Date: Thu, 1 Jun 1995 10:17:33 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary June 1, 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-Infected Patients Cost Hospitals Up to $260,000 Per Year, Study Says" "Republicans Don't Enjoy Having Budget Compared to AIDS Virus" "Scientists: Airline's Primate Ban Could Hinder Medical Research" "The Stuff of Dreams Nears Reality" "Some U.S. States Have Toughened Up on Tattoo Artists" "300 People Face HIV Test after Rome Blood Probe" "Progenics Report on HIV Antiviral Molecule Published in AIDS Research and Human Retroviruses" "Exploring Transgenic Plants as a New Vaccine Source" "Morbidity and Mortality from Transfusion-Transmitted Disease in Haemophilia" "Under False Pretenses" "In a New Light: Sex Unplugged" ************************************************************ "AIDS-Infected Patients Cost Hospitals Up to $260,000 Per Year, Study Says" Baltimore Sun (06/01/95) P. 16A AIDS patients--many of whom rely on Medicaid or charity for life-extending treatment--can cost hospitals as much as $260,000 a year, researchers said on Wednesday. A study in the Journal AIDS shows that many hospitals are so strapped that if Congress cuts billions from Medicaid, they may have to allot AIDS care to stay in business. In some hospitals, AIDS patients take up more than 7 percent of the beds each day, according to the National Public Health and Hospital Institute study. Also, an AIDS patient's stay averages 12 days, compared to just 7.2 days for the typical patient's hospital visit. The Institute's president, Dennis Andrulis, reported that inpatient HIV care cost $1.6 billion in 1991. While the average small hospital lost $92,000 that year treating people with AIDS, the average deficit approached $260,000 at teaching hospitals, where most AIDS patients seek care, Andrulis said. However, he added, the financial picture at teaching hospitals has improved since 1988, when the average loss was $500,000. Continuing losses are due to the fact that 90 percent of HIV-infected patients in public hospitals rely on Medicaid, Medicare, or charity for care. "Republicans Don't Enjoy Having Budget Compared to AIDS Virus" Washington Times (06/01/95) P. A6; Garrett, Major On Wednesday, Republicans reacted to claims by White House AIDS Policy Director Patricia S. Fleming that their health care budget proposals are as dangerous to AIDS patients as HIV. Rep. Steve Gunderson (R-Wis.), a longtime advocate for AIDS funding, called Fleming's remarks "cruel, callous, and insensitive." Fleming told participants of an AIDS conference on Wednesday that the GOP budget would reduce services for poor AIDS patients. The House's budget resolution would reduce the projected growth in Medicaid spending by $187 billion over seven years, while the Senate's version would reduce growth by $175 billion over the same period. Medicaid, which provides health care for poor and disabled Americans, makes up about 6 percent of the annual federal budget. Due to rising costs, however, Congress has decided to let states administer the programs to see if they can lower costs through innovation. Opponents argue that this move will encourage states to cut corners of health care for the poor. Fleming said the administration will fight the GOP Medicaid plan "to the bitter end." "Scientists: Airline's Primate Ban Could Hinder Medical Research" Journal of Commerce (06/01/95) P. 1A; Koenig, Robert Lufthansa Cargo AG's decision last month to stop transporting primates has limited the supply of animals, and has scientists warning that their medical research will be seriously impaired. Officials at the German airline, which had been the largest transporter of primates, said they stopped carrying monkeys primarily because of the emotional campaigns waged by animal-rights groups. "Clearly, this will impact many pharmaceutical companies and medical-appliance companies that are required by the FDA to test new products on primates," said Joe Bielitzki, a veterinarian at Emory University who is an expert on the use of primates for research. Bielitzki also cautioned that because primates are critical to some AIDS research, airlines' refusal to carry them "could slow down some aspects of AIDS research by two or three years." "The Stuff of Dreams Nears Reality" New York Times (06/01/95) P. D1; Fisher, Lawrence M. Several pharmaceutical and biotechnology companies are utilizing gene therapy to develop vaccines and treatments for various diseases, including cancer and AIDS. Many of these companies are discovering the difficulty of mastering gene therapy as their technique of injecting DNA into "deactivated" viruses raises questions of possible infection. Analysts say that many gene therapy companies lack sufficient financing to complete their first products and will not secure funding in the public market. Among the companies engaging in gene therapy are Bayer, Rhone-Poulenc Rorer, and Genetic Therapy. "Some U.S. States Have Toughened Up on Tattoo Artists" Reuters (06/01/95) Since the discovery of HIV, many U.S. states have become tougher on tattoo artists, a new report has found. According to a report in the Journal of the American Academy of Dermatology, 17 states have increased tattoo regulations and seven states now prohibit the practice. Although no cases of HIV transmission through a tattoo needle has even been documented, there have been cases of people contracting hepatitis B while being tattooed, the report said. "300 People Face HIV Test after Rome Blood Probe" Reuters (05/31/95) Following an investigation into alleged violations of blood donor regulations at about 50 private clinics in Rome, more than 300 people must be tested for HIV and hepatitis B and C, Italian health officials announced on Wednesday. The move comes after magistrates learned that some donors at the Sanatrix clinic may not have been properly screened. Sanatrix, which has been closed pending completion of the probe, has denied any wrongdoing. Officials in Rome are investigating a number of private clinics on suspicion of violating the law. They are also investigating claims that staff at public hospitals sold blood supplies to the private sector at greatly inflated prices. "Progenics Report on HIV Antiviral Molecule Published in AIDS Research and Human Retroviruses" PR Newswire (05/31/95) In the May issue of AIDS Research and Human Retroviruses, researchers from Progenics Pharmaceuticals, the Aaron Diamond AIDS Research Center, and the Centers for Disease Control and Prevention report that a proprietary Progenics molecule potently and broadly neutralizes clinical strains of HIV in vitro. PRO 542 (CD4-IgG2), a novel recombinant protein based on Progenic's HIV Universal Antiviral Binding Agent technology, neutralizes the virus by high-affinity binding to the viral envelope of the glycoprotein and by detaching the envelope glycoprotein from the HIV particle--thus inactivating HIV. The company is developing the molecule for post-exposure prophylaxis and immunotherapy. Progenics intends to file an Investigational New Drug application on PRO 542 and begin Phase I clinical trials by early 1996. "Exploring Transgenic Plants as a New Vaccine Source" Science (05/05/95) Vol. 268, No. 5211, P. 658; Moffat, Anne Simon Recent research results suggest the possibility of genetically engineering plants and plant viruses to produce vaccines for diseases ranging from bacterial diarrhea to AIDS. Jan Holmgren an immunologist at the University of Goteborg warns of "a lot of unknowns" and hazards surrounding plant vaccines, such as the need to purify the vaccines of toxic plant materials and alkaloids. However, David Russell, director of plant molecular biology at Agracetus Inc., contends that plant-made proteins would be easy to produce and less expensive than current vaccines. A team led by plant scientist Charles Arntzen of Texas A& M University is investigating the possibility of engineering edible plants with plant-based vaccines. Arntzen introduced a gene encoding a surface protein from the hepatitis B virus and an enterotoxin into the tobacco plants to demonstrate that plants can elicit an immune response in animals. Several concerns surrounded his experiment, such as the effect of other immunizing proteins aside from enterotoxin and the selection of appropriate foods. Agracetus has found that plant proteins in genetically engineered soybeans can create the monoclonal antibody, BR96, which is used in cancer therapy. In addition, Jack Johnson of Purdue University, George Lomonosoff of the John Innes Institute, and Lisa Wisniewski of Axis Genetics have placed fragments of the HIV gp41 surface protein on a cowpea mosaic. Wisniewski said, "The results indicated the possibility of producing a preventive HIV vaccine by presenting a cocktail of specific HIV epitopes on the surface of a plant virus." "Morbidity and Mortality from Transfusion-Transmitted Disease in Haemophilia" Lancet (05/20/95) Vol. 345, No. 8960, P. 1309; Lee, Christine A. ; Sabin, Caroline A.; Phillips, Andrew N. et al. Lee et al. report that 111 male hemophiliacs at London's Royal Free Hospital Haemophilia Centre were infected with HIV between 1979 and 1985. The men, who are reviewed at least every six months, have been followed for up to 15 years since HIV seroconversion. At the time of HIV infection, the men were coinfected with the hepatitis C virus (HCV). As of Jan. 1, 1995, 61 men were still alive, six of whom have AIDS. The average time to AIDS progression in this group is now 14.2 years. A total of 13 patients have shown no signs of HIV infection. HCV progression in HIV-infected patients is accelerated by coinfection with HIV. Overall, 9 of the 50 men who died experienced liver failure. Although the prospect of mortality and morbidity related to HCV infection is of concern, there is no reliable indicator of which patients are likely to develop liver disease. As efforts are made to increase the life expectancy of HIV-infected hemophiliacs, substantial morbidity and mortality related to HCV infection are likely to occur, the authors conclude. "Under False Pretenses" Advocate (05/16/95) No. 681, P. 34; Dahir, Mubarak Researchers who conduct clinical trials advise against cheating not only to protect their data, but also to protect patients' health. However, an unknown number of participants in AIDS clinical trials routinely violate the conditions of the study. "Nathan," for example, analyzed a sample of a liquid with which he has been injecting himself as part of a double-blind study. If the liquid contains a drug, he will remain in the trial. But if it is a placebo, he will leave the study to enroll in another. "The strategy is to jump from study to study and get as much short-term benefit as you can," he explains. Some patients falsify their medical history to qualify, seeking access to new drugs or improved health care. Others, like Nathan, have their drugs tested or change the dosage. While some experts on AIDS clinical trials estimate the number of cheaters is less than 10 percent of all those enrolled, others say the number is higher. "It is very prevalent," says Petros Levounis of the Columbia University School of Medicine. Drug trials are designed with safeguards to detect cheating. Research sites are regularly inspected and blood tests can sometimes reveal whether a patient is taking certain drugs. Still, if a person is intent on cheating, he or she will find a way to do it. The best way to reduce cheating on trials, says Tulane University's Lynn Besch, is to win the participants' trust prior to the trial by getting them involved in planning and review stages as early as possible. "In a New Light: Sex Unplugged", Centers for Disease Control and Prevention (5/23/95) Thursday night, June 1st from 8-9 pm ET, ABC-TV is presenting the fourth annual "IN A NEW LIGHT," a public information outreach special. This year's show is subtitled, "SEX UNPLUGGED" and will deal with the pressure that young people feel to become sexually active. The show focuses on teenagers who have chosen abstinence, decided to postpone sex, or are sexually active and are protecting themselves. Special events are being planned in communities across the country in coordination with the airing of the primetime telecast. Contact the CDC National AIDS Hotline (800) 342-2437) for additional information, receive an information packet and to register your viewing event. You may also call the CDC National AIDS Clearinghouse at (800) 458-5231 to have the packet faxed to you on NAC FAX.