Date: Wed, 18 Jan 1995 09:15:20 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary January 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 ************************************************************ "Findings: Tuberculosis on the Rise" "Difficult Questions on Care for AIDS" "AIDS Society Wins New Hearing on Disclosure" "Romanian Parents Sue State over AIDS Children" "French Against Vatican Sacking of "Red Cleric"" "Admissibility of Sexual Orientation at Issue" "1994 a 'Mediocre' Year for Drug Breakthroughs" "Biomune Systems Inc. Announces Fiscal 1994..." "Sexual Attitudes and Lifestyles" "FDA 'Remains Committed' to Quick Approval of AIDS Drugs" ************************************************************ "Findings: Tuberculosis on the Rise" Washington Post (01/18/95) P. A2 A new study conducted by the World Health Organization and the Centers for Disease Control and Prevention reports that tuberculosis (TB) is increasing in most parts of the world. Ninety million new cases of TB will have been reported from 1990 to 1999, and the disease may kill 30 million people during the 1990s, according to the study. The spread of TB is partially blamed on AIDS--which leaves patients susceptible to such infections--and partially on the emergence of drug-resistant strains of TB. About 95 percent of new cases occur in developing countries; the highest infection rates are in sub-Saharan Africa and Southeast Asia. The number of TB cases reported in the United States each year has increased by about 14 percent from 1985 through 1993. "Among adults, TB is the world's foremost cause of death from a single infectious agent," the study concludes. Related Stories: Wall Street Journal (01/18) P. B6; USA Today (1/18) P. 1A; Baltimore Sun (1/18) P. 9A "Difficult Questions on Care for AIDS" Washington Times (01/18/95) P. A3; Price, Joyce A study by doctors at San Francisco General Hospital Medical Center has raised questions as to the cost-effectiveness of intensive care for AIDS patients with pneumonia and severe respiratory failure. The study found that since 1988, charges for such patients dying during hospitalization have doubled. The report in the Journal of the American Medical Association was based on the review of 113 AIDS patients with pneumocystis carinii pneumonia (PCP) and respiratory failure who were mechanically ventilated at San Francisco General between 1981 and 1991. The post intensive-care unit (ICU) admission charges for all 113 patients was more than $6.5 million, and only 25 percent lived to be discharged. There was a major "deterioration" in cost-effectiveness, said Dr. Robert M. Wachter, director of the hospital's internal medicine residency program. From 1981 to 1985, ICU admission and subsequent hospitalization cost $305,795 per year of life saved. The amount fell to $94,528 for patients treated during the mid 1980s, but rose to $215,233 for PCP patients treated in the ICU between 1988 and 1991. The majority of the patients either had Medicaid or were uninsured. Wachter noted that any decision to "ration" such high-tech care would be "difficult" in that "withholding" breathing equipment from a patient with PCP and respiratory failure "means almost certain death." "AIDS Society Wins New Hearing on Disclosure" Toronto Globe and Mail (01/17/95) P. A3 The Canadian AIDS Society has been given a new hearing on a ruling that would have allowed the Canadian Red Cross (CRC) to disclose the names of 13 HIV-infected blood donors to Ontario health officials. The Ontario Court of Appeal ordered the case back to a lower court to examine new evidence that blood tests to confirm positive results were conducted at a federal laboratory. The society claims that the lab does not have to comply with provincial law requiring disclosure. Both the province and the CRC contend that the location of the testing is irrelevant. The society did not learn that a federal laboratory was used until Jan. 5, almost two months after it filed an appeal on a November ruling. Russell Armstrong, an official with the AIDS Society, says he is upset that the CRC did not make the facts available earlier, because now another expensive hearing is necessary. The CRC claims it was not trying to conceal anything and went to an independent lab so that the results could not be questioned. The problem concerns blood donated at the Toronto Blood Centre from December 1984 to September 1985, before the CRC introduced an HIV-antibody test. "Romanian Parents Sue State over AIDS Children" Reuters (01/17/95); Dascalu, Roxana A growing number of Romanian parents are challenging authorities over their children's infection with HIV while in hospitals. Romania has the highest rate of juvenile AIDS in Europe. Romanian doctors blame the high rate of infection among children on unscreened blood transfusions during the communist era, lingering neglect, and unhygienic hospital practices. Next month, a court in Iasi is scheduled to hear the case of six-year-old Ioana Iasmina--who is dying of AIDS--against a local hospital and the Health Ministry. Social workers and lawyers expect the case will set a precedent for other child AIDS patients in the country. Ioana's parents are suing for US $113,000 in damages from the Health Ministry and the Sfanta Maria hospital in Iasi, where she was treated for influenza three years ago. If they win, her parents say they will donate the money to an AIDS foundation for children. The Health Ministry has rejected allegations that the girl was infected during her stay at the hospital in 1992, saying that the exact time of her infection could not be determined. The Romanian media have reported that the basis for the case will be that the hospital staff failed to sterilize the medical equipment. "French Against Vatican Sacking of "Red Cleric"" Reuters (01/17/95) A CSA survey for the Catholic weekly La Vie has found that most French people disapprove of the Vatican's firing of a liberal bishop and think it will harm the Catholic Church in France. A total of 64 percent of the public were against the firing of Jacques Gaillot as bishop of Evreux in Normandy last Friday. Only 11 percent approved of his firing and 25 percent were undecided. Forty-seven percent of practicing Catholics opposed Pope John Paul II's action. Defying Vatican doctrine, Gaillot had urged the use of condoms to protect against AIDS, spoke in favor of allowing priests to marry, and called for greater tolerance of homosexuality. Of the French polled, 64 percent said that the Vatican decision would be negative for the church "because it illustrates its difficulty in confronting problems of the modern world." The poll also showed that French people believed Gaillot was acting within his role as a bishop by joining squatters actions in favor of the homeless and speaking in favor of contraception. "Admissibility of Sexual Orientation at Issue" Wall Street Journal (01/16/95) P. B2; Felsenthal, Edward To help prove that his client shot two men in self-defense, Marvin McClendon's lawyer wants to introduce evidence that the two victims were gay. Ronald Parrish also wants to show the results of AIDS tests conducted during the autopsies. Thus far, courts have been wary of admitting evidence about the sexual orientation of a crime victim. Some lawyers complain that banning such evidence makes defense attorneys and prosecutors dance around the subject of sexual orientation. In his argument to admit the HIV results, Parrish says that if either man had AIDS, it would strengthen his client's case that he was fending off an assault. If they were infected, "in essence, they had a deadly weapon with them," says Parrish. Some legal specialists have criticized Judge Billy J. Landrum for taking extra time over the HIV issue and for admitting evidence on sexual orientation. A federal appeals court, however, recently ruled that a victim's sexual orientation "was a significant issue at trial because it bore upon the factual basis for [a] claim of self-defense." The judge is reserving judgment until the Jan. 30 trial. "1994 a 'Mediocre' Year for Drug Breakthroughs" Baltimore Sun (01/16/95) P. 11C The past year was a disappointing one for the pharmaceuticals industry, partly due to unsuccessful trials of treatments for hepatitis, sepsis, and Lou Gehrig's disease. In addition, drugs for epilepsy, asthma, and migraines caused severe and even fatal side effects, while drugs that did make it to market were primarily improvements on existing drugs. Bristol-Myers Squibb Co. seemed to have the most success with new products, including Zerit, Glucophage, and Serzone. Candidates that may receive approval in 1995 include Pfizer's Enable, Biogen's beta interferon, and two new AIDS treatments from Merck & Co. "Biomune Systems Inc. Announces Fiscal 1994..." Business Wire (01/16/95) Biomune Systems Inc. reported a net loss of $0.35 per share on revenues of $365,000 for fiscal 1994 on Monday. Fiscal 1993's loss was $0.41 per share on $357,000 in revenues. President David G. Derrick said, "Biomune is in a strong position to continue its efforts to bring Immuno-C to market." Immuno-C is the company's treatment for AIDS-related cryptosporidiosis. "Sexual Attitudes and Lifestyles" Journal of the American Medical Association (01/11/95) Vol. 273, No. 2, P. 168; Webb, Warren W.; Hollender, Marc H. "Sexual Attitudes and Lifestyles" is a study of the sexual behavior of "a representative sample of the British population" conducted from 1986 to 1994. The study consisted of a face-to-face interview for general attitudes followed by a self-completion booklet for more intimate, personal behavior questions. The researchers found that the British AIDS public education message of "safe sex" being enhanced by either a sexually exclusive relationship or condom use seems to be getting through. A total of 27 percent of the men and 36 percent of the women endorsed exclusive relationships, while 75 percent of the men and 81 percent of the women supported condom use. During the last year, unsafe sex was reported by 6 percent of the men and 4 percent of the women. The search for data relevant to the HIV epidemic was hampered by political considerations. On Sept. 10, 1989, then Prime Minister Margaret Thatcher vetoed the study because of "its intrusiveness and its unacceptability to the British people." In October 1989, however, the research continued after a large grant from the Wellcome Trust. "FDA 'Remains Committed' to Quick Approval of AIDS Drugs" American Pharmacy (12/94) Vol. 34, No. 12, P. 14 FDA spokesman Arthur White said recently that the agency would not change its policy on accelerated approval for medications for life-threatening conditions. "The agency remains fully committed to fast-track approval," said Whitmore. The FDA held a public meeting in September, at which researchers and manufacturers expressed their views on the policy, which was prompted by AIDS activists in 1992. Now the Treatment Action Group is asking the FDA to require large, placebo-controlled trials for accelerated approval. The group is worried that drug companies may not follow up with confirmatory trials in a timely manner. However, other activists objected to placebos because they wanted to know what drugs they were taking. The FDA plans to release a "guidance document" that will delineate more clearly the requirements for accelerated approval. THE END.