Date: Thu, 22 Dec 1994 09:06:07 -0500 From: "JOHN FANNING, CDC NAC" AIDS Daily Summary December 22, 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 ************************************************************ "Ares-Serono AG Drug Cleared for Treatment of AIDS Weight Loss" "AIDS Breakthroughs and AIDS Politics" "Around the Nation: Addenda" "Prison Inmate Has TB, 5 Staffers Test Positive" "Pioneer AIDS Organization Leaves Bankruptcy, Plans to Raise Funds" "Ohio's Universal Guaranty Life Sued by HIV-Positive Florida Lawyer" "ChemTrak Enters Home HIV Testing Market with Acquisition of Coonan Clinical Laboratories" "Clinton to Seek More AIDS Money" "Chaperoning a Pathogen" Out of the Closet on the Right to Die" ************************************************************ "Ares-Serono AG Drug Cleared for Treatment of AIDS Weight Loss" Wall Street Journal (12/22/94) P. B8 The Food and Drug Administration (FDA) has approved the use of a human-growth hormone, Serostim, made by Ares-Serono AG for the experimental treatment of severe weight loss in AIDS patients. AIDS advocacy groups hailed the FDA action because there is no other therapy for AIDS-related wasting syndrome. During Phase III clinical trials, patients injected with the drug gained significantly more weight than those receiving the placebo. Ares-Serono hopes to seek FDA marketing approval in 1995. In the meantime, Serostim may be available to AIDS patients diagnosed with wasting syndrome at $150 per six-milligram dose. The treatment is daily and lasts for three months. "AIDS Breakthroughs and AIDS Politics" Washington Post (12/22/94) P. A19; Hentoff, Nat The discovery that AZT, when given to HIV-infected pregnant women, reduces the risk of HIV transmission to infants by two-thirds is surrounded by controversy. Mandatory prenatal testing could prevent transmission of a fatal infection to the child, but would violate the mothers' privacy. AIDS czar Patricia Fleming says that she would have providers "offer" the test, meaning voluntary counseling. Dr. Philip Pizzo of the National Institutes of Health said that if all pregnant women were tested for HIV and then administered AZT, many children's lives would be saved. Dr. Ruth Macklin, a bioethicist at the Albert Einstein College of Medicine, said, "It is an invasion of privacy. It threatens the women's interests." She added that one has to balance freedom against lives. Finally, the American Civil Liberties Union (ACLU) adamantly opposes mandatory HIV testing of mothers during pregnancy or at birth. "Around the Nation: Addenda" Washington Post (12/22/94) P. A14 After learning that the adoptive parents of a 3-year-old girl are infected with HIV, a St. Petersburg, Fla., judge reversed her adoption. The girl has been living with the couple since June 1992. Related Story: Washington Times (12/22) P. A10 "Prison Inmate Has TB, 5 Staffers Test Positive" Baltimore Sun (12/22/94) P. 1B; Shatzkin, Kate Inmates and staff at two of Maryland's state prisons are being tested for tuberculosis (TB) after an inmate was discovered to be infected with a rare strain of the disease that is resistant to seven drugs. While five of the 82 staff members who had the most contact with the prisoner have tested positive for TB bacteria, none of them have developed active tuberculosis. The approximately two dozen inmates housed near the infected man have also produced negative skin tests and x-rays. Testing of all 400 staff members will not be completed for at least another month. Skin tests will be redone on those who were exposed to the prisoner because an infection can take several months to show up. The inmate is the third in the Maryland prison system to be diagnosed with multiple-drug resistant TB--and the first in Maryland to be resistant to so many drugs. "Pioneer AIDS Organization Leaves Bankruptcy, Plans to Raise Funds" Philadelphia Inquirer (12/22/94) P. B1; Kaufman, Marc; Collins, Huntly Now that its plan for reorganization has been accepted, Blacks Educating Blacks About Sexual Health Issues (BEBASHI)--the pioneering AIDS education group--is emerging from bankruptcy. BEBASHI will begin fundraising again and will be in a better position to obtain government grants, officials said. Lorina Marshall, chairwoman of the BEBASHI board, said the court's approval of the plan would permit BEBASHI to initiate a private campaign aimed at raising approximately $125,000 to help eliminate the group's debt and continue its programs. The organization was founded during the mid-1980s when awareness of AIDS was limited in the black community. Rashidah Hassan, former executive director of BEBASHI, said that despite the bankruptcy, the group was able to continue providing services to more than 375 people with HIV or AIDS, as well as counseling, testing, and information to thousands more. "Ohio's Universal Guaranty Life Sued by HIV-Positive Florida Lawyer" Knight-Ridder (12/22/94); McCabe, Robert Universal Guaranty Life in Ohio has been sued by a HIV-positive Florida lawyer who claims that the company sold life insurance policies to people with AIDS, cancer, and other illnesses and then tried to drop them as policyholders. Gay activist Allan H. Terl accuses the company of racketeering and is seeking the original $50,000 coverage promised under his policy as well as unspecified damages. Terl said that the "Protector Series" policies were sold without requiring a physical examination and without asking whether the applicant had HIV. After having filled out the application and sent in the first payment, Terl received a letter from the president of Universal Guaranty Life stating that the agent who sold the policy was not licensed in Florida and had been soliciting business fraudulently. Terl was offered a settlement of his paid premium, plus $1,000 if he would voluntarily surrender his policy within 10 days. Terl refused and is demanding that the company honor the contract. The agent has been confirmed to be licensed in Florida but under the first name "Vanda" not "Wanda," which appears on her business card. "ChemTrak Enters Home HIV Testing Market with Acquisition of Coonan Clinical Laboratories" Business Wire (12/22/94) ChemTrak Inc. has entered into an agreement to acquire Coonan Clinical Laboratories Inc. (CCL). Subject to certain conditions, the closing is expected to occur within 30 days. CCL is in the third year of developing a home HIV-1 blood collection kit and is in the final stages of preparing a Pre-Market Approval application for the U.S. Food and Drug Administration. Under the agreement, ChemTrak will pay CCL a maximum of 400,000 newly issued shares of ChemTrak common stock. "Clinton to Seek More AIDS Money" Philadelphia Inquirer (12/21/94) P. A3; Connell, Christopher Officials announced Tuesday that the Clinton Administration will seek $91 million in additional funding next year to care for people with AIDS. The administration will also keep a special housing program for AIDS patients. The president has already increased spending on the programs, which are part of the Ryan White Act, by 82 percent. The programs provide direct medical and social services to people living with HIV and AIDS. Intense lobbying by AIDS groups, Housing Secretary Henry G. Cisneros, and AIDS policy director Patsy S. Fleming convinced the Clinton budget office to halt a proposal to stop funding a $186 million housing assistance program. Housing Opportunities for People With AIDS (HOPWA) was enacted by Congress in 1990 to deal with the special housing problems faced by HIV and AIDS patients. The Office of Management and Budget wanted to eliminate HOPWA and switch some of the funds to block grants for areas hardest hit by the AIDS epidemic. "Chaperoning a Pathogen" Nature (11/24/94) Vol. 372, No. 6504, P. 319; Cullen, Brian R.; Heitman, Joseph Studies conducted by Franke et al and Thali et al identify a human protein, cyclophilin A, that promotes the formation of infectious HIV-1 virions. Brian Cullen and Joseph Heitman, both of the Howard Hughes Medical Institute and Department of Genetics at Duke University Medical Center, question where the protein acts in the HIV-1 life cycle and how it exerts its effect. They suggest that cyclophilin A may play a role in virion morphogenesis, or that the protein may act during initial stages of the next viral replication cycle. One hypothesis about cyclophilin A is that it catalyses a "trans" to "cis" isomerization of a peptidyl-prolyl bond. Although the finding that an analogue of the immunosuppressive drug cyclosporin A--which inhibits proline isomerase activity--also blocks cyclophilin A incorporation and HIV-1 infectivity is inconsistent with the hypothesis, there are also data suggesting that cyclophilin A can act as a true protein--independent of its action as a proline isomerase. Cullen and Heitman are pessimistic that cyclosporin A might be useful in the treatment of AIDS because the levels of the drug needed to prevent HIV-1 replication are also sufficient to block the enzymatic activity of the cyclophilins. In addition, because SIV--a similar infection found in simians--is not dependent on cyclophilin A for infectious virion production, HIV-1 may be able to mutate to a cyclosporin-A resistant form. "Out of the Closet on the Right to Die" American Medical News (12/12/94) Vol. 37, No. 46, P. 13; Morain, Claudia Physicians are helping young, politically savvy AIDS patients in the push for assisted suicide. "I've always believed every person has the right to freedom of decisions about their own body, including the timing and mode of their own death," testified AIDS specialist Dr. Peter Shalit. Earlier this year, Shalit was a plaintiff in the Washington state case--propelled by a woman with AIDS--that overturned the state's 140-year-old ban on assisted suicide. Similar cases are taking place around the country. Ralph Mero, executive director of Compassion in Dying, said that nearly half of the group's calls for aid-in-dying come from people with AIDS. "It is a captive population which has already been condemned to death," said Mero. "They want options." A survey in the New England Journal of Medicine of 938 doctors found that 53 percent thought assisted suicide should be legal, and 40 percent said that would be willing to participate in it--there was much less support for euthanasia, which many defined as active killing. Assisted suicide proponents contend that legalizing aid-in-dying would end the suffering caused by failed suicides and would better protect the patients by being open and regulated.