Date: Fri, 16 Dec 1994 10:51:07 -0500 From: awilson@smtpinet.aspensys.com (Wilson, Anne) AIDS Daily Summary December 16, 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 ************************************************************ "Virus May Cause Kaposi's Sarcoma" "A Bittersweet Visit by an Ailing Santa" "U.S. Scientists Find Cell that Attacks HIV Virus" "OXiGENE Announces Results of Assay Used as Prognostic Indicator for HIV Infection in 133 Patients" "Washington CTED Awarded Grant to Develop Housing Opportunities for People with AIDS" "Specific Incorporation of Cyclophilin A into HIV-1 Virions" "Sexual Behaviors and Drug Use among Youth in Dropout-Prevention Programs--Miami, 1994" "Sounding Board: Targeted HIV-Prevention Programs" "Wrong HIV Test Leads to Job Loss" Ethics Committees Urged to Promote Benefits of Testing" ************************************************************ "Virus May Cause Kaposi's Sarcoma" Washington Times (12/16/94) P. A12 A team of Columbia University scientists announced on Thursday that they had found strong evidence of an apparently newly detected virus that might cause Kaposi's sarcoma (KS) in AIDS patients. Dr. Yuan Chang and her husband, Dr. Patrick S. Moore, found that unique DNA sequences were isolated from tissues of KS lesions taken from AIDS patients. "The DNA sequences we found contain portions of at least three different genes that are unique to herpes virus. The evidence strongly suggests that these DNA sequences belong to a new herpes sequence, but additional tests are needed to confirm it," said Chang. Laboratories from around the world have been trying to discover if KS--a skin cancer that strikes more than one-fourth of all homosexual men with HIV--is caused by some infectious agent. Dr. Robert Gallo of the National Institutes of Health said, "It's really good work and it could be a substantial advance." Related Stories: New York Times (12/16) P. A1; Wall Street Journal (12/16) P. B4; USA Today (12/16) P. 1A "A Bittersweet Visit by an Ailing Santa" New York Times (12/16/94) P. B1; Martin, Douglas Mark Woodley sued Macy's department store for discrimination after he wrote on his employment application that he was taking AZT, an AIDS medication. Woodley says that Macy's refused to rehire him after a season of being Santa Claus in 1989. He is suing for more than $3 million in damages and to let him be Santa again at Macy's. "If a certain behavior costs a corporation a lot of money, they'll stop the behavior," he said. "They won't stop it because somebody says it's wrong." Macy's said that in the year they refused to rehire Woodley, he was offered a position as a Santa supervisor, which paid $1 more an hour than the Santa position. Due to Macy's bankruptcy, the suit has been inactive since 1992. Because the store is emerging from Chapter 11, however, Woodley's lawyer has notified Macy's that he wants to proceed with the case. A complication to the case is Woodley's admission on the application that he was taking Prozac, an antidepressant that some medical reports have linked to violent episodes and suicide attempts. At the time, Macy's said it was concerned the drug would cause mood swings. Woodley said he would argue that Macy's fear of Prozac was unfounded and a smokescreen for the store's fear of AIDS. "U.S. Scientists Find Cell that Attacks HIV Virus" Reuters (12/15/94) U.S. scientists announced on Thursday that the discovery of immune cells that attack HIV and could be a potential cure for AIDS. Dr. Jay Levy and collaborators found that the immune cells, called CDT-T, decrease levels of the virus in the blood, causing the flu-like illness experienced during the first stages of AIDS to subside after two to six weeks. The CDT-T cells appeared to briefly stop the spread of the disease. The University of California at San Francisco researchers concluded that the discovery of the HIV-attacking cells will help in understanding the disease. The study found that three out of seven patients had reduced HIV levels in their blood as their blood immune cell activity increased. The researchers said that the finding suggests the cells were "responsible for the control of HIV replication." "OXiGENE Announces Results of Assay Used as Prognostic Indicator for HIV Infection in 133 Patients" PR Newswire (12/15/94) On Dec. 11, Dr. Michael Marmor of the Center of AIDS Research at New York University announced preliminary results demonstrating the superior effectiveness and usefulness of OXiGENE Inc.'s immune function/DNA repair assay as a prognostic indicator for HIV-infected patients. OXiGENE's immune repair assay, which gauges total serum thiol levels, predicted clinical outcome of the disease more strongly than Beta-2 microglobulin, a frequently used alternative marker. The OXiGENE test is also considered less expensive and easier to use for both researchers and clinicians. "Washington CTED Awarded Grant to Develop Housing Opportunities for People with AIDS" PR Newswire (12/15/94) The U.S. Department of Housing and Urban Development has granted the Washington state Department of Community, Trade, and Economic Development (CTED) $1 million to develop Housing Opportunities for People With AIDS (HOPWA). The award will allow CTED to help people through contracts with nonprofit organizations and housing authorities in four impacted communities. The grant will also fund research of the housing needs of people living with HIV/AIDS and develop a statewide plan to meet their needs. HOPWA grants provide housing assistance and support services to low-income individuals living with HIV/AIDS. The assistance will include a number of measures to prevent homelessness among patients and their families. "Specific Incorporation of Cyclophilin A into HIV-1 Virions" Nature (11/24/94) Vol. 372, No. 6504, P. 359; Franke, Ettaly Kara; Yuan, Hannah En Hui; Luban, Jeremy Researchers from Columbia University have found that cyclophilin A is specifically incorporated into HIV-1 virions, but not into virions of other primate immunodeficiency viruses. For cyclophilin A to bind and incorporate, a proline-rich region conserved in all HIV-1 Gag polyproteins is necessary. Disruption of a single proline prevents the Gag-cyclophilin interaction in vitro, blocks cyclophilin A incorporation into virions, and inhibits replication of HIV-1. Franke et al conclude that the Gag-cyclophilin A interaction is necessary for the formation of infectious HIV-1 virions. "Sexual Behaviors and Drug Use among Youth in Dropout-Prevention Programs--Miami, 1994" Morbidity and Mortality Weekly Report (12/02/94) Vol. 43, No. 47, P. 873; O'Hara, P.; Messick, B.J.; Kennedy, M.G. et al To estimate the prevalence of risk behaviors among potential dropouts, researchers from the University of Miami School of Medicine surveyed students in two Miami dropout-prevention programs (schools A and B) and compared the responses to those from a survey of Miami public schools. In general, prevalences of specific risk behaviors were higher among students from the dropout prevention programs than among the public school students. At 29.8 percent, school A students had a higher prevalence of a report of previous sexually transmitted disease (STD) or HIV/AIDS diagnosis than school B students (0) and public school students (4.4 percent). School A students also had a higher rate of injection drug use. While only 13.5 percent of the public school students reported having used drugs or alcohol before their last sexual intercourse, 33.3 percent and 23.4 percent of respondents from schools A and B, respectively, said they had done so. The editors of the Morbidity and Mortality Weekly Report suggest that STD/HIV prevention-service providers consider developing more intensive disease prevention programs targeted at students at risk for dropping out of school, risk levels of students in such programs be assessed, and prevention programming be tailored to the diverse needs of the students populations at risk. "Sounding Board: Targeted HIV-Prevention Programs" New England Journal of Medicine (11/24/94) Vol. 331, No. 21, P. 1451; Des Jarlais, Don C.; Padian, Nancy S.; Winkelstein Jr., Warren Universal and targeted components are the keys to an effective HIV-prevention program. The universal element--a unified national response--consists of reducing HIV-related discrimination, providing basic information about HIV and transmission, and removing the legal and commercial restrictions on the availability of condoms, sterile needles, and other materials necessary for safer behavior. The targeted components--efforts that are very specific to high-risk behavior, demographic characteristics, and geographic areas--require concentrating the limited resources for intensive programs of behavioral change on situations in which the risk of HIV transmission is highest. Such a prevention strategy would inform a greater number of people about the risks of HIV while limited funds are focused on those who are most at risk. "Wrong HIV Test Leads to Job Loss" American Medical News (12/05/94) Vol. 37, No. 45, P. 17 A federal trial court for Puerto Rico has ruled that the government cannot be held liable in a medical malpractice action. While a Veteran's Canteen Service worker, who voluntarily submitted to an HIV test, was found HIV-positive in Oct. 1987, a Western Blot test in January 1988 showed he did not have the virus. After the first test, the treating physician sent a memo to the employee's supervisor stating he was unfit to work in food handling and recommended that he be removed from his food-service position. The employee sued the government for medical malpractice, arguing that the hospital and physician were negligent in handling the test results--that they were confused with another worker's--and that his test results were improperly disclosed and, therefore, breached physician-patient confidentiality. The court found that the test mix-up theory lacked merit because the test showed a positive reaction and because the worker was diagnosed with Pneumoncystitis carinii pneumonia--a condition frequently found in AIDS patients. The court also said that Puerto Rico law recognizes no malpractice claims where a physician's diagnosis fell within the accepted range of medical practice. No breach of confidentiality occurred, the court held, because the memo only stated the employee was unfit to work, not that he was HIV-infected. "Ethics Committees Urged to Promote Benefits of Testing" AIDS Alert (11/94) Vol. 9, No. 11, P. 158 Dr. Martin W. Sklaire, chairman of the provisional committee on pediatric AIDS of the American Academy of Pediatrics, has challenged hospital ethics committees to take a leading role in helping to educate pregnant women about the benefits of HIV testing. "Ethics committees could have an enormous impact on AIDS educational efforts," he says. Policy-makers at the Centers for Disease Control and Prevention (CDC) are currently working to develop guidelines for pregnant women with AIDS that emphasize counseling and education as well as the importance of informed consent. "Confidentiality will be a critical component of screening programs provided by health care providers," adds Dr. Martha Rogers, chief of the HIV epidemiology branch of the division of HIV/AIDS at the CDC. Sklaire says that in anticipation of the CDC guidelines, hospital ethics committees should start planning educational efforts--such as partnerships among the ethics committees, school-based health clinics, and urban crisis centers.