Date: Tue, 03 May 1994 09:17:52 -0400 (EDT) From: "ANNE WILSON, CDC NAC" AIDS Daily Summary May 03, 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 "Theory Tested on Why Body's Defenses Go Haywire in AIDS" New York Times (05/03/94) P. C3; Angier, Natalie While AIDS gradually breaks down the body's immune system, it creates mass confusion at every node of the defense network, as some immune cells overreact to the invasion and others fail to respond when called. Now, researchers at Stanford University School of Medicine suggest something known as oxidative stress may play a critical role in the slow decay of the immune system. The damage resulting from too many dangerous oxygen molecules banging around inside immune cells, they say, may disrupt the cells' performance and ultimately cause them to die. The Stanford scientists believe that an important feature of AIDS is a sharp decline in the body's concentration of glutathione, an important mechanism that absorbs excess oxygen and protects from oxidative harm. The researchers suggest that replenishment of the body's stores of glutathione could delay progression of disease. A clinical trial is currently being conducted to evaluate the usefulness of N-acetylcysteine (NAC), a compound from which glutathione is made, in blocking the malignant course of HIV infection. Scientists warn, however, that NAC would, at best, only slow the pace of deterioration, not act as a cure. "AIDS Is Top Killer in State Prisons" Chicago Tribune (05/03/94) P. 1-7; Thomas, Jerry With the number of inmates with AIDS in Illinois prisons skyrocketing from just one in 1984 to 177 at the end of 1993, the disease is now the No. 1 cause of death in the state's prisons, according to the Illinois Department of Corrections. Last year, 23 of the 96 prisoner deaths were attributed to AIDS--more than murder, suicide, heart attacks, and cancer, say corrections officials. Currently, 119 inmates have been diagnosed with AIDS, reports Howard Peters, director of the Corrections Department. Another 468 prisoners are infected with HIV, he adds. "The people who are dying of AIDS came into the system HIV-infected or with AIDS," according to Peters. "They engaged in high-risk behavior that exposed them to the virus. Intravenous drug use is high among offenders." A 1988-89 study conducted at Joliet Prison by the Centers for Disease Control and Prevention found that about 4 percent of incoming male prisoners were HIV-positive. Peters says the study refuted the myth that the growing AIDS problem is being propelled by rampant homosexual behavior in prisons. "It is a misstatement of fact that everyone in prison is having sex," he says. Peters notes that educational programs have been implemented to teach inmates and staff about the disease; nevertheless, some critics insist that segregation of infected inmates is the solution. Related Story: Boston Globe (05/02) P. 1 "German Firm Ordered to Pay AIDS Compensation" Reuters (05/02/94) A Bonn court yesterday ordered German pharmaceutical firm Biotest to pay more than $150,000 to a 13-year-old boy who became infected with HIV through contaminated blood products distributed by the company. That amount, in addition to compensation arising from the firm's medical liability, placed the total award at about $240,000, according to a Biotest spokesperson. The pharmaceutical company was linked to a national scandal that surfaced last year when another company, UB Plasma, was found to have distributed unscreened blood products that were given to millions of people nationwide for more than a decade. Biotest, as one of the distributors who bought blood from UB Plasma, had its license to make the blood products suspended. The court ruled that the company did not prove that it had not shown lack of due diligence when the hemophiliac youth was infected during routine treatment in 1989 with a preparation derived from HIV-tainted blood. Biotest has already settled out of court with 10 other patients who were infected through the same batch of blood. "UC San Francisco Researchers Discover Possible Way in Which AIDS Virus Causes Dementia" Business Wire (05/02/94) Researchers at the University of California at San Francisco have found a possible mechanism to explain how HIV is able to destroy brain cells and cause dementia in infected children and adults. When GP120, a critical piece of HIV, is introduced into human fetal cells in test tubes, the protein triggers the release of toxic amounts of inflammatory proteins called cytokines, according to Dr. Allan Lau, a UCSF associate professor of pediatrics at San Francisco General Hospital. The two cytokines, tumor necrosis factor (TNF) and interleukin-6, normally help regulate immune function, but too many of them can create a toxic effect. In that case, they cause noticeable deterioration in the fetal brain cells and ultimately result in cell death, says Lau. At least 20 percent of AIDS patients experience dementia, which is characterized by memory loss, difficulty in concentrating, and motor and sensory problems. Infected children may also develop a form of dementia in which they experience developmental delays, learning disabilities, and trouble relating to other people. "European Court to Hear AIDS Plea Against France" Reuters (05/02/94) The European Court of Human Rights announced yesterday that it will consider a plea against France being brought by a Turkish hemophiliac who contracted HIV through contaminated blood. Mustafa Karakaya, who became infected between August 1984 and July 1985 in France, launched an appeal to a French court in May 1990, which has yet to be settled. At the time of infection, French authorities were aware that some blood in banks was tainted with HIV, but still did not take measures to screen the blood. The Strasbourg-based European Court has already ruled twice against France in similar cases, saying that the rights of AIDS patients had been violated because French authorities took an excessive amount of time in compensating them. More than 1,250 hemophiliacs were infected through transfusions, about 400 of whom have already died. "HIV Alters DNA, Causing Rare Cancer" Science News (04/16/94) Vol. 145, No. 16, P. 244; Pennisi, E. Researchers at the University of California at San Francisco have for the first time demonstrated a direct link between HIV and tumor growth. The team discovered that a piece of HIV genetic material had inserted itself into human DNA near a particular cancer-causing cell, thereby activating this oncogene, which is associated with several other types of tumors. In seven HIV patients, white blood cells had multiplied and spread out of control, creating a lymphoma with a mixed cell type. Previously, most lymphomas observed in AIDS patients came from a single white cell type, often B cells. These AIDS-related cancers seem to surface as a result of a weakened immune system. The seven San Francisco patients, however, tended not to exhibit symptoms of immune suppression. Instead, "most of them had this [cancer] as their [first AIDS] symptom," according to researcher Michael S. McGrath, a cancer biologist at USCF. McGrath offers two explanations for the sudden appearance of this cancer in HIV patients. HIV may be evolving and may have developed different ways of acting inside white blood cells, which suggests that HIV may also alter the way it infects people. The second explanation is that these cancers may be an unwelcome result of HIV patients living longer because of treatments that combat opportunistic infections and delay the spread of the virus in the body. "Newspaper Revives Anti-HIV Claims" Nature (04/14/94) Vol. 368, No. 6472, P. 577 In an April 3 article appearing in the London Sunday Times, the newspaper's science correspondent, Neville Hodgkinson, asserts that there exists a "large and growing network" of "highly qualified" people who are willing to admit dissension from the theory that HIV causes AIDS. These individuals apparently are the signatories of a three-year-old open letter appealing for reappraisal. "The HIV hypothesis is unfalsifiable, and useless as a medical hypothesis," says Kary Mullis, inventor of the polymerase chain reaction (PCR). The report says that scientists "have been careful not to rock the HIV boat, which carries jobs, reputations, and huge research funds." Hiram Caton, head of the school of applied ethics at Griffith University in New South Wales, concludes that when "no vaccine will be forthcoming," scientists will "have to come to terms with the awful fact that the AIDS epidemic was a mirage." "Personal Screening for HIV in Developing Countries" Lancet (04/16/94) Vol. 343, No. 8903, P. 960; Frerichs, Ralph R. Rather than blindly following old assumptions about HIV, health officials should be receptive to new ideas and programs, says Dr. Ralph R. Frerichs of UCLA's Department of Epidemiology. He notes that, for people in developing countries, there are three primary strategies to prevent HIV transmission from an infected partner--the first two of which are correct and consistent condom use, and a vaccine--which has yet to be developed. A third approach that holds great promise, says Frerichs, is voluntary and anonymous home testing for HIV. The technology to perform such tests already exists in the form of saliva collection devices. With some modifications in the marketplace, people could send numbered specimens to local labs and receive results within a few days. Subjects with positive results should be urged to seek confirmation with a medical practitioner. Home testing would eliminate the need for screening facilities and pretest counseling sessions--two elements that contribute greatly to the cost and inconvenience of testing in many developing countries. Since accurate, acceptable, and inexpensive HIV screening tests already exist, what is needed is the political will to make them widely available in the private sector and to support this method as a control strategy for HIV, Frerichs concludes. "Permission Denied" Far Eastern Economic Review (04/14/94) Vol. 157, No. 15, P. 38; Friedland, Jonathan; Matsubara, Lily Feminists, birth-control advocacy groups, and eight foreign pharmaceutical manufacturers question why the Japanese government won't approve low-dose oral contraception. Japan does allow women to take a high-dose drug, but doctors claim they would be better served with a low-dose type, which has significantly lower chances of side effects. Yet, many Japanese women would probably not take the drug because they lack information on its effects and believe it would lead to breast cancer. The Japanese government refuses approval because it claims the drug contributes to the rising number of AIDS patients, according to Tatsuo Kurokawa, deputy director of the Ministry of Health's new drug division. Agency officials want to gather more data about the possible link to AIDS and want the number of cases to decline before they issue approval. However, drug makers say they have produced documents showing no association with AIDS. In addition, fertility rates have decreased, notes Dr. Kunio Kitamura, director of the Japan Family Planning Association. Politicians dislike the dropping fertility rates. Also, foreign drug manufacturers would profit from the birth control pill, while Japanese firms make money on condoms.