From: "ANNE WILSON, CDC NAC" Subject: CDC AIDS Daily Summary 02/24/94 AIDS Daily Summary February 24, 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 "H.I.V. Counseling Keeps Mothers Connected" New York Times (02/24/94) P. A22 (Gottfried, Richard N.) A recent New York Times article about the New York State Health Department panel's decision to reject a proposal for obligatory HIV testing may have been misleading, says Richard Gottfried, chairman of the Assembly Health Committee in Albany. The panel's focus, Gottfried corrects, was not "how to balance the rights of women with those of their children," but to identify the most effective way of detecting HIV-positive newborns and treating them. The panel favors mandatory HIV counseling of all pregnant women and new mothers, but with HIV testing on the basis of consent. This approach, contends Gottfried, will identify and treat more HIV-positive mothers than will mandatory testing without consent, which will drive some mothers and babies from the system. If this results in compromised health for even a fraction of the 300,000 babies born each year in the state, he says, mandatory testing will do more harm than good. On the other hand, HIV testing with consent and HIV counseling keeps mothers and babies connected to the hospital for care, Gottfried concludes. "Therion Biologics Corp. Wins Federal Approval to Test AIDS Vaccine on Humans" Knight-Ridder/Tribune Business News (02/24/94) Therion Biologics Corp., a small pharmaceutical firm in Cambridge, Mass., has been granted approval from the federal Food and Drug Administration to test its AIDS vaccine on humans. Fifty volunteers at four medical centers will receive the vaccine, known as TBC-3B, which is designed to inoculate people so that they are no longer vulnerable to AIDS. The drug, which passed FDA safety reviews, has previously been tested only on mice, rabbits, and monkeys, according to Dennis Panicelli, Therion's president and chief executive. While TBC-3B uses eight proteins to stimulate a defensive response in the body, Panicelli says there are five or six other vaccines in development which use only a single genetically engineered HIV protein. The human tests of TBC-3B, to be conducted by the National Institute of Allergy and Infectious Diseases, will determine the safety and efficacy of the drug. According to Panicelli, tests are scheduled to begin next week, and will run for 18 months. "Study Finds Benefits to Early AZT Treatment" Reuters (02/23/94) Baltimore--Early treatment with the antiviral drug AZT can prolong life even after the onset of AIDS, concludes a new study. The findings run contrary to a 1993 French and English study which cast doubts on AZT therapy by suggesting that early treatment with the drug actually hastens death once full-blown disease develops. "Starting AZT treatment early--before AIDS--gives the person some extra survival time before AIDS begins, but also extends the time before the first AIDS symptoms appear," explains Dr. Alfred Saah, an associate professor of epidemiology at Baltimore's Johns Hopkins University and lead author of the new study. "AZT works after AIDS, even in someone who received it before AIDS." Saah said that early treatment may give patients extra survival time while they are relatively healthy and still able to enjoy a better quality of life. The study followed more than 3,000 men who were already infected with HIV, became infected, or developed AIDS during the course of the study. "German Ministry Links Rise in AIDS to Sex Tourism" Reuters (02/22/94) Bonn--"Sex tourism" is contributing to the spread of HIV in Germany and other countries, the German Health Ministry declared on Tuesday. In a statement based on preliminary results of a study it commissioned, the agency said that travelers must be informed about the risks of prostitution tourism, which occurs when vacationers--men, in particular--visit countries with large sex industries. In that study, more than half of the men surveyed admitted to paying for sex. "The risk of HIV/AIDS infection through unprotected sexual intercourse has increased dramatically in recent years in the main destination countries of prostitution tourism," such as southeast Asia, read the statement. "New infections with the HIV virus in Germany are linked to the sex engaged in by German holidaymakers." The ministry said that preventive measures were necessary and would be developed, in part with tourism companies. "We have to educate the tourists and the companies, make them aware through leaflets and by discussing ways with the industry of using their brochures to promote safe sex," commented a ministry spokeswoman. "Court Rejects Tainted Blood Class Action Suit" Reuters (02/18/94) (Willmer, Tanya) Toronto--Last week, a Canadian court rejected a class action suit filed against the Red Cross and the federal government by a woman who contracted HIV from contaminated blood. Ontario court judge Robert Montgomery denied certification of the class action, saying that lawsuits involving tainted blood should be launched individually. The law firm handling the class action case is considering an appeal. "The decision in no way ... exonerates either the Red Cross or the government," which are charged with negligence, commented Nicholas Fursmann of the law firm Siskind, Cromarty, Ivey, and Dowler. He pointed out that it was the Ontario government that introduced legislation allowing class actions only last year, and that individual actions would be more time- and money-consuming. The woman who launched the class action suit was one of about 1,000 Canadians who became infected with HIV from contaminated blood distributed during the late 1970s and early 1980s in what now constitutes a national scandal. Hemophiliac groups say rejection of the class action places added pressure on those who have to decide by a March 15 deadline whether to accept a government compensation package, which waives future rights to litigation. "France Supports Methadone in AIDS, Heroin Fight" Reuters (02/17/94) Paris--Alarmed by the wildfire spread of AIDS among intravenous drug addicts, France has reversed a previous stance and now supports the use of methadone to treat heroin addiction. The country had a long-standing opposition to the substitute drug, which can be used to wean addicts from heroin, because it did not want to encourage the use of any narcotic. But Social Affairs and Health Minister Simone Veil revealed that the use of needles by drug addicts is currently the leading cause of HIV transmission, particularly among women. "For 10 years, France ignored the question although it was the country worst hit by AIDS," she said. "It [methadone] is all the more necessary today as it's a weapon against AIDS." Veil said the state is now encouraging methadone treatment, and hopes to enroll 1,000 users in a national program by the end of the year. The United States and many other countries have already established active methadone treatment centers. "Dealing With HIV at the Day-Care Centre" Toronto Globe and Mail (Canada) (02/22/94) P. A21 (Wainberg, Mark A. and Renaud, Anne) In recent weeks, Canadian media have focused attention on two-year old Jessica, who has been banned from a Montreal day-care center because the facility learned that the toddler is HIV-positive. The decision to ban the child, say Mark A. Wainberg and Anne Renaud of the McGill AIDS Centre, has renewed old fears and passions based on ignorance and misunderstanding, and serves as a reminder of just how few strides have been made in AIDS education, despite concerted efforts. An estimated 12,000 HIV-positive Canadians are thought to be living in Quebec, say Wainberg and Renaud, and they have daily contact with other people. While there is no guarantee that HIV transmission can never occur in a day-care environment, it must be understood that although there are thousands of HIV-positive children attending day-care centers, no case has ever been reported of the virus being spread among children attending them. Furthermore, Wainberg and Renaud speculate, it is probable that there are some infected day-care employees. They conclude that illogical, ill-placed, emotional hysteria should not be permitted to distract society from the true methods of HIV prevention--behavior modification and responsible sexual relationships. "UK Newspaper Goes Quiet on Challenge to HIV/AIDS Link" Nature (02/10/94) Vol. 367, No. 6463, P. 500 (Clarke, Maxine) Britain's Sunday Times newspaper appears to be slacking off from its independent effort to discredit the relationship between HIV infection and AIDS disease. Last year, the publication ran 25 stories--most of which were intended to challenge the scientific validity of claims about the causal relationship between HIV and AIDS, and to question the severity of the AIDS epidemic in Africa. In comparison, the Times has run only one AIDS story this year, and that was a widely published report on a woman who is suing Wellcome over her husband's treatment with AZT. Although reader correspondence concerning the debate on the link between HIV and AIDS has been closed by the Times, reports in scientific documents and anecdotal reports from African nations continue to refute the paper's views. "AIDS Digest: AAPHR Issues Guide for HIV-Infected Doctors" Washington Blade (02/11/94) Vol. 25, No. 6, P. 31 The American Association of Physicians for Human Rights (AAPHR), a gay doctors' organization, recently announced the release of a legal guide designed for health care workers who are infected with HIV. The Legal Rights and Obligations of HIV-Infected Health Care Workers, a 47-page booklet, provides information on job discrimination, informed consent laws, privacy and confidentiality, and insurance. AAPHR said an overwhelming number of phone calls it received prompted the association to put out the guide, which was published jointly by AAPHR and the National Lawyers Guild AIDS Network. "Redistribution of HIV Outside the Lymphoid System With Onset of AIDS" Lancet (Great Britain) (02/12/94) Vol. 343, No. 8894, P. 382 (Donaldson, Y. K. et al.) Researchers still have a poor understanding of the basis for many symptoms and pathological transitions observed in AIDS patients. To explore the extent to which direct HIV infection produces disease manifestations of AIDS, Donaldson et al. used a quantitative polymerase chain reaction in a comparison of five AIDS patients who died from AIDS-defining illness and three HIV-positive subjects who died without HIV-related disease. In the AIDS patients, Donaldson et al. found HIV infection at various sites, including the brain, lung, colon, and liver. But in the HIV patients, the researchers found no evidence of significant infection of any non-lymphoid organ. In both groups, however, there were high levels of HIV infection in the cells of the spleen, lymph nodes, and peripheral blood. Pathological examination of tissues from the AIDS patients revealed many abnormalities, some of which were specifically linked to high levels of HIV infection. The findings of Donaldson et al. suggest that the spread of HIV beyond immune system cells is a late event in HIV infection, and is extremely sensitive to the degree of immunosuppression in the patient.