "Tuberculosis and HIV Infection" Lancet (04/02/94) Vol. 343, No. 8901, P. 851; Brindle, Richard; Zumia, Alimuddin; Chintu, Chifumbe Chintu and Zumia disagree with Reeve's statement that "HIV remains a terminal illness and the palliative treatment of HIV-related conditions must remain a low-priority in African countries with limited health budgets." Labeling those comments fatalistic and inappropriate, they argue that HIV and TB must be contained, and that researchers must learn to prevent and control HIV-related diseases. Improving the quality of the patient's life by all means possible--regardless of HIV status--should be the goal, assert Chintu and Zumia. They say this philosophy applies not only to Africa, but to South and North America, as well as Asia. Brindle, however, shares Reeve's concern about the use of chemoprophylaxis for the prevention of TB in HIV patients. First, says Brindle, TB is not the only cause of HIV-related morbidity. He adds that in order to implement chemoprophylaxis, virtually the entire population would have to undergo HIV testing, at great expense and trouble. Chemoprophylaxis would have to be for life, but would not help any of the many other infections common to HIV patients. Even more importantly, Brindle suggests that with chemoprophylaxis comes an increase in isoniazid resistance as the drug becomes more widely available. A combination of TB and HIV is bad enough, says Brindle, but a combination of isoniazid-resistant TB and HIV is unthinkable. For serious TB control, he recommends that attention be focused on strengthening existing TB services in sub-Saharan Africa.