Date: Mon, 14 Feb 1994 09:58:20 -0500 (EST) From: "ANNE WILSON, CDC NAC" Subject: CDC AIDS DAILY SUMMARY 02/11/94 AIDS Daily Summary February 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 1993, Information, Inc., Bethesda, MD "Tuberculosis Funding" Associated Press (02/11/94) (Neergaard, Lauran) Washington--Rep. Tony Hall (D-Ohio) has criticized the U.S. Agency for International Development (AID) for not doing its part to combat the global epidemic of tuberculosis. Hall says that if the agency does not believe that fighting the deadly disease is worth "a mere $3 million, even in a tight budget," he will ask Congress to allocate the funds. "I can't believe they're not making this a priority," he said. "This is the most neglected disease in the world today." Tuberculosis is responsible for 3 million deaths every year--more than all other infectious diseases combined. The World Health Organization asked AID for $3 million this year to help fight the spread of tuberculosis in developing countries. Although AID rejected the request last month, the agency is now reconsidering. However, AID health chief Dr. Ann Van Dusen said that the agency's funding priorities are still AIDS and children's health. "Dr. H.M. Temin, 59, Dies; Cancer Research Laureate" New York Times (02/11/94) P. B7 (Altman, Lawrence K.) Dr. Howard M. Temin, awarded a Nobel Prize in 1975 for his research on the nature of cancer, died Wednesday of a rare form of lung cancer. Temin's Nobel was for his discovery of an enzyme, reverse transcriptase, that allows certain cancer-causing viruses to convert their RNA into DNA and therefore improve their chances of survival once they enter DNA-dominated animal cells. These viruses that use reverse transcriptase are known as retroviruses, a class that includes HIV and Hepatitis B. Reverse transcriptase allowed researchers at the Institute Pasteur in Paris to identify HIV. The concept has also proven instrumental to genetic engineering, particularly in the development of insulin and tpa. Although Temin's lung cancer was a rare type not related to tobacco use, he was a fierce critic of smoking. When receiving his Nobel Prize, Temin blasted the audience for smoking. Born in 1934, Temin earned his Ph.D. from the California Institute of Technology. The work he began there on how viruses cause cancer continued when he moved to the University of Wisconsin at Madison. "Health Officer Held in Faked AIDS Data" New York Times (02/11/94) P. B3 New York City Health Department data supervisor Daniel Wiley has been charged with altering the results of an AIDS test from positive to negative. Wiley knew the person whose results he changed, according to a spokesman for the Department of Investigation. Wiley's lawyer said his client was "trying to protect the confidentiality of a patient or testee." "Timing and Flexibility Crucial to Partner Notification Counseling" AIDS Alert (01/94) Vol.9, No.1, P. 13 Because most newly diagnosed HIV patients have enough difficulty coping with their own seropositivity, experts say how and when a counselor discusses partner notification can determine whether the outcome is favorable or unfavorable. "It's not an easy thing for counselors to do," says Ruth John-Bonnette, deputy director of HIV counseling and testing for the New York City Department of Health. "It's a segue from routine pre- and post-test counseling, and the way a counselor puts it in a session is what makes it work or not work." The best time to introduce the issue of partner notification is during pre-test counseling, so that patients can begin thinking about disclosure in the event that they test positive. For clients who are willing to contact partners, the post-test counseling session should pick up on previous discussions about partner notification. The counselor and patient should decide how, when, and where to notify a partner--including whether to do so in public or private, as some HIV-positive women are subject to abuse. It is best for the patient to notify partners as soon as possible, but many clients need time to adjust to their own feelings about their infection. In fact, some experts say that post-counseling is the worst time to discuss partner notification. "How can they focus on their partner when they are told they have a fatal disease?" asks Kathleen Toomey, state epidemiologist for Georgia. "Ethical, Behavioral, and Social Aspects of HIV Vaccine Trials in Developing Countries" Journal of the American Medical Association (01/26/94) Vol. 271, No. 4, P. 294 (Lurie, Peter et al.) As investigators prepare to conduct efficiency trials of HIV vaccines in developing nations, researchers warn that unless they address unique ethical, social, and behavioral issues that surround vaccine testing, they will jeopardize the success of these trials as well as that of future AIDS research in the host countries. Following a review of previous problems encountered in HIV studies in the developing world, a panel of 12 investigators from across the globe produced guidelines for future trials. Some of the basic recommendations included conducting research on vaccines active against developing world HIV isolates, establishing and maintaining an adequate technological infrastructure, assessing recruitment in nations where the threat of HIV is denied, and creating methods of getting informed consent from individual subjects. Lurie et al. also suggest creating local instruments to measure risk, identifying a behavioral intervention for placebo and treatment groups, providing clinical methods of distinguishing between natural HIV infection and vaccine-induced seropositivity, and ensuring an effective vaccine at no charge to the placebo group and at an affordable cost for other host country citizens. Lurie et al. conclude that host country scientists, government officials, and media must all be actively involved in every aspect of the trials. "Theft of AIDS Records Raise Security Concerns" AIDS Alert (01/94) Vol. 9, No. 1, P. 15 Thiefs who burglarized Miami's Jackson Memorial Hospital on Nov. 15 got away with computerized records containing the names of more than 6,000 HIV patients, sparking concerns over security. The theft was not publicized for three weeks for fear of alarming the public, and on Dec. 15, police arrested two hospital security guards. Investigators believe that the goal of the "inside job" was to steal computer equipment and not the records they stored. Three computers, two printers, and several diskettes were stolen from the offices of South Florida AIDS Network, but no paper files were removed. Hospital spokesperson Betty Bader claims that the computer hard drives and diskettes were protected with access codes, user codes, and passwords. Two computers were recovered and their hard drives were erased, nonetheless, according to the Miami Herald. The incident raised concerns about the security of records at AIDS agencies and health departments countrywide. "AIDSLine: Weight Loss as a Predictor" Advocate (02/08/94) No. 648, P. 33 Nutrition influences survival among people with HIV, independently of CD4-cell counts. An article in the November 1993 issue of the Journal of AIDS outlined a study of 77 HIV patients, who were studied retrospectively for predictors of survival. The two markers of nutritional status were serum albumin and percent of usual body weight. According to the authors, weight loss may not be a good predictor of survival because AIDS patients "can exhibit profound depletion of body cell mass while having a minimally abnormal loss of weight."