Date: Fri, 20 May 1994 09:27:59 -0400 (EDT) From: "ANNE WILSON, CDC NAC" AIDS Daily Summary May 20, 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 "Mass. Panel Clears Bill on AIDS Testing" Journal of Commerce (05/20/94) P. 7A The Massachusetts Health Care Committee this week endorsed a far-reaching bill concerning AIDS that would prohibit insurance companies from testing customers for the disease. Insurers have resisted efforts to ban testing, a proposal pushed by AIDS activists who claim that infected individuals have difficulty getting insurance. The bill would also require training for health care and emergency workers to avoid infection, and grant the state more power to discipline doctors who refuse to treat AIDS patients. In addition, the proposed legislation seeks expanded treatment for intravenous drug users--who are at high risk of contracting the illness. "CDC Warns About Danger of AIDS in Home Care" Reuters (05/19/94); Morgan, David The Centers for Disease Control and Prevention yesterday reported two new cases of household HIV transmission, and issued a warning about the increasing potential for the spread of the virus in the home. The two household transmission cases, among eight that have occurred since 1986, may be the first in the country in which HIV infection clearly occurred through care-giving. In both cases, the virus was transmitted because standard precautions were not followed. One case involves the 5-year-old child of HIV-positive parents who researchers believe may have contracted the virus either through open sores on her mother's body, or by sharing a toothbrush at a time when the woman suffered from bleeding gums. Although the child initially tested negative for AIDS in 1990 and July 1993, HIV antibodies were present last December. More relevant to researchers is the other case--that of a 75-year-old woman caring for her HIV-infected adult son. The elderly woman, who had no other risk factors, tested positive for HIV in August 1991, a year after her son died. "She did provide nursing care to her son," said Dr. Harold Jaffe, director of the CDC's HIV/AIDS division, explaining that the woman was exposed to her son's urine, feces, and blood. "She wore gloves part of the time but not all the time." The CDC has issued a set of precautionary guidelines for people caring for HIV-infected loved ones at home. The recommendations include wearing protective gloves, careful handling and disposal of needles, and bandaging all open sores. Jaffe says the cases illustrate a problem posed by a lack of adequate instructions from medical professionals. "New Test May Check for HIV in Newborn Babies" Reuters (05/19/94) A new test that examines umbilical cord blood samples to detect cogenital infections in newborns may also effectively track whether HIV is transmitted from mother to baby, according to researchers. By testing for a protein called CD45, found in two forms in white "T" blood cells, in newborns and measuring the relative proportions of these two proteins, Drs. Colin Michie and David Harvey of the Royal Postgraduate Medical School were able to diagnose perinatally acquired infections such as chicken pox, cytomegalovirus, and toxoplasmosis in the infants. Michie and Harvey warn that these were the results of a preliminary study, and that a larger trial is needed to assess the suitability of the technique for determining whether HIV has been transmitted from a chronically infected mother to her baby. "China's HIV-Infected Population Seen Climbing" Reuters (05/20/94) The number of people in China confirmed to have HIV has reached 1,159, but health officials place the number of unreported cases of infection at between 5,000 and 10,000, according to the Ming Pao Daily News. "Eighty percent of the AIDS cases are found in Yunnan, where the main infecting conduit is through the use of intravenous drug needles," said Sun Xinhua, an official at the Ministry of Public Health, as quoted by the paper. Although the Chinese government spent $1.1 million on AIDS prevention last year, Sun said this amount was far from enough. "HK Businesses Lag on AIDS Prevention in Asia" Reuters (05/19/94); Mudie, Luisetta Large, private companies in Hong Kong are being urged to catch up with other Asian countries in the fight against AIDS. Japan and Thailand, where business coalitions have been formed to combat the spread of AIDS, are two Asian nations that are ahead of Hong Kong in terms of AIDS prevention, according to Lisa Ross, whose consultant firm Information for Life advises businesses on AIDS education and health programs. "It would be really nice for the Hong Kong business community to take the lead in the region, and they're already falling behind," she comments. Last month, in an effort to mobilize the Hong Kong business sector against AIDS, insurer Aetna Life & Casualty Co.'s Asia-Pacific arm sponsored a conference with the World Health Organization. Aetna says it experienced difficulty in convincing Hong Kong businesses to take part in the conference. "The attitude seemed to be that it's someone else's disease, someone else's problem that affects people in Thailand and Africa but not here," said Dennis Pedini, director of East Asia Aetna Insurance Group in Hong Kong. WHO statistics report that some 1 million Asians are now infected with HIV, and the group estimates that the epidemic will generate 10 million new cases by the end of the century. "Sheffield Medical Technologies Announces the Issuance of Second Canadian Patent for its RBC-CD4 Technology" Business Wire (05/19/94) Sheffield Medical Technologies Inc. has been granted two Canadian patents covering a technology related to an electro-insertion procedure that is potentially applicable as a therapeutic AIDS treatment. The patents together give the company exclusive proprietary rights to both the process of making and using RBC-CD4 for treating HIV infection and AIDS. The process involves exposing red blood cells to a pulsed electrical field, thus allowing the CD4 to be incorporated into the cell's membrane to form RBC-CD4, which acts as a sponge, absorbing free-floating HIV and forming aggregates with HIV-infected cells. Research suggests that, once bound and internalized by RBC-CD4, HIV disintegrates and is removed from the body. Sheffield, based in Houston, Texas, is preparing to enter Phase I/II human clinical trials of the technology. "A Cytotoxic Response Against AIDS" Lancet (04/30/94) Vol. 343, No. 8905, P. 1093; Thompson, Clare In examination of HIV pathology, one area of interest is the difference between short-term HIV survivors, who progress rapidly to full-blown AIDS, and long-term survivors, who remain healthy after a decade or more. There is also a subset of patients known as long-term non-progressors, who manage to stay healthy and maintain CD4 T-cell counts above 500. At the April meeting on Biotechnology against AIDS in Florence, several AIDS researchers discussed the possible role of CD8 lymphocytes in long-term survival. Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases described how the lymph-nodes of short-term survivors show a high level of viral burden and virus replication, and ultimately destruction of the lymph-node architecture, while the lymph-nodes of long-term non-progressors remain intact even after 10 years of infection. The differences suggest either that AIDS progression depends upon viral load, or that long-term non-progressors have some immune response that can clear the virus. "New York Revises State Safe-Sex Guidelines" Advocate (05/03/94) No. 654, P. 31 On March 18, the New York State Board of Regents voted unanimously to revise its safe-sex guidelines, which have long been criticized because they stress abstinence and say that sex with condoms still carries a significant risk for exposure to HIV. The guidelines, which have not been revised since 1987, will be modified to emphasize that condom use significantly reduces the chance of HIV transmission. Since some school districts may chose to adopt or not adopt the new guidelines, the revised version may have little effect on AIDS education programs in many school districts, according to state education commissioner Thomas Sobel.