Date: Thu, 4 Apr 1996 17:49:57 +0500 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 04/04/96 AIDS Daily Summary April 4, 1996 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 National AIDS Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD ************************************************************ "Whitman Panel Urges Needle Exchange Program" "New Program Offers AIDS Patients Free Assistance with Tax Questions" "Assisted-Suicide Debate Summed Up in Opposite Actions of 2 Doctors" "Internet Ad for HIV Cure Draws Restraining Order" "Why Kessler Must Go" "New AIDS Drug Wins Approval" "Former Blood Official Contests Probe" "Schools Alter Their HIV Rules" "Australia Reports on AIDS: Nef Deletions, Live Vaccines, Chinese Travelers" "Tuberculosis Program Changes and Treatment Outcomes in Patients with Smear-Positive Pulmonary Tuberculosis in Blantyre, Malawi" ************************************************************ "Whitman Panel Urges Needle Exchange Program" New York Times (04/04/96) P. B8; Preston, Jennifer Despite New Jersey Gov. Christine Todd Whitman's own opposition to providing clean needles to drug addicts, her advisory council on AIDS voted on Wednesday to recommend that the state allow needle exchange programs and the sale of syringes without a prescription at pharmacies. It is unlikely the recommendations will be carried out, however, in light of Whitman's opposition. The panel advised that the programs also offer other services including drug and AIDS education and counseling, HIV testing, and referrals to drug treatment programs. New York and Connecticut allow needle exchanges, and Connecticut is one of five states that allows the sale of syringes without a prescription. In New Jersey, intravenous drug use accounted for 51 percent of the state's AIDS cases from the early 1980s through December 1995. The panel's chairman, David W. Troast, said the programs could save about 650 lives a year by reducing the transmission of HIV. Related Story: Philadelphia Inquirer (04/04) P. B5 "New Program Offers AIDS Patients Free Assistance with Tax Questions" Washington Post (04/04/96) P. A19; Crenshaw, Albert B. AIDS patients may have problems preparing their tax returns, with complications including disability income, part-year wages, and part-year Social Security disability income. This year a group of gay Internal Revenue Service (IRS) workers, known as IRS GLOBE, has created a volunteer force providing free tax help to people with HIV and AIDS. The service is offered at clinics in Washington, D.C., and three other cities. Jeffrey Brooke, co-chair of GLOBE, said the service was created to fill a need. "It's not that their returns are incredibly complicated, but they are unusual," he noted. The group also sees AIDS patients who have not filed returns for several years and want to get back into compliance. "Assisted-Suicide Debate Summed Up in Opposite Actions of 2 Doctors" Washington Post (04/04/96) P. A18; Goldstein, Amy The debate over assisted suicide is illustrated by two doctors who chose different sides. In the first case, a Washington, D.C. doctor who specializes in AIDS provided information to help a pain-stricken AIDS patient die. Meanwhile, a doctor in Charlottesville, Va., refused to comply with another AIDS patient's request for death. He started the patient on morphine, steroids, and physical therapy, and the patient lived to enjoy one last summer with his family. An appeals court in New York ruled this week that it should not be against the law for doctors to help patients commit suicide. The decision echoes a recent Washington state ruling and suggests that the Supreme Court will face the issue this year. "Internet Ad for HIV Cure Draws Restraining Order" Wall Street Journal (04/04/96) P. B8 A Brockton, Mass., woman who advertised a cure for HIV on the World Wide Web has removed the ad after a judge issued a temporary restraining order. Massachusetts Attorney General Scott Harshbarger, in his first action against misleading advertising on the Internet, said the case should be a warning to other "cyber-snakeoil salesmen." The state seeks to obtain a permanent injunction against the advertisement, which gives users a 900-number to call for more information, as well as restitution and penalties from Marjorie Phillips, the woman who placed the ad. Expressing her surprise at the state's action, Phillips has maintained that the cure, a combination of three herbs, is effective. "Why Kessler Must Go" Wall Street Journal (04/04/96) P. A12; Goldberg, Robert M. In a Wall Street Journal editorial, Robert M. Goldberg, of the American Enterprise Institute, points out why he thinks Food and Drug Administration Commissioner David Kessler should be removed from his position. He says that under Kessler, the development and approval times for new drugs has been extended and that Kessler has no real reason for the delay. Kessler, he says, has let politics drive accelerated review, citing the example of vocal AIDS activists getting rewarded with faster drug approvals. Goldberg also takes issue with Kessler's role in the delayed consideration of a home HIV test. More than 10 years after an application for such a test was submitted, it has been found accurate and safe by the agency, but not approved for marketing. Goldberg concludes that Kessler's leadership of the FDA has followed a trend of wanting to hold on to power but not letting people make important medical decisions for themselves. "New AIDS Drug Wins Approval" Toronto Globe and Mail (04/03/96) P. A4 The Canadian government has approved the sale of the protease inhibitor saquinavir, Roche Canada announced Tuesday. In clinical tests, saquinavir, being sold by Roche as Invirase, has been shown to boost the immune system and reduce the amount of HIV in the blood. Other protease inhibitors, including indinavir by Merck & Co. and ritonavir from Abbott Laboratories, are awaiting approval in the country. "Former Blood Official Contests Probe" Toronto Globe and Mail (04/04/96) P. A4 A former director of the Canadian Blood Committee has asked the Federal Court of Canada to stop a government investigation into the destruction of records associated with the tainted-blood scandal. Denise Leclerc, who headed the now-defunct committee from 1982 to 1988, has held that federal Information Commissioner John Grace does not have the authority to investigate the committee because it was not a federal agency. The committee was responsible for supervising the blood system when the blood supply became contaminated with HIV. A federal inquiry into the blood system suggested that documents were destroyed to ensure that they would not be disclosed to journalists under the Access to Information Act. "Schools Alter Their HIV Rules" Chicago Tribune (03/02/96) P. 1-7; Martinez, Michael; Dell'Angela, Tracy The Chicago school board updated its policies on HIV last week, eliminating rules suggestive of discrimination that had been made in 1986. A legal group privately warned the school leaders that the policy, which called for a job applicant to disclose his HIV-status, mode of infection, and treatments, violated the 1990 Americans With Disabilities Act. Similar problems with old policies could occur in other districts nationwide, since many schools implemented AIDS and HIV policies during the panic over HIV in the late 1980s. Law experts say they suspect such policies are more common among small private employers. "Australia Reports on AIDS: Nef Deletions, Live Vaccines, Chinese Travelers" Journal of the International Association of Physicians in AIDS Care (03/96) Vol. 2, No. 3, P. 6; Mascolini, Mark One focus of the Seventh Annual Conference of the Australian Society for HIV Medicine was the nef gene's role in HIV and AIDS. Nicholas Deacon of the Macfarlane Burnet Center for Medical Research in Fairfield, Victoria, presented research that suggested that, without the nef gene, HIV is weakened. His conclusion is based on the cases of seven people who were infected with HIV through blood transfusions from a single infected donor but did not develop AIDS. The meeting also highlighted the controversy over testing a live attenuated HIV vaccine. If exposed to the virus, the immune system may be able to better defend itself, but critics say the virus may be able to mutate and take hold. Ronald Desrosiers of Harvard Medical School said he supports testing a live vaccine in humans as a result of his work on vaccines for simian immunodeficiency virus (SIV), including a successful vaccine in which the nef gene was deleted from the virus. Concerns about that vaccine were raised by another study which found that offspring of the vaccinated monkeys were infected with SIV. Other topics discussed at the conference included AIDS-related dementia and tuberculosis. "Tuberculosis Program Changes and Treatment Outcomes in Patients with Smear-Positive Pulmonary Tuberculosis in Blantyre, Malawi" Lancet (03/23/96) Vol. 347, No. 9004, P. 807; Harries, A.D.; Mbewe, L. Nyong'Onya; Salaniponi, F.M.L.; et al. Malawi, one of the world's poorest nations, has experienced an increase in tuberculosis (TB) cases since 1985, primarily as a result of the spread of HIV. The national TB cure rate decreased from 80 percent in 1988 to 63 percent in 1992, as the TB program tried to keep up with increasing numbers of patients. A.D. Harries, of the College of Medicine in Blantyre, and colleagues analyzed TB data in the city of Blantyre between 1989 and 1993. They found an increase in the proportion of patients being treated outside Queen Elizabeth Central Hospital, which they attributed to the hospital's saturation. From 1989 to 1991 the number of TB cases at the hospital rose, and treatment outcomes deteriorated as a result. In 1991 and 1993, improvements in staffing, staff activities, treatment, and education were made, and the cure rate consequently rose from 40 percent in 1991 to 52 percent in 1993. Since 1987, HIV-seroprevalence in TB patients in Malawi has risen to at least 70 percent, contributing to the increasing death rate in TB patients. The higher death rate among HIV-positive TB patients has been attributed to bacterial infections, so the authors therefore suggest that better treatment of these infections may reduce the TB mortality rate.