Date: Wed, 14 Aug 1996 10:05:49 -0400 From: "Sarah Araghi" Subject: CDC AIDS Daily Summary 8/14/96 AIDS Daily Summary August 14, 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 ****************************************************** "Circuit Court Backs Insurer on HIV Test Nondisclosure" "Tax Report: Many Patients With Severe Illnesses Win Tax Relief" "Genes That Protect Against AIDS" "Across the USA: Michigan" "When Savings Run Out, Some Shun Lifesaving" "Epidemic of HIV Infection in Odessa Called 'Explosive'" "Thailand Places HIV/AIDS Information in Internet" "750 Cases of AIDS Reported in Lebanon Since 1989" "Extensive Polymorphisms Observed in HIV-1 Clade B Protease Gene Using High-Density Oligonucleotide Arrays" "Serostatus and Counseling" ****************************************************** "Circuit Court Backs Insurer on HIV Test Nondisclosure" Washington Post (08/14/96) P. A3; Schwartz, John A federal appeals court has ruled that a Mississippi life insurance company was not obligated to tell a policyholder that he had tested positive for HIV. Following the death of her husband, Jody Deramus sued Jackson National Life Insurance (JNL) in 1992 for not revealing why the company refused her husband additional coverage. The couple did not learn of Frank Deramus' infection until 18 months after the company's tests, and thus took no precautions to prevent HIV transmission during that time. To date, Jody Deramus has tested HIV-negative. The appeals court's decision upheld a ruling by U.S. District Court Judge Henry T. Wingate last year. JNL, meanwhile, has been notifying applicants' physicians of HIV-positive results since 1993, although it is not required to do so by law. Jody Deramus said she hopes to appeal the decision. "Tax Report: Many Patients With Severe Illnesses Win Tax Relief" Wall Street Journal (08/14/96) P. A1 The health insurance bill recently approved by Congress includes a significant tax break for people with chronic or terminal illnesses. The bill allows these people to exclude accelerated death benefits or payments they receive from selling their life insurance policies to qualified "viatical settlement providers" from their reported income. Currently, people who receive such payments must pay federal income tax on the money. "Genes That Protect Against AIDS" New York Times (08/14/96) P. A20 Genetic mutations are not necessarily bad, as evidenced by the recently discovered mutation that protects some people from HIV infection, notes a New York Times editorial. Researchers at the Aaron Diamond AIDS Research Center in New York City announced last week that they had found a genetic mutation in two homosexual men who remained uninfected despite repeated exposure to HIV. Because they had a defective gene, their cells also lacked a receptor needed for the virus to enter. The scientists say the finding could help explain why some people, who may only have one copy of the gene, are able to survive HIV infection longer than others. The new discovery could also be used for the development of better drugs or a vaccine, the editors conclude. "Across the USA: Michigan" USA Today (08/14/96) P. 12A Michigan's Housing Opportunity for People With AIDS has granted the Lighthouse of Oakland County $37,800 to provide emergency housing aid. "When Savings Run Out, Some Shun Lifesaving" New York Times (08/14/96) P. C9; Gilbert, Susan A new study suggests that seriously ill patients are more likely to forgo life-prolonging care if they are also suffering economic hardship. Kenneth E. Covinsky, of Case Western Reserve University, and colleagues report that the likelihood of such patients deciding to seek comfort care rather than continued treatment was 30 percent greater for those whose illnesses had created serious financial hardship. Doctors say the results suggest that patients are not denying themselves care because they think it is futile but because they do not want to bankrupt their survivors or cause them to make major life changes, like putting off education. The study also found that family members or friends generally said they would have made the same decision as the patient. "Epidemic of HIV Infection in Odessa Called 'Explosive'" Reuters (08/13/96) The number of HIV infections in the Odessa region of the Ukraine had reached 3,715 by August 1, 39 more than had been reported in the entire country as of March 1. Since the beginning of 1996, 2,863 new HIV infections, 917 among women, have been diagnosed in the region. Of the infections, about 70 percent are drug-related and the majority of the others are attributed to sexual contact. Most of those infected are between the ages of 18 and 40. "Thailand Places HIV/AIDS Information in Internet" Xinhua News Agency (08/14/96) Information about HIV prevention, treatment, diagnosis, and other issues is now offered on the World Wide Web by Thailand's Public Health Ministry. Data about the rights of people with AIDS is also included, and officials say a more in-depth version will be created for medical students and people interested in scientific developments related to AIDS. A version for children is also planned. "750 Cases of AIDS Reported in Lebanon Since 1989" Xinhua News Agency (08/14/96) Since 1989, 750 AIDS cases have been reported in Lebanon, and the average age of patients is under 31. A health specialist noted that 75 percent of the cases involved transmission through sexual contact, while 15 children had been infected by their mothers and a few cases were attributed to blood transfusions. She added that since 1993, there has been a decrease in the number of women infected by their husbands. "Extensive Polymorphisms Observed in HIV-1 Clade B Protease Gene Using High-Density Oligonucleotide Arrays" Nature Medicine (07/96) Vol. 2, No. 7; P. 753; Kozal, Michael J.; Shah, Nila; Shen, Naiping; et al. HIV-1 is able to mutate and develop resistance to protease inhibitors, but little is known about such mutations. Thomas R. Gingeras, of Affymetrix in Santa Clara, Calif., and other researchers, used high-density oligonucleotide array sequencing to determine the sequences of 167 viral isolates from 102 patients. They report that the DNA sequence of USA HIV-1 clade B proteases was extremely variable and that 47.5 percent of the 99 amino acid positions varied. This is the greatest level of amino acid diversity known out of all worldwide HIV-1 clades combined. Many of the amino acid changes that are known to play a role in drug resistance occurred as natural polymorphisms in isolates from patients who had never received protease inhibitors. The authors suggest that the current evaluation of protease inhibitors in clinical trials could be adversely affected by the presence of naturally occurring mutations. They say that patient care may be managed on an individual basis, relying on genotypic analysis of viral and bacterial isolates. Before decisions about therapy can be based on vial genotype, however, the authors say further study is needed to determine the structural basis of viral resistance. "Serostatus and Counseling" Focus (07/96) Vol. 11, No. 8; P. 1; Ball, Steven Just as gay psychotherapists have used self-disclosure as a tool to help clients feel understood, the disclosure of serostatus by social service providers could be beneficial. By serving as role models, counselors can help uninfected gay men stay uninfected and help men with AIDS take care of themselves, while aiding both infected and affected men in maintaining a sense of hope and intimacy. Role modeling has been useful for many HIV-negative gay men, who often feel abandoned by communities and social services which focus on the needs of the HIV-positive community. As they serve as caregivers, outsiders, and mourners, HIV-negative gay men are often unable to express their fears of becoming infected, or to discuss their loneliness or burnout. Many even let other people assume they are infected. As a result, mental health and social service providers have begun developing services, including support groups, especially for uninfected men.