Date: Thu, 1 Feb 1996 10:16:07 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 02/01/96 AIDS Daily Summary February 1, 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 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 1996, Information, Inc., Bethesda, MD ************************************************************ "Abbott AIDS Drug Halves Death Rate, New Study Reports" "Survival of AIDS Patients Linked to Doctors' Knowledge of AIDS" "Deaths from AIDS in U.S. Outpace New HIV Infections" "Army Sergeant with HIV Feels Deserted by Policy" "Students Lobby for AIDS Funds in Washington" "Japan Reports Change in Pattern of Contracting AIDS" "Gilead Sciences Announces Statistically Significant Anti-HIV Activity of GS 840" "Inquiry Criticizes Red Cross Officials" "CDC Study: AZT Reduces HIV Risk From Needlesticks" "Surveillance of Tuberculosis and AIDS Co-Morbidity--Florida, 1981-1993" ************************************************************ "Abbott AIDS Drug Halves Death Rate, New Study Reports" Wall Street Journal (02/01/96) P. B5 A new drug offered by Abbott Laboratories has been found to reduce the death rate and progression of disease by half in seriously ill AIDS patients. Researchers reported that 4.8 percent of the 543 people taking the drug Norvir (ritonavir) died within seven months, compared to 8.4 percent of 547 patients who did not receive the drug. All of the patients were also continuing any therapy they had started before the study. Of the patients using the drug, 13 percent died or had their disease progress, compared to 27 percent in those who did not receive the drug. Abbott and Merck & Co. announced earlier this week that separate studies showed that ritonavir and the Merck drug Crixivan each showed potent antiviral activity against HIV when combined with other drugs. Related Story: Los Angeles Times--Washington Edition (02/01) P.A1 "Survival of AIDS Patients Linked to Doctors' Knowledge of AIDS" New York Times (02/01/96) P. A12; Altman, Lawrence K. An AIDS patient's survival is directly linked to how much his doctor knows about treating the disease, scientists reported at a meeting in Washington Wednesday. The study, conducted by researchers at the University of Washington, looked at the survival of more than 400 AIDS patients treated by 125 primary-care doctors from 1984 to 1994 at a health maintenance organization in Seattle. It found that after the disease was diagnosed, the median survival of the most experienced doctors' patients was 26 months, compared to 14 months for patients of doctors with the least experience with AIDS. The study found a decreasing risk of death for each successive patient a doctor treated. The areas where experienced doctors were attentive were monitoring of the patients immune cell count, prescribing drugs for pneumocystis carinii pneumonia, and in providing aggressive anti-HIV therapy. In a second study reported at the meeting, researchers at the New York City and New York State health departments reported an increased incidence of invasive cervical cancer in women with HIV. "Deaths from AIDS in U.S. Outpace New HIV Infections" Washington Times (02/01/96) P. A3; Price, Joyce Since 1993, the number of Americans that die of AIDS each year has surpassed the number of new infections by 10,000 to 20,000. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the epidemic is starting to wane. He was responding to a report by Dr. Robert Biggar of the National Cancer Institute, who estimates that 60,000 Americans die of AIDS each year and 40,000 are becoming infected with HIV. Biggar says the plateau is the result of people in high-risk groups taking precautions to protect themselves from infection. Biggar said, however, that new infections are rising among young people, especially minorities and heterosexuals. Troy Petenbrink, of the National Association of People with AIDS, says he finds it hard to believe that the new infection rate is lower than the AIDS death rate. "Army Sergeant with HIV Feels Deserted by Policy" Washington Post (02/01/96) P. A3; Priest, Dana A sergeant who has been with the U.S. Army for 10 years would be forced out of the military by an HIV-related provision in the Defense authorization bill President Clinton is expected to sign early next week. Marie got the disease from her late husband. She has not told her young daughter or her co-workers, although she was diagnosed five years ago. Marie said she feels anger for the bill's sponsor, Rep. Robert K. Dornan (R-Calif.), who said that service members become HIV-infected by injecting drugs, having heterosexual sex with prostitutes, and having unprotected homosexual sex. Dornan, when learning of this woman's situation, said, "It sounds like a tragic case." He added, however, that service members with AIDS put an extra burden of others by not being able to serve overseas. Some high-ranking military officials have supported the policy change, saying that HIV-positive service members impair military readiness. Administration officials say they hope to have an alternative to the provision prepared when Clinton signs the bill. "Students Lobby for AIDS Funds in Washington" Baltimore Sun (02/01/96) P. 3B; Respers, Lisa Six teens from a Baltimore County high school lobbied for funding for AIDS research in Washington on Wednesday. The members of Student AIDS Advisory of Baltimore County, along with Dr. Michelle A. Leverett, director of the county health department, met with Patricia Fleming, director of AIDS Policy for President Clinton. Fleming said she was impressed with the students' initiative. "Peer education has proven to be effective," she said. The students gave Fleming a scroll with 150 signatures from students calling for continued support for AIDS research. "Japan Reports Change in Pattern of Contracting AIDS" Reuters (01/31/96); Yoshikawa, Miho The way in which people in Japan contract HIV has changed, with most infections now occurring in men who contract the disease in Japan rather than abroad. Until now, men's trips abroad--especially to Southeast Asia--were thought of as the main source of AIDS in Japan. Kenji Soda, of the Yokohama City University and a member of the government panel on AIDS, estimates that 70 percent of the people with HIV in Japan were infected inside the country. The Japanese government reported an increase in the number of new AIDS cases on Wednesday, and attributed the rise to widespread complacency and ignorance. The report said that 446 new cases of HIV and AIDS were reported in 1995. The government said that 57 percent of the people affected were men. Sexual transmission is the source of most of the AIDS cases, a Health Ministry official said. "Gilead Sciences Announces Statistically Significant Anti-HIV Activity of GS 840" Business Wire (01/31/96) Gilead Sciences Inc. reported on Wednesday the results of a Phase I/II clinical trial of GS 840 (adefovir dipivoxil) for the treatment of HIV-infected patients. According to Gilead, GS 840 was well-tolerated and produced sustained improvements in surrogate markers of HIV infection, including a reduction in HIV viral load and progressive increases in CD4 cell counts. The data also suggest that the drug may decrease levels of cytomegalovirus (CMV) in semen and may therefore be active against the disease. GS 840 is a member of a new class of antiviral compounds known as nucleotides that can remain active within both healthy and infected cells for prolonged periods. "Inquiry Criticizes Red Cross Officials" Toronto Globe and Mail (01/30/96) P. A1 More than 70 allegations have been made against top officials of the Canadian Red Cross as a result of the federal inquiry into the tainted blood tragedy. The Red Cross is accused of not excluding blood from high-risk donors, misrepresenting Red Cross policies, withholding information, and giving inaccurate information at critical points. The organization is challenging the finding's of misconduct. More than 1,000 Canadians became infected with HIV with the tainted blood in the 1980s. The inquiry found that, among other missteps, the Red Cross failed to inform potential donors of the conditions under which they would be high-risk, and voluntarily refrain from donating blood. "CDC Study: AZT Reduces HIV Risk From Needlesticks" American Medical News (01/15/96) Vol.39, No.3, P. 18 The Centers for Disease Control and Prevention (CDC) reported that health care workers who took AZT to prevent infection after exposure to HIV through accidental needlesticks reduced their chance of infection by 79 percent. An AIDS expert who counsels hospital workers exposed to HIV said that drug combinations for AIDS may be a better solution. HIV can quickly develop resistance to AZT. Many health care workers exposed to HIV on the job already take the drug to fight infection, although the government has not approved it for that use. The CDC said this study provides evidence that the drug can prevent infection and should be approved by the government for such cases. But Dr. David Rimland, an AIDS expert at the Veterans Administration Medical Center in Atlanta, said the recommendation may not be the best advice, because AZT can cause side effects and other drugs are becoming available. The CDC does not know how much AZT lowers the risk of infection, and says care-givers who are exposed to HIV should consider the type of injury when considering whether to take the drug. The study found that the largest risk of infection was associated with a large amount of tainted blood, AIDS patients who were close to death, and when the worker had stuck themselves with a large needle that had been in the patient's veins. "Surveillance of Tuberculosis and AIDS Co-Morbidity--Florida, 1981-1993" Morbidity and Mortality Weekly Report (01/19/96) Vol.45, No.2, P. 38 Because people infected with HIV have weakened immune systems, they are more susceptible to tuberculosis (TB). In 1987, extrapulmonary TB was added to the surveillance case definition for AIDS and in 1993 pulmonary TB in people with HIV was added. In many areas surveillance for AIDS includes assessing the completeness and accuracy of reported cases based on links with the registries for TB and other diseases. In December 1993 the Florida Department of Health and Rehabilitative Services matched TB and AIDS case lists to verify TB data, include more complete TB data on the AIDS records, and identify cases in the AIDS records with unreported TB. They matched all 16,559 reported cases of TB in Florida between 1984 and December 1993 with all 36,002 cases of AIDS reported in the state from 1981 to December 1993. Computer and manual matching found 2,567 patients on both lists. Of that total, 83.2 percent had TB noted on their AIDS record, but the remainder did not have TB documented. Medical records were reviewed for 679 AIDS cases with TB that were not listed in the TB registry. In an editorial note, health departments are urged to improve their staff's awareness of TB, help people with TB get tested for HIV, and provide TB tests to people with HIV.