Date: Wed, 5 Jul 1995 09:45:28 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary July 5, 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 ************************************************************ "Helms Puts the Brakes to a Bill Financing AIDS Treatment" "Fanfare: Johnson, Lakers Nearing a Reunion" "Fat-Bubble Drugs Near Approval" "The Vanishing Heroes of Science" "Advanced Viral Research Corp. Filed Form 8-K" "Antigenic Oscillations and Shifting Immunodominance in HIV-1 Infections" "Directly Observed Therapy for Tuberculosis: History of an Idea" "AIDSWatch '95 on Capitol Hill" "Handle with Care" ************************************************************ "Helms Puts the Brakes to a Bill Financing AIDS Treatment" New York Times (07/05/95) P. A12; Seelye, Katharine Q. Sen. Jesse Helms (R-N.C.) wants to reduce the amount of federal funds that go to AIDS patients because he says it is their "deliberate, disgusting, revolting conduct" that is responsible for their infection. Helms also argues that while AIDS is only the ninth-leading cause of death in the United States, the disease accounts for more federal funding than diseases that kill a greater number of people--an assertion which is not supported by Public Health Service data. The senator's bid to cut AIDS spending comes as Congress decides whether to reauthorize the Ryan White CARE Act of 1990, a law named for an Indiana teenager who died after contracting HIV from a blood transfusion. Despite extensive bipartisan support in both houses of Congress, the bill appears stalled. In the Senate, the measure has cleared the committee level but has not reached the floor. In the House, the bill is stalled in committee--opposed by a group of religious organizations unless the law requires the mandatory testing of newborns for HIV. Helms wants to amend the measure to reduce the amount of money spent on AIDS relative to the amount spent on heart disease and cancer, the two leading causes of death in Americans. "Fanfare: Johnson, Lakers Nearing a Reunion" Washington Post (07/05/95) P. D2 Basketball star Magic Johnson is considering a return to his former team, the Los Angeles Lakers. "We're talking about it, so we have to see what happens," he was quoted as saying in Tuesday's Honolulu Advertiser. This is thought to be the first time the Lakers have publicly said they are considering such a move. Since retiring twice after announcing in 1992 that he is HIV-positive, Johnson ended attempts at a comeback after some players expressed concerns over contracting HIV should he spill blood while on the court. However, Lakers General Manager Jerry West said times and attitudes about AIDS have changed since the basketball great last attempted a comeback. "Now there's so much more information about health concerns that I think it's easier for him to make a decision today," he noted. If Johnson decides to play, he will be forced to give up his ownership rights to the team. "Fat-Bubble Drugs Near Approval" Washington Post (Health) (07/04/95) P. 15 An advisory panel to the U.S. Food and Drug Administration has recommended approval of two experimental drugs made of fat bubbles for the treatment of Kaposi's sarcoma (KS). Scientists believe that the fat coating--made up of liposomes, or microscopic fat bubbles used to coat highly toxic medicines--allows the drugs to travel to site of the disease without spreading into other cells and poisoning them along the way. This method permits more of a drug to be delivered without severe side effects. The two drugs receiving tentative approval from the committee were NeXstar Pharmaceuticals Inc.'s DaunoXome and Liposome Technology Inc.'s Dox-SL, which was recommended under certain conditions. A study of more than 200 advanced KS patients found that those who received DaunoXome lived one year, while those on standard therapy lived 26 fewer days. More importantly, DaunoXome patients had 10 times fewer side effects than other patients, NeXstar officials said. "The Vanishing Heroes of Science" New York Times (07/04/95) P. 31; Greenberg, Daniel S. Dr. Jonas Salk was on the scale of such greats as Benjamin Franklin, Marie Curie, and Albert Einstein, writes Daniel S. Greenberg--editor and publisher of the newsletter Science & Government Report--in the New York Times. During the forty years since Salk developed his polio vaccine, however, science, medicine and technology have been demythologized by tales from within and marred by allegations of fraud and glory-stealing. The degree of change, notes Greenberg, can be seen in Salk's response to the question of who hold's the polio vaccine's patent. Salk had replied, "Well, the people, I would say. There is no patent. Could you patent the sun?" With its high level of public fear and intensity of research, AIDS--the modern counterpart of polio--has not yet produced such a hero. The first great discovery was the identification of HIV, but almost immediately the claims of discovery produced a bitter war between France's Pasteur Institute and Robert Gallo of the U.S. National Institutes of Health. The government eventually concluded that its star researcher had failed to give the French credit for their work. Although Gallo was not charged with misconduct, the circumstances do not make for hero worship, Greenberg concludes. "Advanced Viral Research Corp. Filed Form 8-K" Comtex (07/03/95) The U.S. Food and Drug Administration (FDA) has placed the Investigational New Drug Application filed by Advanced Viral Research Corp. for its drug Reticulose on an inactive status. To remove the application from this status, Advanced Viral Research must provide the FDA with pre-clinical information regarding the drug as a treatment for HIV. "Antigenic Oscillations and Shifting Immunodominance in HIV-1 Infections" Nature (06/15/95) Vol. 375, No. 6532, P. 606; Nowak, Martin A.; May, Robert M.; Phillips, Rodney E. In the British medical journal The Lancet, Nowak et al. describe a new mathematical model of antigenic variation that deals primarily with the interaction between cytotoxic T lymphocytes (CTL) and multiple epitopes of a genetically variable pathogen. The researchers demonstrate that the nonlinear competition among CTL responses against separate epitopes can explain immunodominance. The model indicates that an antigenically homogeneous pathogen population tends to generate a dominant response against a single epitope--unlike a heterogeneous pathogen population, which can stimulate complicated fluctuating responses against several epitopes. In the immunodominant epitope, antigenic variation can transfer responses to weaker epitopes, thus lessening immunological control of the pathogen population. According to the researchers, these findings are consistent with detailed longitudinal studies of CTL responses in patients infected with HIV-1. In terms of vaccine design, the new model indicates that the primary response should be directed against conserved epitopes, despite the fact that they are subdominant. "Directly Observed Therapy for Tuberculosis: History of an Idea" Lancet (06/17/95) Vol. 345, No. 8964, P. 1545; Bayer, Ronald; Wilkinson, David In the United States, directly observed therapy (DOT) has become the standard of care in the treatment of tuberculosis (TB). The Advisory Council for the Elimination of Tuberculosis (ACET), for example, has recommended that DOT be used in all locations that do not achieve at least a 90 percent completion rate for treatment. For more than 30 years, foreign studies have indicated that a broad application of supervised therapy is important. However, U.S. TB-control efforts all but ignored the relevance of such findings, focusing instead on what insights might be relied upon to predict patient behavior and medication use, and on the importance of fashioning clinical structures and practices that would overcome noncompliance. DOT was often seen as an imposition that could only be justified in the presence of evidence that the patient would behave in a way that posed a threat to the public health. Since 1993, when ACET decided to make DOT the standard of care, the transformation of federal policy has been reflected at the local level as state, county, and municipal health departments create their TB policies and practices. "AIDSWatch '95 on Capitol Hill" AIDS Treatment News (06/16/95) No. 225, P. 6; Tobias, Tadd In May, more than 500 advocates--including people with AIDS, caregivers, and service providers from 38 states--converged on the nation's capital to learn about federal AIDS issues and to lobby members of Congress. The focus of this annual event, which was coordinated by the National Association of People With AIDS and co-sponsored by 26 national organizations, is to educate members of Congress and ask for their support on AIDS issues. Items on this year's agenda included reauthorizing full funding of the Ryan White CARE Act, supporting AIDS treatment research at the National Institutes of Health, sustaining community-based Centers for Disease Control and Prevention AIDS prevention activities, and opposing mandatory HIV antibody testing of pregnant women. "Handle with Care" Economist (06/24/95) Vol. 335, No. 7920, P. 27 In light of the recent incident at the White House, when several guards wore rubber gloves to search the belongings of homosexual officials, one might think that the government would be taking steps to instruct its employees about HIV transmission, write the editors of the Economist. President Clinton promised enhanced HIV education in his June 18th letter of apology. However, instead of improving such education, Congress is now considering whether to eliminate it for federal workers. Presidential candidate Robert Dornan (R-Calif.), along with other conservatives, claims the president's "AIDS at Work" program "promotes homosexuality or bisexuality as just another healthy lifestyle choice." Dornan was scheduled to be the lead witness in a recent House subcommittee hearing on issue. Other witnesses included representatives from the Family Research Council and Concerned Women for America, two groups whose politics are similar to Dornan's. The American Red Cross declined to testify, which caused some activists to cynically question whether the decision was connected to the fact that the agency is run by Elizabeth Dole, the wife of Senator Bob Dole, who is the Republican front-runner for the presidency.