Date: Thu, 17 Feb 1994 09:15:04 -0500 (EST) From: "ANNE WILSON, CDC NAC" Subject: CDC AIDS DAILY SUMMARY 02/17/94 AIDS Daily Summary February 17, 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 "Immunologist to Head AIDS Research Office" Washington Post (02/17/94) P. A21 (Brown, David) National Institutes of Health Director Harold E. Varmus yesterday appointed well-known NIH immunologist William E. Paul to head the agency's Office of AIDS Research (OAR). Paul, who currently heads the Laboratory of Immunology at the National Institute of Allergy and Infectious Disease (NIAID), discovered interleukin-4, an important member of a family of immune system regulatory chemicals known as cytokines. While immunology is key to much AIDS research, Paul's work has not specifically centered on the disease. He says he is looking forward to working with the AIDS community, which he acknowledges has been "enormously valuable in getting us where we are today." Replacing NIAID Director Anthony S. Fauci, the 57-year-old immunologist will become OAR's first full-time director. He takes control of an agency that recently underwent a transformation and is now, presumably, more influential. As reconstituted, OAR will have substantial influence over how the government spends its annual $1.3 billion AIDS research budget. Rather than choosing which labs and scientists will be funded, OAR will help set priorities for research. Related Stories: New York Times (02/17) P. D22; Philadelphia Inquirer (02/17) P. A31. "Schaefer Pushes for Name Reporting of HIV Patients" Baltimore Sun (02/17/94) P. 3B (Selby, Holly) While it is agreed that Maryland needs to track the spread of HIV while protecting the privacy of infected individuals, state officials are divided over the method that should be used. The 1992 General Assembly ordered development of a code system, which uses a "unique identifier" rather than a patient's name, but the Schaefer administration is fighting for name reporting. "It is still the administration's and the health department's contention that a unique identifier system doesn't work as well," confirms Bonnie Kirkland, the governor's chief legislative officer. "It is more cumbersome and costly and prone to error than simple name reporting." An administration bill proposes that the names of infected Marylanders be reported to the state health department, which would keep them confidential, but the legislature has twice rejected this type of HIV reporting. Although all states do report the names of people with full-blown AIDS, some fear a similar practice for HIV infections would accelerate the epidemic because people would avoid testing. "People with the infection don't want to be on lists," says Dr. John Bartlett, director of infectious diseases at Johns Hopkins University Medical Systems. Dr. Liza Solomon, an epidemiologist at Johns Hopkins School of Medicine, also disagrees with name reporting. "Names do not impart any more needed information than a unique identifier, but a name has the potential for a breach of confidentiality," she says. "Houston Doctors to Take Part in Research Project on AIDS" Houston Chronicle (02/16/94) P. 27A (Sorelle, Ruth) In what will become one of the largest AIDS-related studies of women, Houston researchers will target HIV-positive pregnant women and their babies as part of a $5 million research project. The team will follow 200 female HIV patients during and after pregnancy for three years, as well as follow the medical and physical course of infants born to the infected mothers, said Dr. Celine Hanson, associate professor at Baylor College of Medicine. Researchers at medical centers in Boston, New York, Chicago, and Puerto Rico will enroll a similar number of women. They hope to discover the answers to such questions as how the disease progresses in women who have been pregnant, what factors are important in mother-to-child transmission, and how the disease progresses in a child. Hanson also said he hopes the research will identify a way to reduce the time it takes to diagnose HIV infection in a perinatally infected baby from six months to 48 hours after birth. The study is being funded by the National Institutes of Health. "AIDS Activists Lobby for Funds" Boston Globe (02/16/94) P. 69 Dozens of activists lobbied Massachusetts Gov. William Weld and other legislators yesterday for increased funding for AIDS-related services, housing, and substance abuse treatment programs. According to the AIDS Action Committee, which organized the rally, the number of state AIDS cases has skyrocketed 267 percent since 1989, while AIDS funding increased only 65 percent. The group's head, Larry Kessler, said the $10 million increase proposed by Weld is not enough to prevent the spread of AIDS and treat those who are already infected. "One in 20 Dutch Homosexuals Has AIDS Virus--Survey" Reuters (02/16/94) Amsterdam--One in 20 gay men in the Netherlands is HIV-positive, according to a state-sponsored survey. The poll of more than 300 homosexual males concluded that the rate of infection in the capital city of Amsterdam--sometimes known as the "gay capital of Europe"--reached almost 14 percent, reported Dutch television. The National Committee against AIDS called the survey findings alarming, and said they contradicted the belief that the rate of infection was slowing. "Cats Said to Carry Bacteria That Can Infect Owners" Reuters (02/15/94) Chicago--Researchers report that many cats carry a bacteria that can cause mild to life-threatening conditions in humans, particularly AIDS patients and other immunocompromised individuals. The bacteria, Rochalimaea henselae, can cause a range of diseases, including bacillary angiomatosis. The researchers note that cats and other pets are often recommended as companions for elderly persons and people with AIDS--both of whom are especially vulnerable to infections from the bacteria. "It is probable that the reported incidence of Rochalimaea-associated human disease will increase substantially" because the number of people with suppressed immune systems is growing, writes Dr. Jane Koehler in the Journal of the American Medical Association. "Blood Plant Wastes Millions of Taxpayer Dollars" Knight-Ridder Financial News (02/16/94) Winnepeg--Canadian taxpayers forked out millions of dollars for the construction of a blood-processing plant that barely worked, then sold the facility to private enterprise for next to nothing, revealed an internal document retrieved from the now-defunct Canadian Blood Committee. According to the report, the Winnipeg Plasma Laboratory and Toronto's Connaught Laboratories Ltd. both wasted large amounts of plasma. This forced the Canadian Red Cross to buy American plasma, which is thought to have a greater risk for HIV contamination. "The Prudential Foundation Honors Eight Non-Profit Leaders" Business Wire (02/16/94) Newark, N.J.--Eight leaders of non-profit organizations, including an AIDS service organization, received the Prudential Foundation Prize for Non-Profit Leadership. The individuals were chosen based on their contributions to their organizations, as well as the impact of their organizations upon the quality of individual and community life. Among the recipients was Carol Levine, head of the Orphan Project in New York City. Her agency is committed to studying and developing solutions to the increasing problems of children who have been left without parents because of AIDS. Levine has spearheaded a major report on AIDS orphans, and has been an advocate of parents and children affected by HIV and AIDS. "Letters Provoke Unintended Response" Science (01/28/94) Vol. 263, No. 5146, P. 461 (Balter, Michael) When nearly 100 researchers signed a letter asking French President Fran ois Mitterand to pardon four doctors convicted for their part in the country's HIV-contaminated blood scandal, they sparked public outrage. Two of the convicted physicians are currently in prison and, if the French press is any indication, the public would like them to stay there. "Justice has been served," declared Simone Veil, France's minister of health and social affairs. "Those voices that are expressing themselves today should have expressed themselves earlier." French immunologist Jean-Claude Gluckmann, however, contends that researchers were not given the opportunity to express their views during the trial and appeal. "The court did not allow expert scientific testimony about the decisions that were made," claimed Gluckmann, who helped draft the letter to Mitterand. For example, he explained, the physicians were accused of giving contaminated clotting factor to hemophiliacs who were already HIV-positive, yet, because the data was taken from monkey experiments, the court refused to hear evidence that this was not harmful. As a result, Gluckmann maintains, the four doctors were victims of "trial by the media, where sensationalism dominated to the detriment of accuracy." Similar views were further expressed in another letter signed by 32 Nobel laureates and six other renowned scientists. "Breastfeeding and HIV in African Countries" Lancet (02/05/94) Vol. 343, No. 8893, P. 362 (Cutting, William A.M. and De Clercq, A.) Ziegler's report on the role of breastfeeding in HIV transmission discusses mothers' awareness of their HIV status and the subsequent decision-making process about whether to breast or bottle feed. William A. M. Cutting of the Department of Child Life and Health at the University of Edinburgh disagrees with Ziegler's statement that "many pregnant women with HIV are aware of their status at the time of delivery." Cutting points out that HIV testing is limited in most parts of Africa, and concludes that, even in communities where HIV is common, women are not aware of their infections. He further suggests that decisions about breastfeeding that are based on mothers' awareness of their HIV status are of little value. Alternatives to breastfeeding, Cutting adds, depend on a variety of factors including availability of domestic water and of formula, mothers' knowledge about formula preparation, and affordability. He cites a 1992 study that compares the cost of commercial breast-milk substitute with the daily wage of a hospital cleaner. The results showed that in Zimbabwe, for instance, the cost was 27-60 percent of the wage and 217-900 percent of the wage in Zambia. The cost of formula feeding is clearly an unreality for most African women, concludes Cutting. A. De Clercq agrees that Ziegler fails to address the practical issues of who will pay for routine prenatal HIV testing, bottle feeding, and milk-suppressing drugs. Studies of vaginal microbicides might be of more direct help, suggests De Clercq.