From: "ANNE WILSON, CDC NAC" <[email-masked]>

AIDS Daily Summary 
                        May 17, 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

"Coping With HIV"
Washington Post (Health) (05/17/94) P. 14;  Siwek, Jay
     Because of rapid changes in AIDS research, it is particularly 
important for HIV patients--more so than patients of other 
illnesses--to be aware of their condition and how to treat it.  
If infected with HIV, family physician Dr. Jay Siwek recommends a
series of steps to remain abreast of the condition and its 
treatment.  Establishing a long-term relationship with a health 
care provider is the first step, he says.  Then, learn all about 
HIV infection and AIDS.  Periodically, a patient's CD4 level 
should be checked and, if the count becomes low, the doctor 
should recommend medicine to treat both the HIV and prevent other
types of infection.  Immunization shots will help prevent other 
infections as well, according to Siwek.  Patients should also get
checked for syphilis and other infections that are transmitted 
through sex or shared needles.  Siwek advises women to have 
regular Pap smears, for the risk of cervical cancer and other 
pelvic problems is amplified with HIV infection.  And, of course,
there is always the risk of transmitting the virus to a baby.  
Finally, recommends Siwek, HIV patients should consider enrolling
in an AIDS clinical treatment trial, joining a support group, or 
subscribing to a publication devoted to people living with HIV.
      
"Across the USA: North Carolina"
USA Today (05/17/94) P. 9A
     In Buies Creek, N.C., today, representatives from Campbell 
University will appear in court to fight federal efforts to force
the school to reinstate an HIV-positive instructor.  Campbell 
denies government accusations that it wrongfully dismissed the 
teacher because he has AIDS.  If the allegations are true, the 
university will be in violation of the Americans With 
Disabilities Act.
      
"Officially, Indonesia Has 263 HIV Cases"
Reuters (05/17/94)
     Indonesia announced on Tuesday that it has 263 cases of HIV 
infection, but ministers and aid workers there argue that the 
actual figure could be 200 times higher than that.  The official 
Antara news agency quoted the director general for Medical 
Services as saying that 50 of the 263 HIV carriers have developed
AIDS.  However, Coordinating Minister for Health and Social 
Services Azwar Anas said that for every documented patient, 
"there could be between 100 and 200 behind every one of them."  
The country has been preparing to launch measures to counter what
it fears may be an epidemic comparable to that of regional 
neighbors, such as Thailand.
      
"Concern About Privacy ..."
Wall Street Journal (05/17/94) P. A1;  Harper, Lucinda
     According to a study by the American Civil Liberties Union, the 
majority of people polled believe that employers should have 
access to the employment and education records of applicants.  
While most people said employers did not have the right to know 
employees' racial designations or sexual orientations, they did 
feel employers should have the right to know whether an applicant
is HIV-positive.
      
"Risk Groups Targeted in AIDS Fight"
Chicago Tribune (05/16/94) P. 1-7;  Wilson, Terry
     Borrowing strategies from the marketing arena, federal 
authorities and community organizations hope to alter deep-rooted
behavior in people who are at high risk for HIV/AIDS.  Fred 
Kroger, director of the National AIDS Information and Education 
Program for the Centers for Disease Control, says the centers are
working with community groups in Portland, Ore., Chicago, 
Phoenix, Nashville, San Francisco, and New York to determine the 
highest-risk populations in each area and develop 
prevention-oriented approaches.  "Sexual behaviors are far more 
complex to change than immunization behaviors," says Kroger.  
"Getting people to a clinic for a shot is a lot easier than 
getting them to change their lifestyle.  It's going to take very 
concerted efforts by many people, and it's not going to happen 
overnight."  Surveys indicate that many people are aware of the 
threat of AIDS and how to avoid it; however, motivating people to
take these steps and continue to do so is difficult, according to
Kroger.
      
"Scientists Sabotaging AIDS Gene"
Houston Chronicle (05/16/94) P. 8B;  King, Warren
     Targeting two of the proteins most crucial to HIV, scientists 
hope to stop the virus in its tracks by throwing monkey wrenches 
into its genetic machinery.  Researchers at Houston's Baylor 
College of Medicine insert into HIV-infected cells a gene that 
inhibits the ability of the virus to reproduce.  Just as HIV gets
its reproductive machinery up and going, the gene produces a 
protein that short-circuits it.  John Belmont and five colleagues
found their laboratory success with a combination of purposely 
flawed versions of two proteins made by HIV to ensure its 
survival.  "Tat" turns on the HIV, gets the genetic machinery 
started, and tells it to keep going, while "Rev" causes the virus
to change gears and begin making the structural parts of new HIV.
Researchers at the University of Michigan and the University of 
Southern California discovered that altered versions of Tat and 
Rev slow down the virus, and the Baylor group extended the 
research by constructing "Trev," a gene that has the same effect 
on HIV as Tat and Rev, but has the more lasting effect of halting
HIV in already-infected cells.  While this type of gene therapy 
is effective only in the laboratory right now, its creators hope 
within the next year to initiate trials in infected babies of 
mothers carrying HIV.  "We want to do it in patients as quickly 
as possible," says Belmont, director of the project and associate
professor of molecular and human genetics at Baylor.  "It could 
give us some real answers and a basis on which to improve."
      
"India Tests Herbal Drugs for AIDS Treatment"
United Press International (05/16/94)
     The government-funded Indian Council of Medical Research, India's
top medical body, says it will begin AIDS-related clinical trials
involving ancient Indian herbal drugs said to stop the spread of 
HIV.  A task force chose 10 drugs for clinical experiments in 
patients who have tested HIV-positive.  The council will 
investigate whether the drugs curb the spread of AIDS in the 
human body.  The drugs were selected from the ancient Indian 
school of Ayurvedic medicine, which uses herbal and root extracts
for treatment of chronic diseases.
      
"Administration of Aerosol Pentamidine: A Program Design"
Journal of the Association of Nurses in AIDS Care (03/94-04/94) 
Vol. 5, No. 2, P. 41;  O'Hara, Constance M.;  Anton, William R.; 
Gormley, Francis X.
     Pneumocystis carinii pneumonia is the most common opportunistic 
infection diagnosed in HIV patients, note O'Hara et al. of the 
University of Washington Medical Center.  For patients with 
constitutional symptoms, CD4 counts below 200, or who have a 
history of PCP but cannot tolerate oral therapies, aerosolized 
pentamidine is the preferred prophylactic treatment.  AP has 
minimal side effects and a convenient once-a-month regimen, which
increases the likelihood of patient compliance.  Successful 
treatments, however, are subject to the skill and training of the
professionals administering AP, thoroughness of patient teaching,
and patient compliance.  Safety of administration is a priority 
for both patients and healthcare providers.  Because of the risk 
of exposure to mycobacterium tuberculosis, patients should be 
tested for TB before AP treatment is initiated.  The staff must 
adhere to universal precautions at all times, and administer 
treatment in an appropriately ventilated area.  The AP program at
UWMC, which centers around a multidisciplinary team approach, 
yields a high rate of patient compliance.  O'Hara et al. believe 
the essential components of UWMC's program can be adapted to most
clinical offices, agencies, or institutions.