Date: Fri, 27 Jan 1995 09:22:34 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary January 27, 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 ************************************************************ "Wellcome Rejects Bid by Glaxo" "Lifeline: AIDS Vaccine" "Hemophiliacs Urge New Jersey to Allow AIDS Suits Against Pharmaceuticals" "Latent AIDS More Dangerous Than Thought" "UCSF Study Identifies Helpful and Unhelpful Behaviors for Friends and Family of Persons With AIDS" "More Pregnant British Women Found With AIDS Virus" "Indonesia Transvestites Think of Fun Not AIDS" "Virologic and Immunologic Characterization of Long-Term Survivors of Human Immunodeficiency Virus Type 1 Infection" "Rapid Turnover of Plasma Virions and CD4 Lymphocytes in HIV-1 Infection" "Effective Response to Emerging Diseases Called an Essential Priority Worldwide" ************************************************************ "Wellcome Rejects Bid by Glaxo" New York Times (01/27/95) P. D1; Stevenson, Richard W. Calling the bid inadequate, Wellcome PLC Thursday rejected the $14 billion takeover offer made Monday by rival drugmaker Glaxo PLC. Wellcome acknowledged that it had no realistic hope of remaining independent because its largest shareholder, the Wellcome Trust, suddenly decided to sell its 39.5 percent stake. The company said that it was now putting itself up for sale in the hopes of attracting a better offer. While analysts said Wellcome's decision was certain given the board's legal responsibility to seek the best price for shareholders, they said Glaxo is likely to prevail because few other pharmaceutical companies have the desire or financial strength to exceed the offer. The combination of Glaxo and Wellcome would create the world's largest pharmaceutical company. Glaxo is best known for Zantac, an ulcer treatment. Wellcome's leading drugs are Zovirax, a herpes treatment, and AZT, or Retrovir, which combats AIDS. Related Stories: Wall Street Journal (01/27) P. A3; Washington Post (01/27) P. F2 "Lifeline: AIDS Vaccine" USA Today (01/27/95) P. 1D; Vigoda, Arlene A scientific advisory panel urged the Food and Drug Administration Thursday to heed AIDS patients' pleas for wider testing of the country's first therapeutic vaccine. The Immogen vaccine was developed by Dr. Jonas Salk, inventor of the first polio vaccine, and is intended to keep HIV-infected people healthier longer. Related Story: Wall Street Journal (01/27) P. A1 "Hemophiliacs Urge New Jersey to Allow AIDS Suits Against Pharmaceuticals" Knight-Ridder/Tribune Business News (01/27/95); Shaw, Donna Advocates for hemophiliacs asked a New Jersey state legislative committee on Thursday to approve a bill permitting lawsuits against drug companies whose medicines were once contaminated with HIV. The bill would exempt one year from the state's statute of limitations, allowing hemophiliacs or their estates to sue the drug companies despite the ten years or more since infection. The government estimates that 8,000 to 10,000 hemophiliacs were infected with HIV in the late 1970s and early 1980s as a result of contamination in their blood-clotting medications. Elena Bostick, executive director of the Hemophilia Association of New Jersey, explained that "patients were frequently advised that HIV was not clinically significant and would not necessarily cause any disease." "Latent AIDS More Dangerous Than Thought" Reuters (01/26/95); Kenen, Joanne There is increasing evidence that HIV is involved in a subtle struggle with the human immune system from the beginning of infection and is reproducing so abundantly that mutations form, creating drug-resistant variations. The immune system eventually surrenders. John Coffin, the author of a new study on the "latent" stage of HIV infection, said this is the bad news from the study. The good news, he said, is that a better understanding of the disease can guide researchers toward treatments that may be able to boost the immune system and enable it to hold off the virus. Coffin is a professor of molecular biology and microbiology at Tufts University Medical School in Boston. His research team came up with a model that shows that HIV is more dynamic in its earlier stages than previously thought. The work expands on research recently published in the journal Nature, which shattered some beliefs about AIDS and prompted experts to start thinking about new and earlier treatments. "It seems the real disease caused by HIV occurs during the period when almost nothing seems to be happening," wrote Coffin in the journal Science. AIDS does not suddenly happen after years of uneventful HIV infection, he said, but is the product of years and years of accumulated damage. "UCSF Study Identifies Helpful and Unhelpful Behaviors for Friends and Family of Persons With AIDS" Business Wire (01/26/95) A new study from the University of California at San Francisco (UCSF) has found that the friends and family of AIDS patients can be invaluable sources of support and strength for the patient, but they can also unintentionally say or do things that are unhelpful or offensive. Often, the friends and family members are uncertain or confused about how they can provide the most support to their loved ones. The UCSF study identifies helpful and unhelpful behaviors from the point of view of a person with AIDS, and provides guidance for those who care but are not sure how to offer support to an AIDS patient. Some of the unhelpful behaviors include avoiding interaction, acting embarrassed or ashamed, breaking confidentiality, and criticizing one's medical care. Helpful behaviors include expressing love or concern, interacting naturally, and offering practical assistance. "More Pregnant British Women Found With AIDS Virus" Reuters (01/26/95) A British government study has found that more pregnant women in London are becoming HIV-infected, while homosexual men continue high-risk behavior that puts themselves and others at risk. Thirty percent of the heterosexual men found by clinics to have HIV had already been diagnosed as HIV-infected, but 74 percent of homosexual and bisexual men and 52 percent of heterosexual women had previously been diagnosed. The health department report showed that drug users and homosexual men were still the most at risk from AIDS. The number of pregnant women diagnosed with HIV in London jumped from one in 1,220 women in 1990 to one in 570 in 1993. There were 2.7 cases of AIDS per 100,000 population in the United Kingdom in 1993, compared to 14.1 in Spain, 9.9 in France, and 8.0 in Italy. "Indonesia Transvestites Think of Fun Not AIDS" Reuters (01/26/95); Pardomuan, Lewa Last June, Indonesia--which has a thriving sex industry and an increasing problem with AIDS--issued its National AIDS Strategy with guidelines for matters such as preventive measures, education programs, and blood testing. Health workers, however, argue that the guidelines are not widely known, which leads to ignorance in many people, particularly those with risky sexual behavior. Transvestites are among those groups most at risk. Many say they are aware of the danger of AIDS, but their knowledge includes little more than trying to persuade their partners to wear condoms. They frequently do not even bother. Aid workers say that officials in predominantly Muslim Indonesia want to publicize the danger of AIDS, but the fear of Muslim pressure has limited education campaigns to low-key promotions of condom use and reducing the number of sexual partners. By the end of 1994, 67 people in Indonesia had AIDS, and 208 were HIV-positive. Health officials claim the number of HIV-positive individuals could be 200 times higher and could reach 500,000 by the end of the year. "Virologic and Immunologic Characterization of Long-Term Survivors of Human Immunodeficiency Virus Type 1 Infection" New England Journal of Medicine (01/26/95) Vol. 332, No. 4, P. 201; Cao, Yunzhen; Qin, Limo; Zhang, Linqi et al. Although most HIV-infected people develop clinical or laboratory evidence of immunodeficiency with 10 years of seroconversion, a few infected people remain healthy and immunologically normal for more than a decade. Cao et al. studied 10 seropositive people who were asymptomatic and had normal and stable CD4 lymphocyte counts despite 12 to 15 years of HIV-1 infection. Plasma cultures were uniformly negative for infectious virus, but particle-associated HIV-1 RNA was detected in four subjects. Standard limiting-dilution cultures detected infectious HIV-1 in peripheral-blood mononuclear cells (PBMCs) in three patients, while CD8-depleted culture found infectious virus in another. A quantitative polymerase-chain-reaction showed that all 10 subjects had detectable, but low, titers of viral DNA in PBMC. While there was no in vitro evidence of host CD4 lymphocyte resistance to HIV-1 infection, long-term survivors had a vigorous, virus-inhibitory CD8 lymphocyte response and a strong neutralizing-antibody response. Cao et al. concluded that those people who remain asymptomatic for many years despite infection with HIV-1 have low levels of HIV-1 and a combination of strong virus-specific immune responses with some degree of attenuation of the virus. "Rapid Turnover of Plasma Virions and CD4 Lymphocytes in HIV-1 Infection" Nature (01/12/95) Vol. 373, No. 6510, P. 123; Ho, David D.; Neumann, Avidan U.; Perelson, Alan S. et al Although an increased viral load correlates with CD4 lymphocyte depletion and disease progression, relatively little is known on the kinetics of virus and CD4 lymphocyte turnover in vivo. Researchers administered ABT-538, an inhibitor of HIV-1 protease, to 20 HIV-1-infected patients to upset the balance between virus production and clearance. They found that ABT-538 caused plasma HIV-1 levels to decrease exponentially and CD4 lymphocytes to increase significantly. Minimum estimates of HIV-1 production and clearance and of CD4 lymphocyte turnover suggest that replication of in vivo replication of HIV-1 is continuous and highly productive, propelling the rapid turnover of CD4 lymphocytes. "Effective Response to Emerging Diseases Called an Essential Priority Worldwide" Journal of the American Medical Association (01/18/95) Vol. 273, No. 3, P. 189; Marwick, Charles Infectious diseases are the leading cause of death worldwide. New infectious agents and diseases once thought virtually eliminated are reappearing as public health problems. The Centers for Disease Control and Prevention is trying to counter the threat of emerging diseases by implementing a number of goals, such as collaborating more closely with states to execute new surveillance systems and to improve existing ones. Funding for surveillance, however, is largely limited to diseases that have already been identified. Of the $40 million allocated to states for infectious disease surveillance, for example, 95 percent goes only to tuberculosis, HIV/AIDS, sexually transmitted diseases, and some vaccine-preventable diseases. "No one denies that funds for AIDS are needed, but they have been taken from the existing budgets of other public health programs. Our ability to respond in other areas has been siphoned off," says Dr. Michael T. Osterholm, state epidemiologist for the Minnesota Department of Health. Public health officials claim that money spent now to detect and prevent diseases before they become widespread is justified by the money that could be saved. THE END.