Date: Thu, 25 Apr 1996 11:52:42 -0400 From: "Vaux, Lenore" Subject: CDC AIDS Daily Summary, 04/25/96 AIDS Daily Summary April 25, 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 ************************************************************ "Mandate That HIV Troops Be Discharged Is Set for Repeal" "Abbott Laboratories: FDA Approves New Test for Detecting AIDS Virus" "AIDS and the City" "Distrust Distorts True Blood Picture" "Don't Abandon Infected Babies" "Immune Activation Impaired in Lungs of HIV-Positive TB Patients" "African Armies Weakened by HIV and AIDS" "Risk Factors for Symptomatic CMV in HIV-Positive Children Identified" "Viral Load: Inconclusive FDA Hearing" "Peripheral-Blood-Based PCR Assay to Identify Patients With Active Pulmonary Tuberculosis" ************************************************************ "Mandate That HIV Troops Be Discharged Is Set for Repeal" New York Times (04/25/96) P. B13; Shenon, Philip Leaders of the House and Senate agreed on Wednesday to repeal legislation that would have forced the discharge of all HIV-positive military members. The repeal was included in a major budget bill that will soon be forwarded to both houses of Congress and is expected to pass easily. Sen. Mark O. Hatfield (R-Ore.) led the fight for the repeal, which was supported by the White House and the Pentagon. The discharge provision was part of a Defense Department spending bill that was passed two months ago. Rep. Robert K. Dornan (R-Calif.), who sponsored the measure, vowed to reintroduce legislation for the ban in the 1997 Defense appropriation bill. Related Stories: USA Today (04/25) P. 9A; Washington Times (04/25) P. A4 "Abbott Laboratories: FDA Approves New Test for Detecting AIDS Virus" Wall Street Journal (04/25/96) P. B2 The Food and Drug Administration has given approval to Abbott Laboratories' new test for HIV, to be called Hivag-1 Monoclonal. The new test, which detects the p24 antigen of the virus, will be used to treat HIV-infected patients and will be sold to blood banks and plasma-collection centers for HIV screening in the United States. The test is designed to detect HIV infection sooner than tests that detect antibodies to the virus. "AIDS and the City" Washington Post (04/25/96) P. A30 An editorial in the Washington Post points out that while Washington, D.C., was recently said to have the highest number of AIDS cases in the nation, the Centers for Disease Control and Prevention statistics compared the city to other states. Because AIDS cases are concentrated in urban areas, the editors contend, it would be expected that the rate appears high when compared with states, even those that have major cities. A more telling analysis, however, would compare metropolitan areas that include large cities and some surrounding counties. By this comparison, Washington would rank fourth behind San Francisco, New York, and Baltimore, respectively. The editors also note that although the CDC report shows the number of new AIDS cases dropping, this decline is a result of a new, broader definition of AIDS being adopted in 1994. "Distrust Distorts True Blood Picture" Toronto Globe and Mail (04/24/96) P. A5; Picard, Andre In a news analysis in the Toronto Globe and Mail, Andre Picard writes that the low public confidence in Canada's blood supply is reasonable in light of Canada's tainted-blood tragedy, but points out that the public should also recognize improvements that have been made in the system. The Canadian Red Cross and public health officials insist that the blood system is safe, yet Picard notes that public distrust of the blood system will remain until an explanation is given for the distribution of tainted blood products. The infections happened more than ten years ago; however, news of the public inquiry into the incident has raised fears about AIDS and hepatitis. Moreover, the threat of becoming infected from a blood transfusion is now greatly reduced, yet a new poll found that people fear transfusions more than they fear dying from surgery. In conclusion, Picard asserts that giving blood will help save lives and notes that although transfusions are safe, they should not be given unless necessary. "Don't Abandon Infected Babies" Wall Street Journal (04/24/96) P. A15; Mayersohn, Nettie In a letter to the editor of the Wall Street Journal, Nettie Mayersohn, a New York state legislator, responds to a previous letter that opposed federal legislation to require newborns to be tested for HIV if their mothers' HIV status had not been determined during pregnancy. Mayersohn writes that she has introduced similar, necessary legislation in the New York State Assembly because many HIV-infected women do not receive prenatal care and thus cannot take advantage of treatment during pregnancy that would reduce the chance of transmission of HIV to their children. She points out that 75 percent of children born with HIV are not really infected and that if their mothers were counseled to avoid breastfeeding, they might not contract the virus. By passing the Ackerman-Coburn Amendment, Mayersohn notes, policy makers could help stem the spread of the epidemic. "Immune Activation Impaired in Lungs of HIV-Positive TB Patients" Reuters (04/24/96) HIV-positive patients with tuberculosis (TB) have a significant reduction in CD4 cell proliferation in lung tissue, New York University researchers report. This contrasts with the normal host response in HIV-negative individuals, marked by a proliferation of CD4 cells. Dr. Kevin F. Law and colleagues tested the cellular response in lung segments of 28 TB patients. Seventeen were HIV-positive. Both HIV-positive and HIV-negative patients had significantly increased numbers of total cells. HIV-positive patients with TB had a lower proportion of CD4 cells and a higher proportion of CD8 cells in the lung segments than HIV-negative patients with TB. "African Armies Weakened by HIV and AIDS" Reuters (04/24/96) Half the soldiers in some African countries are infected with HIV, participants in an AIDS conference for military officers were told Wednesday. The prevalence of HIV in the armies of developing countries, especially in Africa, are exceptionally high, Malawian Defense Minister Justin Malewezi reported. Ebrahim Samba, the World Health Organization director for Africa, said soldiers are a high-risk group because they are young, sexually active, and away from home for long periods of time. These men may pay prostitutes for sex or have sex with women from the local community, and do not usually use condoms, he added. "Risk Factors for Symptomatic CMV in HIV-Positive Children Identified" Reuters (04/23/96) New York University researchers report in the Pediatric Infectious Diseases Journal that HIV-positive children with cytomegalovirus (CMV) infection and low CD4 cell counts are more likely to develop symptoms of CMV infection. Children with elevated levels of HIV p24 antigen are also at greater risk for the disease. Dr. Sulachni Chandwani and colleagues studied three groups of children: some who were HIV-positive, some who were seroreverters born to HIV-positive women, and some who were born to HIV-negative women. Seven of the 40 HIV-positive children with CMV developed symptoms of the infection. They also had significantly lower CD4 T cell counts and greater HIV p24 concentrations. "Viral Load: Inconclusive FDA Hearing" AIDS Treatment News (04/05/96) No. 244, P. 5; James, John S. The Food and Drug Administration met in March to consider the first viral load testing kit, Hoffmann-La Roche's Amplicor HIV Monitor, to be submitted for formal FDA approval. While the agency is likely to approve viral load tests, it may approve them for prognosis only--which could result in managed care and insurance companies paying for only one or two tests in a patient's lifetime. Many doctors, however, would want to use the tests to determine what treatment strategy is best for a patient and to monitor the effectiveness of drug therapies. Some activists are now worried that the FDA's approval might discourage this use of viral load testing. "Peripheral-Blood-Based PCR Assay to Identify Patients With Active Pulmonary Tuberculosis" Lancet (04/20/96) Vol. 347, No. 9008, P. 1082; Condos, Rany; McClune, Amy; Rom, William N.; et al. Dr. Neil W. Schluger and colleagues at the Bellevue Hospital in New York report that they used a polymerase chain reaction (PCR) assay, which detects circulating mycobacterial DNA, to test peripheral blood from 88 patients admitted to a chest ward with suspected pulmonary tuberculosis (TB). The researchers compared the PCR results to the final clinical diagnosis and found that the PCR assay correctly identified 39 of the 41 patients with proven TB. Of that number, 63 percent were sputum-smear negative. HIV infection was common among the patients. Overall, the sensitivity and specificity of the PCR assay were 95 percent and 89 percent, respectively. Based on these findings, Schluger et al. believe that peripheral-blood-based PCR detection for the diagnosis of TB is technically feasible and has a potentially important role in TB diagnosis.