Date: Tue, 20 Dec 1994 09:26:51 -0500 From: "JOHN FANNING, CDC NAC" AIDS Daily Summary December 20, 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 ************************************************************ "Going Off the Beaten Path to Track Down Clues about AIDS" "Judge Gives Defense Time to Explain Marijuana Use" "Will New HIV Test Kits Ease the Stigma?" "AIDS Victim's Family Has 'Celebration of Life'" "Prostitution Boom Boosts AIDS Risk in Zaire" "Xerox Service Engineer Granted Leave to Work with AIDS Patients" "Elders Vows to Continue Speaking Out" "Cellular Immune Response to Common Mycobacterial Antigens in Subjects Seropositive for Trypanosoma Cruzi" "Heated Debate over a Law for the Dying" "The WHO and Why of HIV Vaccine Trials" *********************************************************** "Going Off the Beaten Path to Track Down Clues about AIDS" New York Times (12/20/94) P. C3; Altman, Lawrence K. Because Dr. Yuan Chang and Dr. Patrick S. Moore were new to the field, they were more able to try wild ideas than many others working in established laboratories. Together, they form the husband-and-wife team that announced last week that they had detected fragments of a possible new virus and that the agent might cause Kaposi's sarcoma (KS). Chang and Moore explored the Cold Spring Harbor Laboratory technique, known as representational difference analysis, which compares DNA in cells from diseased and normal tissues of the body, and pinpoints significant differences in their chemical sequences. Working with colleague Dr. Melissa S. Pessin, the team hoped to spot genetic differences that might be the inserted genetic material of an infectious agent. While the discovery raised many questions, the doctors' conclusions emphasize the need to grow the full virus in the laboratory, to identify it through an electron microscope, and to prove its relationship to KS. A blood test to diagnose the disease is also needed. A blood test might also answer questions about KS and AIDS if frozen samples from AIDS patients are screened. "Judge Gives Defense Time to Explain Marijuana Use" Baltimore Sun (12/20/94) P. 5B; O'Brien, Dennis At the end of an AIDS patient's hearing on Monday for the possession and manufacturing of marijuana, a Charles County, Md., judge said that he would give the defense lawyers 10 days to submit legal memos supporting their position. The prosecution will have five days to respond before a decision is made. Jerome E. Mensch, a 43-year-old dairy farmer, told the judge that the marijuana he was growing in his back yard was helping him fight the effects of AIDS. The marijuana cigarettes, he said, stimulated his appetite and curbed the nausea that accompanied his illness. Mensch's physician testified that he was so convinced of the drug's effects that he wrote a note certifying that Mensch was HIV-positive and allowing him to buy marijuana through a "Cannabis Buyers Club" for AIDS patients in Washington. Assistant State's Attorney Patrick Devine claimed that Mensch did not try legal alternatives--such as Marinol, which contains the active ingredient in marijuana and is legal for use by AIDS patients--before turning to marijuana. Related Story: Washington Post (12/20) P. D1 "Will New HIV Test Kits Ease the Stigma?" Houston Chronicle (12/19/94) P. 21A; Lum, Lydia Although HIV home test kits may soon become available, a stigma still surrounds the HIV screening process. Although the AIDS epidemic has been around for more than 10 years, proponents of the home test say that people still tiptoe around the topic of HIV testing. Both health providers and clients alike often have so much difficulty approaching a subject with sexual implications that the test is postponed or avoided. Many people cite feelings of awkwardness or paranoia that someone will know they have been tested or will have seen them leave the building. The home test kits--in which the user would learn the results over the phone--have raised concerns of a possible gap in counseling and education about HIV and AIDS. The idea of home convenience, however, has drawn support from those who say more people would be willing to test if the home test is approved. "AIDS Victim's Family Has 'Celebration of Life'" Houston Chronicle (12/19/94) P. 17A; Zuniga, Jo Ann Instead of mourning his death from AIDS on Dec. 5, Brian Cammack's family organized a "celebration of life" party on Sunday. As a tribute to her brother, 19-year-old Nicole Turpeau organized Stop AIDS Let's Unite to Educate (SALUTE) last year. Turpeau speaks to high school groups and community groups about how to avoid contracting the disease. Cammack, who died at the age of 30, was diagnosed with AIDS when he was just 19--before the government began educating the public about how the disease could be contracted. Much of the last two years of Cammack's life were spent in Twelve Oaks Hospital. Staff members attended the celebration and spoke of how strong Cammack's family support remained. "The main difference in this case was the caring manner of the family, how they were there to support him, taking turns to be with him night or day, even when he may not have known they were there," said activity therapist Evelyn Riggs. "Prostitution Boom Boosts AIDS Risk in Zaire" Reuters (12/19/94); Wrong, Michela An increasing number of women in Zaire are turning to casual prostitution, thus providing a breeding ground for AIDS. Because Zaire's recession is leaving many men without work and because an 8,500 percent annual inflation rate is undermining living standards, women of all ages have become prostitutes. Researchers estimate that 7 percent to 8 percent of the general population and as much as 40 percent of prostitutes in Zaire are now HIV-infected. In a sample group of 1,000 prostitutes tested over a period of 30 months, 27 percent who were HIV-negative at the beginning of the study had become infected by the end. Doctors blame ignorance about HIV and AIDS on a cultural reluctance to speak openly of sex and on the lack of media coverage. "Xerox Service Engineer Granted Leave to Work with AIDS Patients" PR Newswire (12/19/94) Xerox Corporation has granted Stephan Lee Clark six months of leave with pay to care for AIDS patients at the Bailey-Boushay House in Seattle--the first skilled nursing home in the nation for people dying of AIDS. Clark made a promise to a Xerox colleague, George Robbins, shortly before Robbins' death from AIDS, that he would do something to help others in the final stages of the disease. "So many patients have been abandoned by their family and friends," said Clark. "Bailey-Boushay helps to lessen their fears and loneliness." Robbins was on the waiting list for Bailey-Boushay. When he became too weak to care for himself, his insurance company paid for someone to care for him during the day, while Clark and his wife cared for him at night. "Elders Vows to Continue Speaking Out" Reuters (12/19/94) Former Surgeon General Joycelyn Elders said she will continue to speak out about the dangers of sexually transmitted diseases (STDs). Elders was forced out of office after she publicly condoned teaching schoolchildren to masturbate as a way to avoid the spread of AIDS. "Sexual practices are, of course, best left to consenting adults, behind closed doors. But sex becomes a proper subject for government when sexual behavior endangers public health, as is clearly the case with AIDS and other diseases..." she said. Elders said she could not remain silent when more and more teenagers are engaging in sexual intercourse--particularly when fewer than half of them use condoms and when the rates of STDs continue to grow. "Cellular Immune Response to Common Mycobacterial Antigens in Subjects Seropositive for Trypanosoma Cruzi" Lancet (12/03/94) Vol. 344, No. 8936, P. 1540; Bottasso, O.A.; Ingledew, N.; Keni, M. et al Researchers studied the impairment of immune responses in patients in the silent stage of Chagas' disease, which is caused by Trypanosoma cruzi and affects about 20 million people in Latin America. Bottasso et al used quadruple skin-testing with new tuberculins in 37 adults who were symptom-free but seropositive for T. cruzi, and in 37 matched seronegative controls. While none of the seropositive group responded to them, nearly one-fifth of the control group responded, with variable specificity, to common mycobacterial antigens. The researchers suggest that the loss of response to mycobacterial antigens may influence the course of Chagas' disease. Individuals who are infected with T. cruzi may be more susceptible to tuberculosis, leprosy, and HIV infection--all of which are associated with immune unresponsiveness. "Heated Debate over a Law for the Dying" U.S. News & World Report (12/19/94) Vol. 117, No. 24, P. 36; Shapiro, Joseph P. Two AIDS patients in Oregon are taking opposite sides in the debate over assisted suicide. Oregon is seeking to become the first place in the world where doctors can legally provide lethal drugs to help the dying end their lives. Michael Vernon wants the ban lifted because he wants control over how and when his life ends. Vernon says that personal choice is the central issue for him because he has seen friends die of AIDS--often after a long and painful assault on their minds and bodies. Eric Dutson, however, is afraid the law will let doctors and the government decide when he should die. "I am concerned that [medical service providers] will subject me to undue influence or duress to end my life myself in order to enable them to avoid" the dilemma between providing treatment at a reduced charge and denying treatment, said Dutson. Supporters of the law say that it has many safeguards, including second opinions and multiple requests to die. In response to a challenge filed by Dutson and others, a federal judge recently issued a temporary restraining order to keep the law from taking effect. "The WHO and Why of HIV Vaccine Trials" Nature (11/24/94) Vol. 372, No. 6504, P. 313; Moore, John; Anderson, Roy John Moore of the Aaron Diamond AIDS Research Center and Roy Anderson of the Centre for the Epidemiology of Infectious Diseases discuss the reasoning behind the World Health Organization (WHO) advisory committee's decision to approve Phase III HIV vaccine trials in developing countries. Ninety percent of the 16 million people estimated by the WHO to be HIV-infected live in poor communities in the developing world. While the main concern of the committee members was that the products would not work, clinicians and epidemiologists argued that the only way to determine efficacy is to run an efficacy trial. The WHO committee concluded that, ultimately, any decision to go ahead with a trial of any product must be made by the host country for the trial. Phase I/II safety trials should precede a Phase III trial. The panel also stated that the specific HIV-1 subtypes among the proposed trial population should be a significant consideration, as should counseling of the trial populations about the potential risks of vaccination and the necessity of following safe sex practices. The WHO committee emphasized a long-term commitment to AIDS vaccine development and testing worldwide.