Date: Tue, 21 Mar 1995 09:34:19 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com AIDS Daily Summary March 21, 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 ************************************************************ "WHO Warns Over TB Threat" "Viagene and Chiron End Merger Talks Without a Deal" "Cuts Set Off Debate on Helping Homeless with AIDS" "The AIDS Breakout" "S. Boston Parade, Already Protesting Gay Group, Bars Veterans with AIDS" "Intestinal Mycobacteria in African AIDS Patients" "Heart Muscle Disease Related to HIV Infection: Prognostic Implications" "Jury Trial Permitted in Suit Against Red Cross" "The Gait of Grief" "Health Heroes: AIDS" ************************************************************ "WHO Warns Over TB Threat" Financial Times (03/21/95) P. 4 Unless new tuberculosis (TB) control strategies are introduced, the global death toll from the disease will increase from 3 million to 4 million a year by 2005, the World Health Organization (WHO) cautioned on Monday. The WHO's recommended strategy, called Directly Observed Treatment, Short-course (Dots), requires health workers to watch their patients take each dose of antibiotics, once a day for two months and then three times a week for four months. Without such supervision, many patients stop taking their medications before the bacteria is completely eliminated, which leads to the emergence of drug-resistant strains of TB. A worldwide campaign based on Dots could save 12 million lives in the next decade, at a cost of $360 million a year, according to Dr. Arata Kochi, TB program manager for WHO. Related Story: New York Times (03/21) P. C12 "Viagene and Chiron End Merger Talks Without a Deal" New York Times (03/21/95) P. D3 Viagene Inc., which produces an experimental AIDS treatment, said on Monday that talks with Chiron Corp. had ended without agreement on Chiron's proposed acquisition of Viagene. Viagene is currently testing HIV-IT, a gene therapy drug for HIV-positive patients. Related Story: Wall Street Journal (03/21) P. B4 "Cuts Set Off Debate on Helping Homeless with AIDS" New York Times (03/21/95) P. B1; Lee, Felicia R. Last week, the House approved cutting a $186 million housing program that would have assisted approximately 50,000 people with AIDS in the 1995 fiscal year. According to the National Commission on AIDS, half to one-third of all Americans with AIDS are either homeless or likely to become so. Rescissions, or midyear budget cuts, were approved last week, which eliminated funds for the Housing Opportunities for Persons with AIDS program. The cut in the program has particularly sparked outrage among advocates for homeless people with AIDS because they believe they represent the most desperate people in the country--people who are poor, sick, homeless, and dying. AIDS advocates say that the unpredictable nature of AIDS distinguishes it from other diseases, and that because of the stigma and fear surrounding the disease, infected people often have a difficult time renting from landlords or staying with family and friends. Many people who work with AIDS patients say the cutbacks in a number of initiatives would force people with AIDS to compete for funds with elderly and disabled people. "The AIDS Breakout" Baltimore Sun (03/21/95) P. 11A; Jacobs, Joanne AIDS activists have long warned that someday the disease would "break out" of the gay community to affect heterosexuals, writes columnist Joanne Jacobs in the Baltimore Sun. AIDS is now out of the gay ghetto, she writes, but not out of the drug ghetto. Last year, drug addicts accounted for almost 75 percent of new HIV infections, according to the New York Times, which cited an as-yet unpublished federal study. While it is not news that HIV is transmitted through shared needles, what is new is the role of crack cocaine, which fuels reckless promiscuity. Up to one half of the women infected through heterosexual sex may be crack addicts, and abuse of other drugs and alcohol is also linked to infection. The role of drug abuse in the AIDS epidemic underscores the desperate need for needle-exchange programs. Giving addicts clean needles in exchange for dirty ones is an effective way to slow the spread of the disease, writes Jacobs. Although attacking the crack factor in HIV transmission requires more drug-treatment options and more money, but offers no guarantee of success, the alternative--letting the drug users die--is grim, concludes Jacobs. "S. Boston Parade, Already Protesting Gay Group, Bars Veterans with AIDS" Boston Globe (03/20/95) P. 1; Lakshmanan, Indira A.R. The veterans group that organized the St. Patrick's Day protest march in South Boston on Sunday would not permit a group of former servicemen who have AIDS to march. "We don't give reasons," said John Hurley, one of the organizers of the event, about why the servicemen were banned. The South Boston Aged War Veterans Council called the march a protest rather than a parade due to a dispute about the participation of a group representing gays and lesbians. The Supreme Judicial Court had ruled that the organizers must include a group of gays and lesbians who wanted to march. A U.S. District Court judge, however, ruled that if the organizers were protesting the state court ruling, and demonstrating in favor of "traditional values"--which they said they were--then the protest could take place. Sunday was the first time the AIDS veterans group had attempted to join in St. Patrick's Day events in South Boston. Jon Stuen-Parker, an AIDS activist and founder of the Veterans With AIDS Drop-In Center, a project of the Boston-based National AIDS Brigade, said that many veterans with AIDS and their families had anticipated the event, only to learn Saturday that they could not march. "Intestinal Mycobacteria in African AIDS Patients" Lancet (03/04/95) Vol. 345, No. 8949, P. 585; Pankhurst, C.L.; Luo, N.; Kelly, P. et al. Infection with both HIV and Mycobacterium tuberculosis has had a significant impact on the epidemiology of tuberculosis (TB) in sub-Saharan Africa. Pankhurst et al. conducted a cross-sectional study of the prevalence of mycobacteria in 120 fecal samples taken from 69 patients with HIV-related diarrhea attending the University Teaching Hospital in Lusaka. Fecal specimens from seven of the 69 patients grew mycobacteria--two had Mycobacterium avium complex (MAC), four had M. tuberculosis, and one had M. flavescens. In a parallel study, the researchers studied fecal specimens from HIV-infected patients in London. Similar rates of recovery of mycobacteria were found, with seven of the isolates being MAC and one M. tuberculosis. One half of the stool-positive cases developed disseminated disease during the 6-12 months of follow-up. Pankhurst et al. concluded that M. tuberculosis and MAC are found in the gut of 10 percent of African patients with HIV-related diarrhea. There is, however, little evidence of the small intestinal mycobacterial disease found in AIDS patients in industrialized countries. Despite high rates of infection in people with AIDS, M. tuberculosis is not a significant contributor. "Heart Muscle Disease Related to HIV Infection: Prognostic Implications" Journal of the American Medical Association (03/08/95) Vol. 273, No. 10, P. 758h To determine the natural course of heart muscle disease in HIV-infected patients, Currie et al. studied HIV-infected adults to detect myocardial dysfunction and time to death. Forty-four of the 296 subjects were diagnosed with cardiac dysfunction. In contrast to other forms of cardiac dysfunction, dilated cardiomyopathy was strongly associated with a CD4 cell count less than 100. Compared to those with normal hearts, patients with dilated cardiomyopathy had significantly reduced survival rates. While 101 days was the average survival time for those patients with cardiomyopathy, those with normal hearts and a CD4 cell count less than 20 lived 472 days. There were no significant differences in survival for participants with borderline left or isolated right ventricular dysfunction. Even with the reduced cell count with which dilated cardiomyopathy is associated, the prognosis for HIV-infected patients with dilated cardiomyopathy is poor. Isolated right and borderline left ventricular dysfunction, however, are not linked to diminished CD4 counts and do not carry adverse negative prognostic implications. "Jury Trial Permitted in Suit Against Red Cross" National Law Journal (03/13/95) Vol. 17, No. 20, P. B15 The Third Circuit Court of Appeals held in February that Carol Marcella, who contracted HIV after receiving a transfusion of contaminated blood in 1985, was entitled to a jury trial. Marcella sued Brandywhine Hospital, her doctors, and the American Red Cross for negligence. The Red Cross filed a motion for a nonjury trial, arguing that it was a federal instrumentality which shares governmental immunity to trial by jury. The circuit court, however, said that the collection and distribution of human blood for medical uses is a commercial operation for the Red Cross, and that the organization was chartered by Congress as a federal corporation. The court also noted that although the Red Cross sometimes appears to be almost an extension of the government, the government does not manage the daily activities, provide the funds to support the activities, or employ or grant civil service status to its workers. "The Gait of Grief" Maclean's (02/13/95) Vol. 108, No. 7, P. 69; Young, Pamela When dancer and choreographer Margie Gillis--who is known for her ability to translate basic human emotions into a clear and powerful language of movement--recently began her 20th season as a solo artist in Toronto, the central emotion was grief. A year and a half ago, her older brother and occasional dance partner, Christopher Gillis, died of AIDS-related causes in New York City, where he had been a dancer and choreographer with the Paul Taylor Dance Company. Margie Gillis, who was her brother's primary caregiver during his final years, is now touring with works that include "Landscape," the final piece her brother created for her. She opened her tour with the first Toronto performance of "Landscape" at Dancers for Life, an AIDS benefit at the Royal Alexandra Theatre on Jan. 31. "We wanted to discuss and share what it's like to die," Gillis said of her brother's "Landscape." "That's what it's about: him teaching me what it felt like from the inside," she added. "Health Heroes: AIDS" Longevity (03/95) Vol. 7, No. 4, P. 56; Wachter, Sarah; Cutting, Lucia Americans may learn most of what they know about fatal diseases--including cutting-edge research, the best treatments, and the latest experimental drugs--from press coverage of an ailing celebrity. Actor Rock Hudson's disclosure in 1985 that he had AIDS brought the disease out of the closet and into greater public discussion. Also in 1985, Hudson's close friend, Elizabeth Taylor, cofounded the American Foundation for AIDS Research (AmFAR), which has awarded more than $71 million in grants to 1,400 AIDS research groups. Ryan White, a 13-year-old hemophiliac who contracted HIV through a blood-clotting product, became an instant celebrity when he was temporarily banned from school near his hometown of Kokomo, Ind. He spoke to other youths about AIDS, and testified before the President's Commission on AIDS in 1988. In 1990, after White's death, Senators Orrin Hatch and Ted Kennedy cosponsored the "Ryan White Bill," to help cities finance AIDS care. Other heroes include Elizabeth Glaser, cofounder of the Pediatric AIDS Foundation, and former NBA legend Magic Johnson, who has been a major player in educating children about safe sex.