Date: Tue, 08 Nov 1994 09:15:45 -0500 (EST) From: "JOHN FANNING, CDC NAC" AIDS Daily Summary November 8, 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 ************************************************************ "Penn Researchers Find Way HIV May Convert to AIDS" "U.S. Cuts AIDS Research Grants in New York City" "Israeli With HIV Reportedly Sought Sex" "It's Cheap and Effective, With Wonders Still Being (Re)discovered" "On the Trail of an AIDS Vaccine" "A Controlled Trial of Intravenous Immune Globulin for the Prevention of Serious Bacterial Infections in Children Receiving Zidovudine for Advanced Human Immunodeficiency Virus Infection" ""Surrogate Markers": Current Status, Future Directions (Part I)" "Update: HIV Prevention and Children" "Community Acquired Pneumonia in Adults in Addis Ababa: Etiologic Agents and the Impact of HIV Infection" "Former Cold War Rivals Share Women's Health Challenges" ************************************************************ "Penn Researchers Find Way HIV May Convert to AIDS" Philadelphia Inquirer (11/08/94) P. A1; Collins, Huntly Researchers at the University of Pennsylvania announced Monday that they may have discovered how HIV progresses from its "latent" stage to start its aggressive attack on the immune system. A protein, unique to AIDS patients, appears to tell infected cells when to produce more HIV. The discovery could lead to new treatments that could help people survive longer. The scientists found that the amount of protein--assembled by an HIV gene known as vpr--in the blood serum of HIV-infected people corresponded with their stage of disease. People with full-blown AIDS had high levels of vpr. The research team found that by exposing the cells to antibodies of vpr in the laboratory, they could prevent the production of new virus. David Weiner, the leader of the study, said that he is trying to develop a vaccine that would create vpr antibodies by injecting people with the vpr gene. He also suggested the existence of a "regulatory loop" in which as HIV infection progresses, the body's balance of vpr antibodies and vpr proteins shifts in favor of vpr protein, which eventually causes cells far from the lymph system to begin reproducing HIV. Related Story: Washington Times (11/08) P. A1; New York Times (11/08) P. C5 "U.S. Cuts AIDS Research Grants in New York City" New York Times (11/08/94) P. A1; Lee, Felicia R. In a decision that is prompting outrage and debate, three of the four community-based clinical trials on AIDS in New York City have been phased out. New York community groups and politicians, such as Senators Daniel P. Moynihan and Alfonse M. D'Amato, are protesting the cuts because they feel that a city with such a high proportion of AIDS patients should have an equally high amount of research funds. There are also complaints that the cuts will mean that fewer drug users and minorities will be in the trials. While noting that the decision was final, Dr. Jack Y. Killen, director of the National Institute of Allergy and Infectious Diseases, Division of AIDS, said that the money went to the best programs, not the ones with the largest number of AIDS cases. "Israeli With HIV Reportedly Sought Sex" Baltimore Sun (11/08/94) P. 4A AIDS-infected Israeli professor Yeshayahu Demner spent the last year of his life advertising for sex. Documents show that after Demner learned he was infected in September 1993, he began advertising for "active partners" and noted that "age and color don't matter." Police say that the Demner--who was bludgeoned to death last week--was trying to get revenge for having AIDS and that he "could have infected 500 men." He offered his partners money in return for not using condoms, police sources say. It is suspected that Demner was slain by a man he had infected. "It's Cheap and Effective, With Wonders Still Being (Re)discovered" Washington Post (11/07/94) P. A3; Brown, David Vitamin A may be one of the few wonder drugs of the world. Used in treatments for keratomalacia--a leading cause of blindness, measles, and anemia--safe and inexpensive Vitamin A may have uses for AIDS patients. Researcher Richard D. Semba of the Johns Hopkins School of Hygiene and Public Health is creating experiments to test the theory that supplementation of Vitamin A-deficient HIV patients is beneficial. One important finding is that Vitamin A may reduce maternal-infant transmission of HIV. Pregnant Malawi women who had sufficient amounts of Vitamin A transmitted HIV to their babies only 7 percent of the time, while those who were severely Vitamin A deficient transmitted the virus 32 percent of the time. While new studies show a dramatic decrease of such transmission when AZT is administered, the anti-viral drug is too expensive for use in many countries where AIDS is spreading quickly and Vitamin A deficiency is common. "In developing countries, there's no cost-effective option," said Semba. "On the Trail of an AIDS Vaccine" Boston Globe (11/06/94) P. 92; Rosenberg, Ronald Currently, only a few companies throughout the United States and Europe are focusing their research efforts on treatments and a potential cure for AIDS. One of these, Therion Biologics, is at the forefront, with one vaccine currently in human testing and another in primate testing. The latter, developed by Ronald Desrosiers, a Harvard Medical School microbiology professor, is very controversial due to its use of a live attenuated HIV virus. Therion is starting to talk to drug companies about exchanging manufacturing, marketing, and distribution rights for funding. "A Controlled Trial of Intravenous Immune Globulin for the Prevention of Serious Bacterial Infections in Children Receiving Zidovudine for Advanced Human Immunodeficiency Virus Infection" New England Journal of Medicine (11/03/94) Vol. 331, No. 18, P. 1181; Spector, Stephen A.; Gelber, Richard D.; McGrath, Nuala et al HIV-infected children frequently experience recurrent serious bacterial infections. A study was conducted to determine the efficacy of intravenous immune globulin in children with AIDS or AIDS-related complex who were being treated with zidovudine (AZT). The trial followed 255 children between the ages of 3 months and 12 years for approximately two years. Each child received 180 mg of AZT orally four times a day. The estimated two-year rate of serious bacterial infections was 16.9 percent for the group that received intravenous immune globulin. The rate for the placebo group was 24.3 percent. The researchers concluded that, for children with advanced HIV who are receiving AZT, intravenous immune globulin decreases the risk of serious bacterial infections. The decrease was seen primarily among the children who were not taking trimethoprim-sulfamethoxazole as prophylaxis when entering the trial. ""Surrogate Markers": Current Status, Future Directions (Part I)" AIDS Treatment News (10/21/94) No. 209, P. 1; James, John S. Because HIV develops slowly and because of a lack of reliable ways to measure treatment effect quickly, researchers been searching for a "surrogate marker" for HIV disease progression. Although the T-helper count and the p24 antigen test have been used for several years, it has become evident that they are not reliable measures of whether or not a drug is working. A new test, which has been used by researchers for years to measure the number of copies of HIV RNA in blood plasma, appears to be a better measure of whether an antiviral treatment is working. Few physicians use the test, however, because of a lack of guidance and collective medical experience in interpreting what the numbers mean. While most believe that reducing the HIV RNA level in the plasma would be beneficial, definitive proof will take years to develop. Scientists have calculated that for proof that a particular blood test works reliably, the treatment error must be about four times the "standard error". Large trials with thousands of patients would be required. And even after these trials are completed, the surrogate marker being tested will only be proven for one class of drugs. If AZT were tested, for example, it would also be accepted for showing the effect of ddI or ddC, but a new trial would be required to prove that HIV RNA also works with protease inhibitors. "Update: HIV Prevention and Children" American Medical News (10/17/94) Vol. 37, No. 39, P. 14 Grants totaling $20.7 million to benefit AIDS prevention and assistance programs for children and families were announced by U.S. Health Secretary Donna E. Shalala. "Programs that help prevent kids from becoming HIV-positive--or help HIV-positive kids and their families to cope--deserve community and individual support," she said. The awards, funded under Title IV of the Ryan White Comprehensive AIDS Resources Emergency Act, will help organizations such as public health departments, universities, and community-based social service groups. "Community Acquired Pneumonia in Adults in Addis Ababa: Etiologic Agents and the Impact of HIV Infection" Journal of the American Medical Association (10/26/94) Vol. 272, No. 16, P. 1234j A study was conducted during 1987 and 1989 at Black Lion Hospital in Addis Ababa, Ethiopia, to determine the prevalence of HIV infection in patients with Community Acquired Pneumonia (CAP). A total of 8 percent of the 110 pneumonia patients were HIV-1 seropositive, compared to the 2.4 percent of the general population who were seropositive for HIV-1. The HIV-infected were more frequently young, male, and of urban residence. The patients had fewer chills, increased bilateral and multilobar lung involvement, and recurrent chest infiltrate. The researchers concluded that the incidence of CAP in patients with HIV would probably increase with the rise of HIV infection. "Former Cold War Rivals Share Women's Health Challenges" Nation's Health (10/94) Vol. 24, No. 9, P. 24; Jones, Dorothy A group of 20 Russian obstetricians took a month-long tour of women's health facilities in the United States. The doctors visited several sites including the District of Columbia General Hospital, the Centers for Disease Control and Prevention in Atlanta, and the Planned Parenthood of Santa Cruz County (Calif.) Teen Clinic. Issues such as HIV in pregnancy, sexually transmitted diseases and AIDS control and prevention, and social service interventions for pregnant women at risk were addressed during the tour. "We share many of the same challenges, including disease reduction and increasing the health of mothers and children..." said Dina I. Zelinskaya, chief of the National Maternity and Child Protection Board.