Date: Thu, 10 Mar 1994 09:27:43 -0500 (EST) From: "ANNE WILSON, CDC NAC" Subject: CDC AIDS DAILY SUMMARY 03/10/94 AIDS Daily Summary March 10, 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 "Philippine Blood Bank Operators Protest Closure" Reuters (03/10/94) Manila--Claiming that the forced closure of their outlets has created a critical shortage of blood in the country, Philippine commercial blood traders appealed to the government to lift the order to shut down operations. The mandate to close 269 blood trading outlets was issued by Health Secretary Juan Flavier after a government study reported that four percent of samples from state and commercial blood banks were infected with syphilis, hepatitis, and HIV. But the Philippine Association of Blood Banks, representing 10 large, private blood banks, denied that its outlets were the source of the tainted blood supplies. PABB attorney Aquilino Pimentel said the closure order was illegal because there was no evidence that PABB outlets were the source of the contamination. "The closure ... has created a critical shortage if not lack of blood supply in many parts of the country," he said. Flavier's order covers 26 licensed PABB outlets, as well as others which PABB says operate autonomously. Unlicensed outlets are often operated out of homes and stores where blood packs are sometimes kept in refrigerators along with food, officials said. "Thailand to Begin Tests on Possible AIDS Vaccine" Reuters (03/10/94) Bangkok, Thailand--Thailand has confirmed that, in May, it will begin testing an experimental AIDS vaccine. In the first stage of the trial, which will take six to eight months to complete, the drug will be tested for safety and immunogenicity on 30 HIV-negative volunteers. If the tests are successful, the drug will be tested on a much larger scale to determine whether it can actually prevent HIV transmission. Health workers say Thailand's high incidence of HIV infection as well as its well-developed public health infrastructure make it an ideal testing site. Thai health officials, however, are concerned about finding enough volunteers to participate in the trials. Inevitably, people will be suspicious of a drug that, although safe, is designed to imitate HIV. Testing of the drug, which was produced by the United States' United Biochemical Inc., will be conducted with the help of the World Health Organization. "Study Shows Two Drugs Can Help Some AIDS Patients" United Press International (03/09/94) (Wasowicz, Lidia) San Francisco--AIDS patients who cannot tolerate or do not benefit from the commonly prescribed drug AZT can find similar relief by taking didanosine (ddI) and zalcitabine (ddC), according to a new report. The study of 467 patients, conducted at 78 sites nationwide, found that ddI and ddC offered safety and effectiveness similar to AZT. When the study began in 1990, ddI was the only antiretroviral medication approved by the Food and Drug Administration for AIDS patients who could not take AZT. Ddc has been approved only for use in combination with AZT. "Although neither of these drugs were very effective in this population of patients with advanced disease, our study suggests ddC alone is as good as ddI, and both should be available as single-agent therapies," said Dr. Donald Abrams, professor of medicine at the San Francisco General Hospital. Abrams noted that ddC, while similar in toxicity and activity to ddI, appeared to result in slightly increased rates of survival. Both drugs, however, caused some side effects--increased neurological leg pain from ddC and diarrhea and abdominal pain from ddI. "AIDS Warning Issued to Michigan Service Personnel" United Press International (03/09/94) Warren, Mich.--Medical officials on Wednesday urged some former and current military personnel who now live in Michigan but served in Europe within the past decade to report for HIV testing at military health centers. The call for testing stemmed from recent reports that a German pharmaceutical company allegedly permitted HIV-infected blood products to be shipped to civilian hospitals and clinics throughout Germany. "A possibility exists that United States personnel stationed in the United States European Command, EUCOM, from 1985-present and received a transfusion of blood or blood-related products in a civilian medical treatment facility may be at risk," announced a statement from the U.S. Army Tank-Automotive Command (TACOM) based in Warren. Although the risk is thought to be minimal, TACOM spokesperson Lynn Duerod confirmed that thousands of Michigan residents are believed to have served with the command during the period when contaminated blood was used. Those treated in U.S. military hospitals in Europe are not at risk, she said. "Hemophiliacs' Fears Ignored, Probe Told" Toronto Globe and Mail (Canada) (03/09/94) P. A1 (Picard, Andre) Canadian hemophiliacs, concerned about the quantity and quality of the blood products supplied to them, demanded in October 1983 that the Ontario government take steps to protect them from contaminated blood, reveal documents released at the Commission on Inquiry on the Blood System in Canada. The documents indicated that Dr. Abraham Shore, a hemophiliac who was a physician at Toronto's Hospital for Sick Children, warned the AIDS committee, PACAIDS, that the AIDS crisis was different for hemophiliacs because "they were unable to avoid their possible exposure to AIDS by modifying their behavior as other groups could." Shore urged the committee to fund research to genetically clone Factor 8 clotting product as a means of avoiding infection, and emphasized the need for hemophiliacs to be provided with accurate information. Yet, according to the documents, PACAIDS never responded to these concerns. No government action was taken until December 1984, when it was decided that all blood products should be heat-treated to kill HIV, and that policy was not fully implemented until July 1985. Today, three in four of the 1,000 Canadians who contracted the virus through contaminated blood are hemophiliacs, the vast majority of whom received transfusions of tainted blood between 1980 and 1985. "Ontario Cool to Free Drug Idea" Toronto Globe and Mail (Canada) (03/08/94) P. A7 (McInnes, Craig) AIDS patients flooded Queen's Park on Monday, demanding that the Ontario government follow through on promises to cover the exorbitant cost of their drugs. The protesters want the government to establish a policy to pay for drugs needed by people with terminal illnesses, including AIDS. At a news conference, reporters were informed that drugs to treat AIDS cost up to $2,000 per month. Some patients are forced to go on welfare in order to pay for their drugs, while others simply must go without treatment. The protesters received sympathy, but little more. Finance Minister Floyd Laughren said his first priority was to deal with the revenue shortfall, and that the province could not afford such a program as the one demanded by the AIDS patients, which would cost about $60 million. Of past pledges, Laughren said, "there were a lot of things we thought we could do when we formed the government, but given the problems we're now facing, we simply won't be able to deliver on" them. "Elton John's AIDS Group, L.A. Charity Compromise" United Press International (03/09/94) Los Angeles--Two separate AIDS-related charity fund-raisers will be held on Oscar night, despite outcry and criticism from the group that planned its benefit first. The AIDS Healthcare Foundation, a Los Angeles organization that funds hospices and clinics, had criticized singer Elton John's Atlanta-based foundation for scheduling a March 21 party in Beverly Hills in what AHF said was apparent disregard for "the long-standing common courtesy in the non-profit sector to avoid conflicting programming." The local group said it would be impossible to compete with the star-studded Elton John AIDS Foundation event. "There cannot be enough fund-raisers to support the fight against AIDS on Oscar night or any other night," the singer's foundation responded, refusing to change its plans. The foundation also declined a request to meet to discuss the possibility of John sponsoring the AHF event. Executive director John Scott, however, did invite AHF to apply for a grant. "We regard it as a peace offering," said AHF president Michael Weinstein. "We're interpreting it as an invitation to apply for money and their inclination to grant it." "Nutritional Intervention & AIDS" Food Management (02/94) Vol. 29, No. 2, P. 50 (Loss, Jana Cunningham) New treatments and therapies are helping AIDS patients live longer and experience better-quality lives. Nutritional intervention is one therapy that is now recognized as valuable in the battle against HIV/AIDS, according to Jana Cunningham Loss, a former clinical dietitian at Parkland Memorial Hospital in Dallas, Tx. One of the main considerations in HIV-positive patients, explains Loss, is malnutrition--which can aggravate a weakened immune system and increase morbidity. Nutritional intervention, she says, can delay or prevent malnutrition and muscle wasting, thereby improving the quality of life for infected persons. In addition, Loss contends, good nutritional status may also reduce the risk of infections and spur quicker recovery when they do occur. HIV/AIDS patients also appear to respond more favorably to medications and other therapies when well-nourished. Anorexia, vitamin and mineral deficiencies, malabsorption, nausea, vomiting, and diarrhea, says Loss, are all examples of conditions that are treatable with diet therapy. "Vaccine Against AIDS?" Lancet (Great Britain) (02/26/94) Vol. 343, No. 8896, P. 493 AIDS is a calamity. A satisfactory drug against the disease eludes scientists and, despite the tremendous amount of research, vaccination still faces myriad difficulties. The main obstacles in the unsuccessful development of vaccines are enormous variation of retroviruses, as well as virus transmission directly from cell to cell by fusion. These setbacks, insist the editors of the British medical journal The Lancet, are not reason to give up on vaccines altogether. At least 15 candidate vaccines have been developed in the face of these limitations, note the editors. As science progresses, researchers will be faced with new approaches that may require several years' work before reaching the stage of field trials. If the first trials are postponed until a perfect vaccine is achieved, The Lancet predicts, the world will wait for decades, maybe forever. This is not to advocate the use of unsafe or inefficient vaccines but simply a warning to be alert for the moment when a cocktail of vaccines might decrease viral load or otherwise improve things. Keep in mind, suggests Lancet, that the main purpose of vaccine is to prevent disease and transmission, not necessarily to prevent infection itself. "AIDS Vaccine: Shooting Blanks or Loaded for Bear?" Men's Fitness (03/94) Vol. 10, No. 3, P. 118 Researchers are squandering money and raising false hopes in their mission to find an AIDS vaccine, declares Paul Abramson, a sex researcher and professor of psychology at the University of California at Los Angeles. He challenges the effectiveness of an HIV vaccine, because a vaccine would be useless against new and possibly deadlier strains of the virus. Abramson insists that research for an AIDS vaccine encourages a false sense of security, since a vaccine would most likely require periodic booster shots--which many people might fail to receive. Another drawback, he says, are problems researchers would face in trying to get the vaccine to the areas most in need, such as developing nations. Finally, Abramson contends that AIDS-vaccine research is diverting valuable money away from treatment and prevention, which he asserts are more productive areas of inquiry. Still, most scientists are committed to the search for an AIDS vaccine. "The frightening pace of the worldwide spread of HIV demands that priority be placed on the development of an effective vaccine," says AIDS researcher Norman Letvin.