Date: Thu, 15 Dec 1994 10:08:04 -0500 From: "JOHN FANNING, CDC NAC" Subject: CDC AIDS DAILY SUMMARY 12/15/94 AIDS Daily Summary December 15, 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 ************************************************************ "Eye Device May Help AIDS Patients" "Promising AIDS Trial of AZT with 3TC Spurs Debate on Combination Therapies" "Mayor's Office Disbands Advisory Unit on AIDS" "Triumphing Over AIDS" "Serving Compassion with a Meal" "Home Tests for HIV Supported" "Family Portraits" "Columbia-Presbyterian Medical Center Press Conference Dec. 15" "Hope for Sale" "Use of Living Wills in HIV Infection and AIDS" ************************************************************ "Eye Device May Help AIDS Patients" Washington Post (12/15/94) P. A12 A double-layered plastic membrane saturated in ganciclovir may be able to control the potentially blinding infection cytomegalovirus (CMV). While CMV is benign in healthy people, it poses a serious threat to people with weakened immune systems--such as AIDS patients. Carl Kupfer, director of the National Eye Institute, says that approximately one-fourth of all AIDS patients develop CMV infection in the eye. Currently, CMV is treated with daily intravenous doses of ganciclovir or foscarnet. AIDS patients must take the drugs for the rest of their lives because they lack the necessary immune system response. With the new device, once the membrane is implanted in the eye, the drug is slowly released, controlling the infection. After eight months in a study of 26 patients with 30 infected eyes--of which 14 of the eyes received the implant--the CMV infection had not progressed in any of the eyes with the implants. An application for Food and Drug Administration approval may be made after two additional clinical trials. "Promising AIDS Trial of AZT with 3TC Spurs Debate on Combination Therapies" Wall Street Journal (12/15/94) P. B6; Moore, Stephen D. A debate on "combination therapies" has erupted after studies found that a combination of the drugs AZT and 3TC could significantly slow HIV progression. While some researchers warned that the supporting evidence is still too preliminary, drug makers and other researchers said the studies clearly demonstrate that a combination of drugs used against HIV can be effective. Drug companies Wellcome PLC and Glaxo Holdings responded enthusiastically to the findings. "There's no doubt that these [study] results are encouraging," said Dr. Brian Gazzard, clinical director for HIV Services at London's Chelsea and Westminster Hospital. "But I think you have to be cautious." Gazzard wants to see whether the combination therapy actually prolongs the lives of AIDS patients or produces statistically significant differences in survival rates between groups of patients receiving varied therapies. Researchers hope to dispel some of the doubts about combination therapy by testing several three- and four-drug combinations during the next two years. "Mayor's Office Disbands Advisory Unit on AIDS" New York Times (12/15/94) P. B5; Dunlap, David W. New York City Deputy Mayor Fran Reiter on Wednesday disbanded the group of outside experts who were trying to restructure the city's Division of AIDS Services. In a letter to the committee's members, Reiter said that "protests, discussions of process, non-negotiable demands and grandstanding" by some AIDS organizations had resulted in "unproductive, time-wasting meetings." She specifically blamed the Housing Works group--which provides housing and other services to about 1,500 HIV and AIDS patients--for disrupting a private meeting last May. The situation will likely prolong the debate over the city agency, which the Giuliani administration considered eliminating earlier this year but abandoned in the face of strong protest. "Triumphing Over AIDS" Washington Post (12/15/94) P. D.C. 3; Young, Vincent "How I Got Over," a special ceremony that celebrated the lives of long-term AIDS survivors, was held in Washington, D.C., on Saturday. "It's time to hear from people who are living, surviving, and thriving," said organizer Gregory Ford, who tested HIV-positive eight years ago. More than 250 people attended the event, where they shared personal testimonies and spoke openly about the difficulties of living with HIV. "Serving Compassion with a Meal" Washington Post (12/15/94) P. D.C.1; Young, Vincent Chocolate Strawberries, a newly opened restaurant in the Washington, D.C., area, reserves its lunch hour to serve free meals to anyone who is hungry and HIV-infected. "We're trying to help give people with HIV-AIDS, who might live on fixed incomes or can't afford to buy food, a chance to get out of the house and eat a healthy meal in a restaurant with friendly people, nice table settings, flowers, and music," said Marsha Richardson, co-founder of the restaurant. The majority of the volunteers who prepare and serve the luncheon meal are HIV-positive or have AIDS. The lunch is open to anyone with HIV, but it is requested that a health or social worker make a referral. "Home Tests for HIV Supported" Houston Chronicle (12/14/94) P. 29A; Lum, Lydia Two Texas legislators, Reps. Glen Maxey and Debra Danburg, said on Monday that they hope to pass legislation to make an HIV home-test kit legal for use in the state. The Food and Drug Administration is currently considering approval of the kits. At this point in Texas, such a kit could not be used because it does not provide the in-person counseling required by state law. With the home-testing kits, people would learn the results over the phone with trained counselors offering advice. The representatives' remarks came during a public hearing on Tuesday in Houston, during which people voiced their opinions and concerns about the home-testing concept. The concerns mirrored the national debate over the kits--impersonal notification, risk of misdiagnosis, and protecting confidentiality. "Family Portraits" Toronto Globe and Mail (12/14/94) P. A15; Mitchell, Alanna A survey of sexually active young adults aged 16 to 19 has shown that teenagers from higher-income families seem to have a greater awareness of sexual health. The 1990 Ontario Health Survey found that while 46 percent of low-income teenagers never used a condom, only 40 percent of middle income and 32 percent of high income teenagers never used one. Sexually active teens from low-income families are also less likely to use other forms of birth control. The result will be an increasing number of teenage pregnancies and greater likelihood of sexually transmitted diseases, such as AIDS, among teenagers of poorer families. "Columbia-Presbyterian Medical Center Press Conference Dec. 15" PR Newswire (12/14/94) The husband and wife research team of Dr. Yuan Chang and Dr. Patrick Moore are holding a press conference at the Columbia-Presbyterian Medical Center in New York on Dec. 15 to discuss their findings of what they believe is a new human herpes virus that may be responsible for Kaposi's sarcoma (KS) in patients with AIDS. KS is the most common cancer in AIDS patients and often first appears as red or purplish sores on the face and in the mouth. "Hope for Sale" American Medical News (11/21/94) Vol. 37, No. 43, P. 13; Pinkney, Deborah Shelton The lack of a therapeutic vaccine for HIV has led to an increasing interest in unconventional AIDS therapies, such as acupuncture, macrobiotic diets, and megadoses of vitamins. Some alternative therapy practitioners work in cooperation with doctors and consider their treatment supplementary. "Many alternative therapies are being integrated into the overall treatment strategy as an additional preventive measure to support and enhance one's life," said Ron Mealy, executive director of the Carl Vogel Center, an HIV/AIDS nutrition and information center in Washington, D.C. The treatments are often used in addition to conventional therapies, but what is especially alarming is that a 1993 New England Journal of Medicine study found that 72 percent of the patients using unconventional treatments had not informed their physicians. A related problem is that many people are being promised miracle cures from unproven therapies. Dr. John H. Renner of the National Council Against Health Fraud estimates that at least 10 percent of HIV-infected people have been conned. Some of the fake cures involve snake venom, ozone injections, or the ingestion of ice balls. In 1990, the FDA established regional AIDS fraud task forces to deal with complaints about harmful therapies and educate consumers about area con artists. "Use of Living Wills in HIV Infection and AIDS" Lancet (11/26/94) Vol. 344, No. 8935, P. 1509; Meadows, Paul In October 1992, The Terrence Higgins Trust, in cooperation with the Centre of Medical Law and Ethics at King's College, London, published a form of living will and healthcare proxy specifically designed for use by people with HIV and AIDS, writes Paul Meadows in a letter to the editor of the Lancet medical journal. Thus far, 20,000 copies of the living will form have been distributed. A questionnaire to test the document's acceptability showed that it is mainly being used by men between the ages of 30 and 40 with a diagnosis of HIV or AIDS. Very few of the living will users discussed their advanced directive with anyone and Meadows notes that the form should emphasize the importance of discussing a living will with someone--especially a doctor--to guarantee that the patient's wishes are carried out. A revised living will form that has been simplified to reflect the concerns of the users identified during research and to clarify the accompanying notes is now available. The revision also reflects changes in recent case law, which shows that under certain condition, the advance refusal of medical treatment will be legally binding.