Date: Mon, 18 Jul 1994 08:58:46 -0400 (EDT) From: "ANNE WILSON, CDC NAC" AIDS Daily Summary July 18, 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 ************************************************************ "Nearly Third of Ugandans in Towns Have AIDS Virus" "Once-Reviled Thalidomide Shows Promise as AIDS Treatment" "Vacationing Kuwaitis Warned About AIDS" "AIDS May Be Rising, But Romania Won't Admit It" "Across the USA: D.C." "Fugitive Prostitute With AIDS Released" "WHO Warns of Global TB Epidemic" "Factors Predictive of Maternal-Fetal Transmission of HIV-1" ************************************************************ "Nearly Third of Ugandans in Towns Have AIDS Virus" Baltimore Sun (07/16/94) P. 7A Thirty percent of Ugandans living in urban areas are HIV-infected, compared to just four percent in rural areas, according to a report from the Health Ministry. Of those infected, 8.2 percent are children aged 11 years or younger, the report said. While government statistics indicate that 1.5 million Ugandans--or 9 percent of the population--have AIDS, private health experts argue that the real figure is twice as high. "Once-Reviled Thalidomide Shows Promise as AIDS Treatment" Washington Post (07/18/94) P. A3; Brown, David Thalidomide, once shunned because of the terrible deformities it caused in children in the mid-1950s and early 1960s, is resurfacing as a potential treatment for AIDS. Intense research is focusing on the drug as an immune system modulator that may inhibit the growth of blood vessels. Researchers led by Gilla Kaplan, an immunologist at Rockefeller University in New York, have demonstrated thalidomide's ability to reduce the body's production of tumor necrosis factor (TNF), a crucial hormone of the immune system. In HIV, high concentrations of TNF activate infected cells, causing them produce more of the virus. This eventually translates into progressive destruction of the immune system and, finally, AIDS. In theory, if TNF could be inhibited in HIV patients, the course of disease could be slowed down and its symptoms decreased. Kaplan et al. recently documented promising evidence of thalidomide's use in reducing wasting symptoms. "Vacationing Kuwaitis Warned About AIDS" Reuters (07/18/94) In in an unusually public gesture, Monday's edition of Kuwait's al-Watan newspaper included a health ministry pamphlet warning travelers about the risks of contracting AIDS on vacations or business trips. The leaflet offered basic facts about the disease, as well as warnings to avoid drug abuse and extra-marital sex. Such explicit and outspoken AIDS education campaigns are virtually non-existent in the Middle East, where tradition hampers open discussion of sexuality. Between 1986 and 1993, Kuwait has reported 10 people with full-blown AIDS--most of whom have died, according to the World Health Organization. "AIDS May Be Rising, But Romania Won't Admit It" Baltimore Sun (07/18/94) P. 5A; Doder, Dusko Despite evidence pointing to an AIDS explosion in Romania, Health Minister Ilulian Mincu and his agency seem to be ignoring the crisis. Critics interpret the apparent indifference as an attempt to avoid more of the worldwide publicity that flooded the country upon discovery in 1990 of Romania's AIDS babies. Officials from ARAS (Romanian Association Against AIDS) also cite ignorance, the puritanical attitude toward sex, and the national aversion toward birth control--including condoms--as barriers to AIDS prevention. Yet, instead of addressing these problems, ARAS says the government has done next to nothing to perform what the agency believes to be the most important function: to educate the public about AIDS and how it is transmitted. Instead, funding for AIDS research has stopped since Mincu's appointment in 1992 to a new government of non-reformers, and an AIDS research team spearheaded by Dr. Emil Tomescu has been disbanded. "Across the USA: D.C." USA Today (07/18/94) P. 12A Plans to unveil the Whitman-Walker Clinic's proposed $700,000 AIDS clinic on South Capitol Street in Washington, D.C., have been canceled until clinic officials can meet with community leaders, who say residents were not consulted about the plans. "Fugitive Prostitute With AIDS Released" United Press International (07/15/94) In what authorities are calling a fluke, police in Alton, Ill., failed to detain a female fugitive wanted for deliberately spreading HIV by soliciting sex. Felician Horton, 24, was arrested on driving-related charges, but was released when a computer did not produce the fugitive warrant filed in 1991. Horton was arrested for prostitution in 1991, when authorities say she was already infected with the deadly virus. She became one of the first people to be charged under a state law declaring it a crime to intentionally attempt to spread HIV. Horton was released on bond three years ago, and has been on the run ever since. "WHO Warns of Global TB Epidemic" Washington Blade (07/08/94) Vol. 25, No. 28, P. 12 Unless tuberculosis "becomes a funding priority," 30 million people will die from the infection in the next decade, the World Health Organization warned recently. TB is spreading with particular speed among the HIV population, according to a WHO report. In 1990, it said, four percent of TB patients were also infected with HIV. The organization predicts that, by the year 2000, nearly one in seven TB patients will also be HIV-positive. Co-infection with TB and HIV has become so common that the Centers for Disease Control and Prevention last year added TB to its AIDS case definition. "Factors Predictive of Maternal-Fetal Transmission of HIV-1" Journal of the American Medical Association (06/22/94-06/29/94) Vol. 271, No. 24, P. 1925; Boyer, Pamela J.; Dillon, Maryanne; Navaie, Maryam et al. Boyer et al. studied 63 HIV-positive expectant mothers and their 69 infants to determine maternal risk factors influencing transmission of HIV, including maternal CD4 levels, the presence of immune complex disassociated (ICD) p24 antigen, maternal AZT therapy, and complications associated with pregnancy. Thirteen of the infants were infected. Researchers found that mother-child HIV transmission is multifactorial. They documented a significant association between increased risk of transmission and intrapartum events that increase fetal exposure to maternal blood. Greater risk of transmission was also associated with the presence of ICD p24 antigen near or at the time of delivery, suggesting--as do other reports--that high viral load may increase the possibility of transmission. Boyer et al. also observed a significant protective effect of AZT treatment despite lower average CD4 cell counts. Finally, AZT therapy administered during pregnancy and/or labor was linked to a marked reduction in transmission. The study suggests that the findings of the AIDS Clinical Trials Group Study 076 may also include women with lower CD4 cell counts, and that prolonged treatment of infants may not be necessary.