Date: Tue, 18 Apr 1995 09:35:53 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary April 18, 1995 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 1995, Information, Inc., Bethesda, MD ************************************************************ "Gay Movie Theater Allowed to Reopen" "Eli Lilly May Acquire License to Antifungals" "Completed U.S. Phase III Study of Thymosin Alpha 1 Shows Favorable Trend in Treatment of Chronic Hepatitis B" "Coram Healthcare Corp. and Lincare Holdings, Inc. Announced a Merger Creating the Nation's Largest Alternate Site Health Care Company" "HIV-1 RNA Serum-Load and Resistant Viral Genotypes during Early Zidovudine Therapy" "A Clear Pattern of Neglect: Prisons and the HIV Crisis" "Co-Incidence of HIV/AIDS and Tuberculosis--Chicago, 1982-1993" "Viral Load is Worth Paying Attention To" "Mobilizing to Fight AIDS" "French AIDS Ad Row" ************************************************************ "Gay Movie Theater Allowed to Reopen" New York Times (04/18/95) P. B3 The Earle, a gay movie theater in Queens, N.Y., reopened Monday after having been closed two months ago when inspectors said they saw several sex acts take place. The theater is one of two that city officials closed this year in an effort to reduce HIV transmission. Under an agreement signed Monday, the owners of the Earle are required to have two uniformed guards monitor the theater at all times. Any patron found engaging in unsafe sex or in "conduct which may reasonably lead to such prohibited sexual activity" must be expelled immediately and told that he will no longer be permitted in the theater. "Eli Lilly May Acquire License to Antifungals" Journal of Commerce (04/18/95) P. 5B Drug maker Eli Lilly & Co. has reached an agreement on the potential licensing of several antifungal compounds discovered by researchers at Montana State University (MSU). The compounds, called pseudomycins, are naturally occurring agents that, in the laboratory, kill some fungi that cause illness and death in humans. The compounds may be used to fight yeast infections in women, said MSU professor Gary Strobel. The arrangement gives Eli Lilly the chance to do a series of lab experiments on the compounds, said company spokeswoman Amy Magan. "Completed U.S. Phase III Study of Thymosin Alpha 1 Shows Favorable Trend in Treatment of Chronic Hepatitis B" PR Newswire (04/17/95) On Monday, SciClone Pharmaceuticals announced the publication of a summary of the U.S. Multicenter Phase III trial that studied the use of Zadaxin (thymosin alpha 1 injection) in patients with chronic hepatitis B. According to the study's authors, the results indicate "a trend in favor of thymosin alpha 1." Twelve of the 49 subjects treated with Zadaxin experienced a sustained elimination of E-antigen during the one-year study or post-study follow-up. In the placebo control group, only six of the 48 patients showed a remission of the disease. "Coram Healthcare Corp. and Lincare Holdings, Inc. Announced a Merger Creating the Nation's Largest Alternate Site Health Care Company" Business Wire (04/18/95) Executives from Coram Healthcare Corp. and Lincare Holdings, Inc. announced on Tuesday that the two companies' boards of directors have approved a merger agreement between Coram and Lincare. The merger represents the union of the United States' largest provider of home infusion therapy and the lowest cost and second largest provider of home respiratory therapy. The merger will also enable Coram to expand its disease management programs beyond cancer and AIDS to diseases that include respiratory problems. "HIV-1 RNA Serum-Load and Resistant Viral Genotypes during Early Zidovudine Therapy" Lancet (04/01/95) Vol. 345, No. 8953, P. 820; Loveday, C.; Kaye, S.; Tenant-Flowers, M. et al. Loveday et al. studied 11 patients with severe HIV infection to determine the response of HIV-1 to initial zidovudine (ZDV) treatment. Within one to two days of treatment, there was a marked decrease in serum HIV-1 RNA. Maximum suppression took place by seven days, which was paralleled by changes in serum p24 antigen. Serum RNA levels began to return to pre-therapy levels within weeks. In most patients, the HIV reverse transcriptase (RT) gene developed mutations associated with drug resistance within months. The codon changes did not explain the early return of serum HIV-1 RNA levels. The authors relate the significance of the findings to the limited long-term efficacy of ZDV. The dynamic time course of viral load and RT responses to ZDV, they conclude, is particularly important in short-term interventions such as pregnancy. "A Clear Pattern of Neglect: Prisons and the HIV Crisis" Gay Community News (Winter 1995) Vol. 20, No. 4, P. 12; Hope, Trevor; Hayes, Peggy The reasons behind the high rate of HIV seroprevalence in prisons are both obvious and complex, write ACT UP Boston members Trevor Hope and Peggy Hayes in Gay Community News. Prisoners with AIDS do not receive adequate health care, they note, and cannot protect themselves and others from HIV. For example, after the deaths of three female inmates in Massachusetts--two of which were AIDS-related--independent investigators found "a clear pattern of neglect, inattention and inappropriate cost containment measures" on the part of the contracted provider. Eventually, the service provider was replaced and the Department of Corrections was ordered to introduce a case-management system with the goal of ensuring improved communication. In 1991, the National Commission on AIDS said that AIDS prevention in prisons should include distributing the means of protection against HIV. Protective methods such as latex condoms and dental dams, however, are actively prohibited in most prison systems. One area that is slowly changing is that of prisoner participation in clinical trials. In response to widespread concern over the misuse of prisoners, many states have now banned their participation in clinical trials. Hope and Hayes conclude that despite such changes, it is clear that the system will continue to falter when faced with the rising seroconversion rate among prisoners. "Co-Incidence of HIV/AIDS and Tuberculosis--Chicago, 1982-1993" Morbidity and Mortality Weekly Report (03/24/95) Vol. 44, No. 11, P. 227 In 1985, HIV infection was recognized as a significant influence on the growing tuberculosis (TB) rate in the United States. Although the incidence of TB in Chicago decreased nearly 40 percent between 1982 and 1987, the rate rose 23 percent between 1987 and 1993. Of the 458 co-incident cases of AIDS and TB identified in the city during 1989 and 1993, pulmonary TB was the only AIDS-defining illness for 17 percent of the total. The other 83 percent had TB and other AIDS-defining illnesses. During that same time period, non-Hispanic blacks made up 50 percent of the AIDS cases, 62 percent of the TB cases, and 71 percent of the co-incident cases. Hispanics accounted for 14 to 17 percent of the AIDS, TB, and co-incident cases. Fifty-two percent of all co-incident cases in Chicago were attributed to intravenous drug use. "Viral Load is Worth Paying Attention To" AIDS Clinical Care (04/95) Vol. 7, No. 4, P. 35; Currier, Judith; Fliesler, Nancy Two studies of HIV-positive patients seem to confirm that viral load is a noteworthy predictor of case outcome irrespective of CD4 count. In the first study, plasma viremia levels were measured in 43 patients given ddI after treatment with AZT. Patients were classified as nonresponders after one month if their viremia decreased less than the median drop, and categorized as responders if their viremia increased more. Responders lived longer without AIDS-defining illnesses and longer overall--even when the results were adjusted for initial levels of CD4 and viremia, and the mutation from AZT resistance. In the second study, a quantitative cell microculture assay was used to gauge HIV titers in peripheral blood mononuclear cells in 109 asymptomatic patients. Virus titers decreased as therapy progressed, while CD4 counts increased as the viral load decreased for the first 12 weeks--they declined after that. The highest increases in CD4 count occurred in patients with the highest initial viral loads. "Mobilizing to Fight AIDS" Mobile Office (05/95) Vol. 6, No. 5, P. 118; Arrendell, Stephen For referral specialists Pauline Green and Robert DeJesus of the Bronx-Harlem Needle Exchange--the largest of five such programs in New York City--mobile communications equipment are not only a convenience, but their clients' lifeline to a more caring world. They serve approximately 10,000 injection drug users, of whom an average of 60 percent in New York are infected with HIV. "The cellular phone has a powerful psychological effect on our clients," says Green. Using the phone to call health-care providers and other service providers "shows the client that you'll extend yourself for them," she adds. The cell phones are also useful in emergency situations, such as overdoses. In addition, the nonprofit organization uses two IBM ThinkPad 355s, which are used to compile a database that serves as the backbone of the program. When each new client registers, he receives a confidential code that is entered into the database, which is used for each of his subsequent transactions. The data is the foundation of the reports that the program files with the New York State Department of Health and funding sources, including the American Foundation for AIDS Research. "French AIDS Ad Row" Adweek (04/03/95) Vol. 36, No. 14, P. 14; Tilles, Daniel Two television stations in France have cited poor taste as the reason why they have refused to air an advertisement, called "April Fool's Day," that calls for increased funding for AIDS research. The spot is one in a series of 15 commercials that will air during a week-long AIDS telethon which began on April 1. The government-owned FR2 and FR3 stations accepted the other 14 commercials. The ad in question features an HIV-infected man breathlessly announcing the discovery of a cure for HIV. The man then says he is only joking. "While waiting for the moment that this can be announced on a day other than April 1st, scientists and those infected such as myself are in need of your help," he concludes. Jean-Pierre Elkabbach, president of the two stations, said he decided not to air the commercial "out of respect for the ill." No other French network has refused to broadcast the commercial.