Date: Fri, 18 Aug 1995 10:15:29 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 08/18/95 AIDS Daily Summary August 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 ************************************************************ "Drugs Chief Urges Reform of U.S. Approval Process" "Blood Bank Testing Finds Rare AIDS Virus" "Driver Pulls Over, Saves Life: AIDS Victim Gets to Go Home Again" "District to Delay Paying Vendors, Health Providers" "Testing Begins on Experimental AIDS Drug" "AIDS Victims Battle More than Disease, Conferees Assert" "Gilead Sciences Completes Public Offering of Common Stock" "Boston: Important Trial of Treatment Vaccine, CD4 Greater than 500" "Seizure Associated with Zidovudine" "Palliative Care for People with AIDS" ************************************************************ "Drugs Chief Urges Reform of U.S. Approval Process" Financial Times (08/18/95) P. 5 Unless drug approval procedures in the United States are amended, foreigners could have the first opportunities to use new drugs, said Pat Zenner, president of the Swiss-owned pharmaceutical company Hoffmann-LaRoche. According to Zenner, Congress will probably begin deliberating reform of the U.S. Food and Drug Administration (FDA) approval process in September. Sixty percent of all FDA-approved drugs between 1992 and 1994 were first approved in another nation, he added. Although the agency has adopted streamlined approval programs for such treatment categories as AIDS or transplants, Zenner said that most drugs waited an average 15 years from laboratory identification to final market release. "Blood Bank Testing Finds Rare AIDS Virus" Washington Times (08/18/95) P. A6 The government announced on Thursday that HIV-2 was found in two blood donations last year and kept out of the nation's blood supply. In 1992, blood banks began testing for both HIV-1 and HIV-2, which is primarily found in West Africa and rarely found in the United States. Dr. John Ward, head of the Centers for Disease Control and Prevention's AIDS surveillance division, said that the U.S. blood supply continues to be safe. There have been no instances of HIV-2 infection through a blood transfusion in the United States, he said. "Driver Pulls Over, Saves Life: AIDS Victim Gets to Go Home Again" Washington Times (08/18/95) P. C8; Mizejewski, Gerald When driving home from his health club last month, John Taylor--a government volunteer who drives the streets of Fairfax County, Va., looking for mistreated pets--noticed an active dog sitting next to a homeless man at the side of the road. Taylor stopped to check on the dog's health and ended up rescuing an AIDS patient and fulfilling his dream of returning to Rhode Island before he dies. "I've had AIDS for 13 1/2 years and I've never met anyone that nice before," said Toby Swenson, who had been hitchhiking to Rhode Island before he became to weak to continue. Taylor tried repeatedly to get Swenson to enter a hospital, but he refused because he did not want to leave his dog--which is also the reason he was denied entry at several homeless shelters. Taylor then contacted a social worker with the Fairfax County Department of Human Development, who ran a check on Swenson and found an old friend who offered to pay for his immediate flight home. Swenson is now staying at the Pawtucket, R.I., home of his sister. "District to Delay Paying Vendors, Health Providers" Washington Post (08/18/95) P. B1; Schneider, Howard In order to avoid running short of cash, the District of Columbia government will delay paying approximately $100 million to vendors and health care providers in the next six weeks. City Administrator Michael C. Rogers criticized the plan but said "it is the only practical way" for the city to survive a cash shortage until Oct. 1, and noted that former Mayor Sharon Pratt Kelly did the same thing toward the end of her term. The city will delay about $40 million in Medicaid funds due to hospitals, nursing homes, and other creditors, and about $60 million to other vendors, Rogers added. "This is nuts," said Jim Graham, executive director of the Whitman-Walker Clinic, the area's largest provider of services for AIDS patients. According to Graham, D.C. owes the clinic nearly $340,000. "Testing Begins on Experimental AIDS Drug" Business Wire (08/17/95) Scientists at Stanford University and four other locations nationwide are initiating tests of HBY 097, an experimental compound that may fight HIV and keep it from mutating into drug-resistant strains. Preliminary tests suggest that HBY 097 is more durable than nevirapine, which also belongs to the class of drugs called non-nucleoside reverse transcriptase inhibitors (NNRTIs). Nevirapine initially showed success against HIV, but later failed due to it apparently increased the virus' tendency to mutate. Under the developmental project of Hoechst AG, Bayer AG, and their U.S. divisions, HBY 097 will be tested at various doses and in combination with AZT. Stanford professor Dr. Thomas C. Merigan and his colleagues will track the virus using a new computer-driven system that analyzes nucleic acids using small glass chips covered with short pieces of DNA. "AIDS Victims Battle More than Disease, Conferees Assert" Boston Globe (08/17/95) P. 10 At an international conference of social workers on Thursday, participants said that people with AIDS have to fight ignorance and discrimination in addition to their disease. "In a way we are the modern lepers, the ones many don't want to get close to," said Patrick Levy, chairman of Israel's AIDS Task Force, at the first International Conference on HIV-AIDS and Social Work. The delegates, who came from 51 nations, said they are trying to find ways to change attitudes and make life easier for AIDS patients. They said that although attitudes had improved in some areas, HIV-infected individuals in other regions of the world were being rejected by their families, imprisoned, or fired from their jobs. In Pakistan, for example, some people with AIDS have been burned alive, said Shouket Ali of the Pakistan AIDS Prevention Society. The conference organizers said that about 60 countries have HIV-related immigration laws, some of which bar AIDS patients from entering the country. "Gilead Sciences Completes Public Offering of Common Stock" Business Wire (08/17/95) On Thursday, Gilead Sciences, Inc. reported that it had completed a public offering of more than 3,500,000 shares of common stock at $23.25 per share for total gross proceeds of nearly $82 million. The company is a leader in the discovery and the development of a new class of nucleotide-based human therapeutics, and its product candidates for clinical studies include treatments for HIV, human papillomavirus-associated genital warts, and hepatitis B infection. VISTIDE (cidofovir), Gilead's most advanced drug candidate, is being studied for the potential treatment of cytomegalovirus retinitis. "Boston: Important Trial of Treatment Vaccine, CD4 Greater than 500" AIDS Treatment News (08/04/95) No. 228, P. 4 Boston's Beth Israel Hospital needs 18 volunteers for a trial of a new peptide vaccine which is being developed by United Biomedicals, Inc., of New York. The conditions for participation include having more than 500 CD4 cells, not having used any antiretrovirals in the past six months, being asymptomatic, and being in generally good health. In tests of a few HIV-negative individuals, the vaccine--which is made completely by chemistry, not from live HIV--appeared to be safe. It also caused the body to produce HIV-specific CD8 cytotoxic T lymphocytes, which may kill some HIV-infected cells. "Seizure Associated with Zidovudine" Lancet (08/12/95) Vol. 346, No. 8972, P. 452; D'Silva, Marisa; Leibowitz, David; Flaherty, John P. In a letter to the editor published in the Lancet, D'Silva et al. report the incidence of a generalized seizure related to the prophylactic use of zidovudine. After receiving a large-caliber contaminated needlestick injury from an HIV- and hepatitis C-infected individual, a man was given intramuscular immunoglobulin and tetanus toxoid, and oral zidovudine. The zidovudine therapy was continued three to four times daily. During the next few days, the patient complained of nausea, anorexia, and emesis--which were treated with ondansetron--as well as exercise intolerance, dull occipital headaches, and insomnia. Six days after the needlestick, he experienced a generalized seizure. The patient had never suffered seizures or adverse drug reactions before, but he had had several concussions from childhood accidents. The zidovudine was abandoned, and no other seizures took place. More than one year later, the patient remains negative for both HIV and hepatitis C. Although it is still not clear whether zidovudine caused the seizure, the potential for severe toxicity should be considered when recommending unproven treatment, the authors note. "Palliative Care for People with AIDS" Focus (07/95) Vol. 10, No. 8, P. 8 D.R. Kuhl's "Ethical Issues Near the End of Life: A Physician's Perspective on Caring for Persons with AIDS" identifies a number of emotional issues that face people with advanced HIV and details ethical dilemmas for doctors dealing with pain and symptom management. For example, many AIDS patients--who often feel powerless in the face of the multiple decisions surrounding their unpredictable disease--must deal with complicated relationships toward the end of life. Palliative care should help patients gain control of their lives and relationships. When doing this, it is important that practitioners respect a client's "personhood"--the ability to undertake active roles, maintain routines, and plan for the future. Providers should be prepared to confront such issues as lack of control and loss of dignity as a means of helping their patients resolve them.