Date: Thu, 21 Dec 1995 09:43:57 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 12/21/95 AIDS Daily Summary December 21, 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 ************************************************************ "AIDS Drug Also Fights Hepatitis B" "U.S. Agency Targets Minnesota Young Adults with AIDS-Prevention Ads" "Blue Cross May Force Illness-Prone New Yorkers into Managed Care Plans" "Venture into the Transplant Unknown" "Vatican Publishes Sex Guide for Good Catholics" "More than Half a Million AIDS Cases Reported in U.S." "Sequus Pharmaceuticals Initiates Commercial..." "A Short-Term Study of the Safety, Pharmacokinetics, and Efficacy of Ritonavir, an Inhibitor of HIV-1 Protease" "Potential AIDS Drug Targets Different Viral Enzyme" "Doctors Who Treat AIDS Support Each Other" ************************************************************ "AIDS Drug Also Fights Hepatitis B" Washington Post (12/21/95) P. A9 Researchers report in today's issue of the New England Journal of Medicine that the recently approved AIDS drug 3TC appears to suppress the hepatitis B virus (HBV) in people with chronic infections. Currently, the only available treatment for hepatitis B is interferon, which can eliminate the virus in some 33 percent of patients but must be taken for several months and produces several unpleasant side effects. In this most recent study, Jules L. Dienstag of Massachusetts General Hospital and other scientists found that a three-month course of 3TC, which is also known as lamivudine or Epivir, can permanently eliminate HBV in about 20 percent of the patients and has few side effects. According to Jay Hoffnagle of the National Institutes of Health, the next will be to determine whether a combination of 3TC and interferon increase the possibility of curing hepatitis B. Related Stories: New York Times (12/21) P. A26; Wall Street Journal (12/21) P. B9; Washington Times (12/21) P. A5 "U.S. Agency Targets Minnesota Young Adults with AIDS-Prevention Ads" Knight Ridder/Tribune Business News (12/21/95); Skog, Jason The U.S. Centers for Disease Control and Prevention (CDC) launched a new national safe sex ad campaign aimed at young people in late November, called "Respect Yourself, Protect Yourself." The series of radio and television spots show young adults speaking candidly about AIDS, sex, and abstinence. CDC spokesman Michael Greenwell notes, "The biggest challenge is making the messages appropriate to reach these people." Educators claim these ads are much needed in the Northland, Minn., where few people know someone with AIDS or have the disease themselves. AIDS is the leading cause of death among 25- to 44-year-olds nationally, though HIV and AIDS are only fifth on the cause of death list in the Northland. The plan there is to have the CDC message reinforced locally, which may require a more conservative method or emphasizing abstinence more. Still, Dr. Georgia Keeney, an associate professor in health education at the University of Minnesota-Duluth, believes that being direct is the best way to talk about AIDS. "I don't care how you get sex-educated, you need to get the message," she says. "Blue Cross May Force Illness-Prone New Yorkers into Managed Care Plans" Knight-Ridder/Tribune Business News (12/21/95) Empire Blue Cross and Blue Shield, New York state's largest insurer, may cancel thousands of individual and family Tradition Plus health insurance policies that enable some of the sickest people to select their own physicians and hospitals. Consumer advocates claim that the insurer's forced move of these people into managed care plans could hurt the patients, many of whom have long-term relationships with their health-care professionals and facilities. Ruth Finkelstein, spokeswoman for New Yorkers for Accessible Health Care, noted that the 60,000 customers affected by the change have serious health problems and that many need specialists. Finkelstein also said that these patients have ten times the incidence of AIDS and three times the incidence of cancer and heart disease than the population as a whole. Empire CEO Michael Stocker said that coverage under one of the company's new managed care plans would be virtually the same, but the lifetime cap would shift for some patients from $1 million to $500,000. "Venture into the Transplant Unknown" Washington Times (12/21/95) P. A18; Ambrose, Jay The promise of last week's baboon bone marrow transplant into an AIDS patient is that scientists not only attempted to produce essentially a second immune system, but they also aspired to learn more about cross-species medicine, writes columnist Jay Ambrose in the Washington Times. A key risk involved is that baboons carry many viruses that are harmless to primates, yet are potentially dangerous to humans. Extreme caution has been exercised from the very beginning of this experiment, Ambrose notes. Still, Ambrose suggests that before further experimentation is allowed, the public should be involved in the procedures with a public discussion and perhaps even a major conference on the issue. "Vatican Publishes Sex Guide for Good Catholics" Reuters (12/20/95); Webber, Jude The Vatican has put out a new sex education guide for parents that says that safe sex is "immoral and dangerous policy." The handbook notes, "Without wanting to take away from them their rightful autonomy, parents must know how to say 'no' to their children when it is necessary." The 60-page book, which was compiled by the Pontifical Council for the Family, implores parents to keep children away from society's "negative influences" and "banalisation of sex" by teaching sex education at home. The Vatican also restated Pope John Paul's thoughts on AIDS. "Parents must refute the promotion of so-called 'safe sex' or 'safer sex,' a dangerous and immoral policy, based on the illusory theory that a condom can provide sufficient protection against AIDS," the guide said. "More than Half a Million AIDS Cases Reported in U.S." Houston Chronicle (12/20/95) P. 4D Federal health officials have recorded more than 500,000 cases of AIDS as of last month. Sixty-two percent of those individuals have died. The largest proportion of the cases is among men who have sex with men, but the figure is decreasing. Other categories that combined now account for more cases than men who have sex with men include injection drug users and people infected via heterosexual sex. "The increase in AIDS cases resulting from heterosexual transmission also is reflected in the increase in cases reported among women," the Centers for Disease Control and Prevention said in the Morbidity and Mortality Weekly Report. The disease also continues to disproportionately affect some races and ethnicities. AIDS cases are six times higher among American blacks and three times greater among Hispanics than among whites. Whites represent less than 50 percent of all AIDS cases in the country. "Sequus Pharmaceuticals Initiates Commercial..." Business Wire (12/20/95) Sequus Pharmaceuticals reported on Wednesday that it has begun shipping DOXIL to wholesalers and distributors, following FDA marketing clearance of the drug. According to I. Craig Henderson, chairman and CEO of Sequus, "We began receiving orders from the field as soon as we announced FDA market clearance of DOXIL and we are currently filling those orders." DOXIL has been approved for the treatment of Kaposi's sarcoma in AIDS patients who are intolerant to conventional therapies or for whom those therapies are ineffective. "A Short-Term Study of the Safety, Pharmacokinetics, and Efficacy of Ritonavir, an Inhibitor of HIV-1 Protease" New England Journal of Medicine (12/07/95) Vol. 333, No. 23, P. 1528; Danner, Sven A.; Carr, Andrew; Leonard, John M; et al. A double-blind, randomized, placebo-controlled Phase I and II study of 84 HIV-infected individuals with CD4 levels greater than 50 revealed that the HIV-1 protease inhibitor ritonavir was well-tolerated and had potent anti-HIV activity. Danner et al. report that during the initial four weeks of the study, which was supported by Abbott Laboratories, the four different ritonavir dosage groups had similar increases in CD4 counts and reductions in the log number of copies of HIV-1 RNA per milliliter of plasma. The three lower dosage groups, however, returned to base lines after 16 weeks. At the 32-week mark, the seven patients receiving the highest dosages had an average 230-cell increase in their CD4 levels, and an average 0.81-log reduction in the plasma concentration of HIV-1 RNA. Side effects included nausea, circumoral paresthesia, and elevated levels of hepatic enzymes. The researchers concluded that these early results with ritonavir monotherapy indicate high levels of antiviral and immunostimulatory activity, though further studies are required to determine ritonavir's efficacy in combination with other drugs. "Potential AIDS Drug Targets Different Viral Enzyme" Chemical & Engineering News (11/27/95) Vol. 73, No. 48, P. 24 Unlike most other AIDS drugs, which block either reverse transcriptase or protease, a potential AIDS therapy called AR-177 inhibits integrase, which HIV uses to insert its genetic code into the DNA of the host cell, according to Aronex Pharmaceuticals' Robert F. Rando and others. Aronex's oligonucleotide is made up entirely of deoxyguanosine and thymidine. The 17 nucleotides are connected by phosphodiester except at the ends, where phosphorothioate bonds are used to reinforce the compound against attack from cellular enzymes. The researchers claim that the molecule folds into a sturdy three-dimensional structure that seems to promote its means of action and lengthy half-life. Phase I clinical trials of AR-177 were initiated in October. "Doctors Who Treat AIDS Support Each Other" American Medical News (12/11/95) Vol. 38, No. 46, P. 28 Eight Dallas doctors have established a support group to help them deal with the stress of treating dying patients. "If I didn't have this group, I do think that I may not have been able to stay involved with treating AIDS patients as long as I have," says Dr. Brady Allen, who has seen 300 people die from AIDS-related causes. Psychologist Stacy Broun explains that the group helps its patients deal with the large number of deaths, as well as the extreme pain many patients experience and the social stigma surrounding the disease. Co-leader Angela Kavas notes that the group gives the doctors a necessary forum in which to discuss their fears, anger, and frustration.