Date: Wed, 8 Feb 1995 09:37:01 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary February 8, 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 ************************************************************ "Settlement Reached in AIDS Suit" "Who Will Care for Children when Parents Die of AIDS?" "Parole Denied to Top Figure in French AIDS Scandal" "Growing AIDS Epidemic Becomes More Diverse" "Chronicle" "Across the USA: Mississippi/New Mexico" "HIV Population Dynamics in Vivo: Implications for Genetic Variation, Pathogenesis, and Therapy" "Drug Malabsorption and Resistant Tuberculosis in HIV-Infected Patients" "Danish Haemophiliacs Court Case Nears Conclusion" "Silence=Stigma" ************************************************************ "Settlement Reached in AIDS Suit" Philadelphia Inquirer (02/08/95) P. B2; Vedantam, Shankar An undisclosed settlement has been reached in the AIDS discrimination lawsuit filed by surgeon Paul Scoles against Mercy Health Corp., with both sides claiming vindication. The settlement came after a federal judge's ruling in December that Mercy Health did not discriminate against Scoles, who is HIV-positive, when it required him to disclose his status to his patients before treating them. Scoles and his lawyers claimed victory for making hospitals in the United States "change their behavior" toward doctors who are infected with HIV. Mercy Health said that because AIDS meant "nearly certain death," it was impossible to hide risks of infection from patients, no matter how small such risks may be. In 1992, Scoles charged that Mercy Health suspended his surgical privileges and ruined his practice after he revealed he was HIV-positive. He claimed that Misericordia Hospital, which is operated by Mercy Health, sent more than 1,000 letters to his former patients informing them that he was infected. "Who Will Care for Children when Parents Die of AIDS?" Philadelphia Inquirer (02/08/95) P. H1; Martin, Antoinette Since late last summer, a series of public service announcements by the National Council for Adoption (NCFA) has urged parents with AIDS to arrange adoptions for their children before they die. One of the ads says, "AIDS. Kids. If you have both, maybe it's time to take a closer look at adoption." The ads have been on television and radio stations in cities including Philadelphia, New York City, Detroit, and San Francisco. "We are targeting areas where the AIDS epidemic is prevalent," says William Pierce, president of the Washington, D.C., non-profit group. Pierce says that hundreds of calls--from people with AIDS, support groups, and people wanting to adopt--have flooded the phone lines since the ads began airing last spring in the Washington area. There have been no negative responses. So far, 64 children have been adopted as a result of the national campaign. The number of children in the United States that have been orphaned by AIDS is estimated to be about 35,000. Health officials project that by the year 2000, there will be between 70,000 and 125,000 AIDS orphans, says Pierce. "Parole Denied to Top Figure in French AIDS Scandal" Philadelphia Inquirer (02/08/95) P. A6 On Tuesday, a Paris court rejected a bid for parole by Dr. Michael Garretta, the head of France's state-run blood bank during the mid-1980s. It was during that period that more than 1,000 hemophiliacs became HIV-infected from tainted blood as officials used up stocks to save money rather than import virus-free products. In making its decision, the three-judge panel cited the "exceptional extent of damages" in the scandal, and noted that "parole...is not an automatic right of the convicted." Garretta was jailed in October 1992 for "fraud in the quality of merchandise." "Growing AIDS Epidemic Becomes More Diverse" Boston Globe (02/07/95) P. 32; Walsh, Pamela M. Although AIDS was once thought of as a disease of only gay men and intravenous drug users, recent data from the Centers for Disease Control and Prevention show that it is now moving into the mainstream. A study at the Living Center, a resource center in Boston for HIV-infected people, identified a shift toward more women and minorities. In 1992, 17 percent of the center's members were black and Hispanic males, but now they make up 32 percent of the 1,000 members. Hispanic women make up 25 percent of the center's female membership, whereas in 1992 there were none. While there were 12 heterosexual members three years ago, there were 40 in 1994. "Chronicle" New York Times (02/08/95) P. B4; Steinhauer, Jennifer The feathered white wings used in the Broadway production "Angels in America" will be donated the AIDS Resource Center's "Valentine Auction," to be held Monday in SoHo, New York. Works donated by artists Louise Bourgeois and Jenny Holzer and the estate of the photographer Robert Mapplethorpe will also be sold. Proceeds from the auction will benefit the AIDS Resource Center, which provides housing for homeless people with AIDS. "Across the USA: Mississippi/New Mexico" USA Today (02/07/95) P. 11A Jury selection began on Tuesday in Laurel, Miss., for the murder trial of 16-year-old Marvin McClendon, who is accused of killing two gay men last October. According to his lawyer, McClendon shot the unarmed men to protect himself from rape and possible exposure to AIDS. In New Mexico, lawmakers are considering a bill to permit state health workers distribute clean needles to drug addicts. The measure, which is intended to stem the spread of AIDS and other diseases, would use $220,000 to initiate pilot programs in two counties. "HIV Population Dynamics in Vivo: Implications for Genetic Variation, Pathogenesis, and Therapy" Science (01/27/95) Vol. 267, No. 5197, P. 483; Coffin, John M. Several recent reports show that the long, clinically latent phase characteristic of human HIV infection is not a period of viral inactivity, but an active process in which cells are being infected and dying at a high rate and in large numbers. John M. Coffin of the Department of Molecular Biology and Microbiology at Tufts University School of Medicine used these results to develop a simple, steady-state model in which infection, cell death, and cell replacement are in balance. The findings suggest that the unique feature of HIV is the exceptionally high number of replication cycles that occur during infection of a single person. A consequence of rapid turnover is the development of genetic variation, which can build up populations of HIV strains resistant to antiviral drugs. Coffin also notes that understanding the dynamics of the latent period may lead to ideas for new therapeutic strategies. "Drug Malabsorption and Resistant Tuberculosis in HIV-Infected Patients" New England Journal of Medicine (02/02/95) Vol. 332, No. 5, P. 336; Patel, Kalpana B.; Belmonte, Romelle; Crowe, Helen M. In a letter to the editor published in the New England Journal of Medicine, Patel et al. describe their experiences in caring for two HIV-infected patients who relapsed into drug-resistant isolates of Mycobacterium tuberculosis (TB). The relapse is presumed to be because of subtherapeutic drug levels caused by malabsorption. The first patient received isoniazid, rifampin, and pyrazinamide daily for ileocecal and pulmonary TB. After four months of observed therapy, he was found to have a new cavitary pulmonary lesion. Sputum cultures grew M. tuberculosis that was resistant to rifampin, but still sensitive to isoniazid, pyrazinamide, ethambutol, and streptomycin. The second patient, diagnosed with pulmonary TB, received rifampin, pyrazinamide, and ethambutol daily under direct supervision in a homeless shelter. A new right-upper-lobe infiltrate appeared after 10 months. An isolate of sputum was resistant to both isoniazid and rifampin, but still sensitive to pyrazinamide, ethambutol, and streptomycin. The cases illustrate that drug malabsorption may contribute to the emergence of drug resistance, as some researchers have theorized. The researchers suggest routine screening of antimycobacterial-drug levels in HIV-infected patients with TB, especially those with advanced HIV disease. "Danish Haemophiliacs Court Case Nears Conclusion" Lancet (02/04/95) Vol. 345, No. 8945, P. 313; Skovmand, Kaare On Feb. 9, a Danish High Court will determine whether the National Board of Health, the Ministry of Health, and factor VIII maker Novo Nordisk are liable for the HIV-infection of eight hemophiliacs. They are being sued by the Danish Haemophiliacs Association, which claims that the patients were infected through factor VIII received after Jan. 1, 1985. The association claims that by Jan. 1, 1985, the authorities and the producer should have been aware of the risk of HIV-transmission via factor VIII. To support the claim that action to prevent HIV transmission through factor VIII products was taken late, the prosecution presented evidence of very poor communication among the authorities in 1985. The defendants claim that their actions were based on what they thought to be right in light of existing knowledge at the time. The trial has added to the bad publicity Novo Nordisk received in 1988 when it was fined Dkr15,000 for having marketed products prepared from blood not screened for HIV. A total of 90 Danish hemophiliacs became HIV-infected during the 1980s through therapy with factor VIII. "Silence=Stigma" Advocate (02/07/95) No. 674, P. 31; Gallagher, John Many AIDS activists say that the stigma attached to AIDS will continue unless individuals, especially famous ones, acknowledge their illness. A. Cornelius Baker, director of public policy and education at the National Association for People With AIDS, said that AIDS is more likely to be hidden if the person who has it is a gay man, particularly if he is a celebrity. For example, journalist Randy Shilts, who died in 1994, has been the object of scorn because he only revealed his illness after his health declined significantly. Despite Shilts' status as a prominent historian of the AIDS epidemic and perhaps the first openly gay reporter in mainstream media, he remained silent for several years about being HIV-infected. Most often, however, the AIDS closet involves the suppression of AIDS as the cause of death in tributes and obituary notices. Often survivors avoid naming AIDS as the cause of death, using instead a kind of code where young men die from "long-term illness" or "heart failure." Although activists hope for more openness, they understand why many people do not choose it. "There has to be a respect for privacy," said Baker. "You have to allow people to die in the fashion they choose."