Date: Tue, 31 Jan 1995 22:23:20 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary January 31, 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 Is Now the Leading Killer of Americans from 25 to 44" "Caremark Will Sell Home Infusion Unit to Coram" "Drug Companies Act in Hemophiliacs' Suit" "Long-Term AIDS Survivors Puzzle Scientists" "AIDS Patient Settles Suit Charging Denial of Care" "In Love, In Danger" "Across the USA: Utah/Washington/Wyoming" "Researchers Find Early Battlers of H.I.V." "Duesberg and the New View of HIV" "Planning Process Localizes HIV Prevention Plans, Say CDC Officials" ************************************************************ "AIDS Is Now the Leading Killer of Americans from 25 to 44" New York Times (01/31/95) P. C7; Altman, Lawrence K. New data has found that AIDS is the leading cause of death among all Americans aged 25 to 44. AIDS surpassed unintentional injury, the Government's category for accidents, which dropped to second place for this age group, said Dr. Harold W. Jaffe, a top AIDS official at the Centers for Disease Control and Prevention (CDC). "AIDS was expected to rise to the top of the list eventually, but no one had predicted which year," he said Jaffe added that the increase "is due to the accumulating toll from AIDS and is almost certain to continue because AIDS deaths reflect infections from HIV...that were acquired several years earlier." More than 440,000 cases of AIDS have been reported to the CDC since the disease was first identified. More than 250,000 people have died from AIDS or AIDS-related causes. About 75 percent of the cases have been reported in the 25 to 44 age group. AIDS is also the leading cause of death in men and women in 79 of 169 American cities with populations over 100,000, and in 15 of the 135 largest cities--including Baltimore, Md.; Miami, Fla.; and Newark, N.J. Related Story: Baltimore Sun (01/31) P. 7A "Caremark Will Sell Home Infusion Unit to Coram" New York Times (01/31/95) P. D5; Feder, Barnaby J. Caremark International Inc. announced on Monday that it will sell its home infusion unit to the Coram Healthcare Corporation for more than $300 million in cash and securities. If approved by antitrust regulators, Coram would clearly become the leader in the highly fragmented business of administering intravenous medicines and nutritional products in the home to patients with AIDS, cancer, and other chronic or acute diseases. Caremark said the sale would give it greater resources to concentrate on other businesses that have become more important to it than home infusion--particularly buying and managing the practices of groups of physicians with multiple specialties. "Home infusion had become the least profitable money-making business in our portfolio," said C.A. Lance Piccolo, chairman and chief executive of Caremark. Related Stories: Washington Post (01/31) P. D2; Wall Street Journal (01/31) P. B5 "Drug Companies Act in Hemophiliacs' Suit" Philadelphia Inquirer (01/31/95) P. A2; Shaw, Donna Attorneys for four drug companies asked a federal appeals panel yesterday to overturn a lower-court ruling allowing hemophiliacs to sue the companies as a group. The hemophiliacs involved in the suit claim they were infected with HIV by the companies' blood clotting medications. The companies are Armour Pharmaceutical Co., Miles Inc., Baxter Healthcare Corp., and Alpha Therapeutic Corp. Douglas F. Fuson, Armour's attorney, argued that the court would waste its time listening to the companies defend themselves against negligence charges in a class-action suit only to hear the same arguments in subsequent cases. "Long-Term AIDS Survivors Puzzle Scientists" Washington Post (Health) (01/31/95) P. 7; Colburn, Don About 5 percent of HIV-positive people seem unaffected by the virus either clinically or immunologically after a decade of infection. Three studies of this group have appeared in the New England Journal of Medicine. One of these, a study of a hemophiliac who was infected before 1983 with a virus containing a defective gene, was conducted at the New England Primate Research Center with the University of Massachusetts and Harvard. The subject's continuing health holds promise for a vaccine against more potent forms of the virus, but an upcoming report in Science magazine indicates that the defective virus caused AIDS in monkeys. "AIDS Patient Settles Suit Charging Denial of Care" Philadelphia Inquirer (01/31/95) P. B2 A private settlement has been reached in the case of a Philadelphia man who alleged that he was denied medical care because he tested HIV-positive. While the plaintiff's attorney said on Monday that the suit had been settled on the eve of the trial, he refused to disclose the details. The attorney filed a suit last year on behalf of John Woolfolk, a city resident who was receiving medical care under the state and federally financed HealthPass program. Woolfolk claimed that the doctor assigned to him told him he did not treat AIDS patients. The doctor denied the allegations. Judge John R. Padova had rejected motions earlier this year to dismiss the suit, which was filed under the Americans with Disabilities Act. "In Love, In Danger" Baltimore Sun (01/31/95) P. 1D; Lippman, Laura To reinforce the message of abstinence, parents and teachers often emphasize the scariest potential consequences--pregnancy or AIDS. In Towson, Md., for example, approximately 500 Baptists will gather this weekend for a "True Love Waits" conference, a national movement to encourage teens to sign sexual abstinence pledges as part of their commitment to God. In the shadow of AIDS, however, other sexually transmitted diseases (STDs) have become secondary in such discussions--which is a disservice to everyone, say local doctors who treat adolescents. While the effects of AIDS and pregnancy are more extreme, gonorrhea and chlamydia are statistically more likely. Chlamydia affects as much as 35 percent of all sexually active women. An STD infection can also make it easier to become infected with HIV, through open sores that allow the virus to enter the bloodstream. "Teenagers don't believe it can happen to them," says Dr. Alain Joffe, director of adolescent medicine at the Johns Hopkins Children's Center. "They think: 'It's people who are promiscuous, people who are dirty. Bad kids get STDs.' And they don't see themselves in that light." Only abstinence can guarantee an individual will not contract an STD, but monogamous relationships help reduce the risk. "Across the USA: Utah/Washington/Wyoming" USA Today (01/31/95) P. 11A The Utah House sent the Senate a bill that subjects injured state residents rescued by public safety officers or Good Samaritans to tests to ensure they do not have AIDS or some other blood-borne disease. Opponents to the bill call it intrusive. In another AIDS-related development, a Washington state study has found that for the first time, new cases of AIDS in the state are increasing faster in smaller, rural communities than they are in the Seattle-King County area. Each day, on average, two AIDS-related deaths occur statewide. In other news, 110 cases of AIDS have been reported in Wyoming since 1984. Ninety-nine of those cases have been in men. A total of 68 have died from AIDS-related causes. "Researchers Find Early Battlers of H.I.V." New York Times (01/29/95) P. 24; Kolata, Gina Small preliminary studies of protease inhibitors--drugs that block a key viral enzyme--to be reported this week at a national medical meeting indicate that a new class of drugs is extremely effective in eliminating HIV and allowing the immune system to recover, at least in the short term. The investigators, however, advise caution in interpreting the results, noting that many promising early findings have failed to lead to effective treatments for AIDS patients. While the drugs currently on the market block a different enzyme, reverse transcriptase, and are generally acknowledged to be weak in fighting HIV progression, the protease inhibitors appear to be different. Dr. David Ho, director of the Aaron Diamond AIDS Research Center, said the protease inhibitors were about 10 times more effective than AZT and other reverse transcriptase inhibitors in stopping HIV replication. Dr. John Leonard, director of protease inhibitor studies at Abbott Laboratories, said that Abbott will report that its drug, ABT-538, can shut off 99 percent of HIV's replication and can reduce the number of virus particles in the blood by 70 to 99 percent. The Merck protease inhibitor, L524, produced similar effects, said Ho. "Duesberg and the New View of HIV" Nature (01/19/95) Vol. 373, No. 6511, P. 189; Maddox, John The new findings on the dynamics of HIV infection are, or should be, an embarrassment to Professor Peter Duesberg of Berkeley, Calif., writes John Maddox in Nature magazine. The findings resolve the paradox that although the concentration of CD4 cells may decline with the persistence of infection, there was no dramatic increase in the frequency of infected T cells as infection gave way to overt disease. The new developments show that the T cells in an infected person's blood are likely to have been created in the previous few days. Only a small proportion will have had the time to become infected. The cells that harbor the virus will be killed off very soon. Thus, the scarcity of T cells is consistent with the claim that the immune system is in overdrive from the onset of HIV-infection. Duesberg is correct to have argued that the usually slow decline of CD4 cells is not consistent with what is expected from a specific cytotoxic viral mechanism. The explanation is that the CD4 population has at any time been freshly created. Maddox wonders why it has only now been found that the response of the immune system to HIV-infection is hyperactivity, and not the opposite. Further studies of the viral dynamics will be eagerly awaited, now that the basis for the low CD4 T-cell count in AIDS patients is clear. "Planning Process Localizes HIV Prevention Plans, Say CDC Officials" Nation's Health (01/95) Vol. 25, No. 1, P. 10 The HIV Prevention Community Planning Process--a program that helps health departments identify high priority prevention needs with the help of community representatives--provides a significant step forward in planning services that specifically address unique community needs, say officials at the Centers for Disease Control and Prevention. The program was developed last year by the CDC with help from governmental and non-governmental organizations. A 1993 guidance document from the CDC required all health departments that receive HIV prevention funds from the CDC's National Center for Prevention Services to initiate an HIV Prevention Community Planning Process in fiscal year (FY) 1994 to qualify for HIV prevention funding in FY 1995 and beyond. The HIV Prevention and Community Planning Process has already made the participants realize the need for parity, inclusion, and representation in the planning process. Other issues to be dealt with include setting priorities and trust among members.