Date: Fri, 06 May 1994 09:18:20 -0400 (EDT) From: "ANNE WILSON, CDC NAC" AIDS Daily Summary May 06, 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 "Mayor to Try to Preserve AIDS Unit, Groups Say" New York Times (05/06/94) P. B3; Hicks, Jonathan P. New York's Giuliani administration, pounded with criticism for its plans to reduce or eliminate the city's Department of AIDS Services, will instead seek ways to keep the agency intact, said AIDS groups and other organizations after meeting with Deputy Mayor Fran Reiter yesterday. "We are optimistic that there are no plans to eliminate or cut the Division of AIDS Services," the eight groups said in a statement. "We are pleased that the administration has recognized the importance of the Division of AIDS Services." The agency, which employs 740 workers, assists 16,000 AIDS patients who are too sick to go back and forth between the various city welfare offices that handle different benefits. The prospect of cuts or elimination of the Division of AIDS Services had sparked a series of protests. By this week, most of the organizations meeting with Reiter had prepared a suit to bar the administration from dismantling the agency, but rescinded plans to file the suit after the meeting. Still, some groups continued to express concern about Mayor Giuliani's commitment to AIDS. "The fact of the matter is that the proposal to cut D.A.S. was seriously considered by the administration," said ACT-UP spokesperson Denny Lee. "Tap Water Source of AIDS-Related Illness" United Press International (05/05/94); Klinger, Karen Tap water may be a major source of mycobacterium avium complex (MAC), a bacterial infection common among AIDS patients, say researchers. A study of patients in the advanced stage of disease found strains of MAC in a number of potable water sources, including municipal water and well water. In an analysis of 36 AIDS patients in New Hampshire and Boston, investigators also concluded that some patients were probably infected through recirculating hot water systems in hospitals. These systems are much more likely to harbor the bacterium than those found in homes, where municipal water "comes through once, and is flushed out," says Dr. Fordham von Reyn of Dartmouth Medical School in Lebanon, N.H., lead author of the study. In hospitals, "hot water is constantly recirculated, so the organisms ... can get in there and persist for two or three years." He notes that 40 percent of the 50,000 to 60,000 Americans diagnosed with AIDS each year will develop MAC infection within the following two years. The infection is characterized by sluggishness, fever, and weight loss. "It shortens survival by about half among those who get it," von Reyn adds. Although the infection is treatable with antibiotics, therapy is not always effective and sometimes causes severe side effects, such as eye inflammation. "Protein Can Boost Immune Function in Fetal Cells and May Do the Same for AIDS Patients, UC San Francisco Researchers Find" Business Wire (05/05/94) Interleukin-12 (IL-12), a recently discovered blood protein, is able to boost the immune function in human fetal cells in the test tube, report researchers at the University of California at San Francisco, who say the finding reinforces the protein's potential value as a treatment for AIDS. IL-12 effectively stimulated natural killer cells, the front-line defenders of the immune system, in fetal cells extracted from umbilical cord blood, said Dr. Allan Lau, UCSF associate professor of pediatrics at San Francisco General Hospital. He and colleagues decided to test the protein in fetal cells because these cells are normally immune-deficient--lacking natural killer cells and cytokines--which explains why babies suffer from severe viral infections in the first few months of life. "When we put IL-12 back into the system, the immune system became normal," Lau explained. "So if AIDS patients are deficient in natural killer cells, we may be able to do the same for them." The researchers also discovered that fetal cells treated with IL-12 became activated in the presence of HIV-infected cells, much in the same way that treated adult cells are stimulated to fight off the virus. "Once you supplement the fetal cells with IL-12, they behave like adult cells," said Lau. The researchers concluded that "IL-12 appears to be a major modulator of these immune processes in response to viral infection." "HIV Inmate's Suit Rejected" National Law Journal (05/02/94) Vol. 16, No. 35, P. A8 Kentucky's policy on HIV screening for prison inmates did not violate the rights of a Florida man who was initially denied such testing, a panel of judges from the 6th U.S. Circuit Court of Appeals decided. The April 19 ruling dismissed a claim of monetary damages by 48-year-old Felix Hernandez of Miami. The three judges also denied a claim that his rights were violated when a prison official read his confidential file, and learned of his HIV infection. "Holding the Phones" Advocate (05/03/94) No. 654, P. 21 A flood of harassing phone calls that appeared to be the result of an organized effort forced officials in Seattle's King County to disconnect an AIDS information hotline. The line was jammed after the number of daily incoming calls leaped from 50 to 100 to more than 2,000. "It was a concerted effort," said Rose Dembo, telecommunications manager for King County government agencies. "It was somebody with a real dedication to this." Police are investigating the incident. "Inhibition of Rev-Mediated HIV-1 Expression: Retraction" Science (04/22/94) Vol. 264, No. 5158, P. 492; Campbell, Mel; Felber, Barbara K.; Nasioulas, Georgios et al. Campbell et al. from the Frederick Cancer and Research and Development Center of Advanced BioScience Laboratories in Frederick, Md., announce that some experiments performed by the author P. Constantoulakis were not reproducible. The failure of the experiments described in "Inhibition of Rev-Mediated HIV-1 Expression by an RNA Binding Protein Encoded by the Interferon-Inducible 9-27 Gene" to duplicate Constantoulakis' experiments casts doubt on the results and conclusions. Experiments are underway to re-evaluate the inhibition of HIV gene expression by the 9-27 protein and the degree to which this inhibition is specific to Rev-dependent expression. At this time, however, Campbell et al., would simply prefer to retract the paper until its conclusions have undergone further experimental tests. The researchers express their deepest regret for any inconvenience that may have been caused to the scientific community. "Excess Deaths in Africa From HIV: Confirmed and Quantified" Lancet (04/23/94) Vol. 343, No. 8904, P. 989; Dondero, Timothy J.; Curran, James W. In the past decade, HIV infection has reached epidemic proportions in sub-Saharan Africa, causing severe illness and death among multitudes of young adults and children. Still, the extent of excess mortality linked to HIV has not been adequately measured. The lack of data in this area has prompted some individuals to maintain that HIV is not responsible either for deaths or for AIDS in Africa. Mulder et al., however, have quantified in an epidemiological study the significant excess mortality associated with HIV infection. The study indicated that young, rural Ugandans testing positive for HIV antibody were 60 times more likely to die during a subsequent two-year observation period than were similar individuals who tested negative. Mortality was highest in those individuals--men and women between the ages of 25 and 34--in whom HIV infection was most common. Even skeptics cannot refute the high prevalence of HIV infection in Africa. The strong connection between HIV and excess mortality emphasizes the critical importance of the AIDS epidemic in Africa, and reinforces the need for global prevention. Further study is needed, however, to demonstrate how many of the excess deaths could have been prevented through medical prevention and treatment of such HIV-related illnesses such as tuberculosis, pneumonia, and diarrheal disease. "Drug Users Who Stop Sharing Needles Cut Risk, Study Shows" American Medical News (04/18/94) Vol. 37, No. 15, P. 13 Intravenous drug addicts who ceased to share needles significantly lowered their chances of becoming infected with HIV, reports the first study to examine the habits of individual users. Researchers followed 173 addicts in Bangkok at a time when the infection rate among Thailand's drug users soared from one percent to 43 percent. Only five percent of the 111 addicts who stopped sharing needles from 1987 to 1989 contracted HIV, compared to 18 percent of the 62 who continued to share needles, the study found. "For the first time there is direct evidence that what drug users are telling us about changing their behavior relates to lower infection," said study head Dr. Don DesJarlais of Beth Israel Medical Center in New York. DesJarlais insisted that his study is proof that needle exchange programs are effective--proof that is needed for such programs to attain federal funding. "Most Physicians Say AZT Benefits Outweigh Fears, Risks" AIDS Alert (04/94) Vol. 9, No. 4, P. 53 Promising results achieved during the AIDS Clinical Trials Group Study 076 on the ability of AZT to reduce the risk of HIV transmission from pregnant women to newborns will encourage physicians to be more aggressive in recommending the therapy, say AIDS doctors. In the study, the rate of perinatal HIV transmission plunged to 8.3 percent among women and babies receiving AZT, compared to a rate of 25.5 among women and babies getting placebos. "I think more doctors will be more comfortable in recommending AZT to pregnant women because of the study's results," says Dr. Melanie Thompson, an internist and president and principal investigator of the AIDS Research Consortium of Atlanta. "In the past, there was a lot of fear about the side effects of AZT to the fetus. But this study shows a clear benefit to the infant and alleviates some of those concerns." Pediatric AIDS specialists are also optimistic. While some worry about possible long-term side effects in infants exposed to AZT, Dr. Ram Yogev insists that future development of side effects is a secondary issue, and that the tradeoff is worthwhile. "We're able to give life at this point. I have a major problem with anyone who tells me that something might happen to these kids when they turn 40," he says. "Without AZT, most of them with HIV may not make it to the age of 12." Still, some physicians will remain reluctant to offer AZT therapy to their pregnant HIV patients until formal clinical guidelines are established. The Public Health Service is in the process of forming a task force to decide precisely what the response to the trial should be.