Date: Tue, 27 Feb 1996 10:05:06 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 02/27/96 AIDS Daily Summary February 27, 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 ************************************************************ "Tokyo Nears Pact With HIV Victims" "Green Cross May Pay Patients with HIV up to $190.8 Million" "Possible TB Case Prompts Tests at Post Office Branch" "White House Criticizes Plan for Welfare" "A Chance for AIDS Action" "Prognostic Factors For HIV Disease Progression Identified" "Experimental Prodrug Shows Activity Against Both HIV and CMV" "Support Group Helps Physicians Cope with AIDS" "Changes in Plasma HIV-1 RNA and CD4+ Lymphocyte Counts and the Risk of Progression to AIDS" "Sleeping AIDS" ************************************************************ "Tokyo Nears Pact With HIV Victims" Financial Times (02/27/96) P. 6; Terazono, Emiko Baxter International has expressed its willingness to negotiate a settlement with Japanese hemophiliacs who contracted HIV in the 1980s through untreated blood products. The U.S. drug maker is one of five drug companies, including Green Cross and Bayer Yakuhin--the Japanese subsidiary of the German pharmaceutical firm--who are charged with distributing HIV-contaminated blood products. The pharmaceutical companies, especially Baxter and Bayer, had initially objected to a proposed $231 million settlement that required them to bear responsibility for paying 60 percent of the compensation and left the Japanese government responsible for a smaller portion. Although Baxter's willingness to compromise may help the division over settlement portions to be resolved, Tomoyuki Iizuka--a lawyer for the plaintiffs--says, "The foreign companies will have to consider...the cost of losing the Japanese market, the world's second largest market for drugs." Related Stories: Journal of Commerce (02/27) P. 6B; Investor's Business Daily (02/27) P. A20; Philadelphia Inquirer (02/27) P. A1 "Green Cross May Pay Patients with HIV up to $190.8 Million" Wall Street Journal (02/27/96) P. B9A Japanese drug maker Green Cross Corp. may pay up to $190.8 million in compensation to hemophiliacs infected with HIV as a result of tainted blood products sold in the early 1980s. Green Cross, the Japanese government, and four other drug companies--Nippon Zoki Pharmaceutical Co., Baxter Ltd., the Chemo Sero Therapeutic Research Institute, and Bayer Yakuhin Ltd.--are being sued by the group of 248 HIV-infected hemophiliacs. The five companies--as well as the government, according to new documents--were aware of the HIV risk when they sold the blood products. Analysts predict that Green Cross will probably pay about 40 percent of the total compensation held responsible by the pharmaceutical firms because it sold the most untreated blood products. "Possible TB Case Prompts Tests at Post Office Branch" Philadelphia Inquirer (02/27/96) P. B2 Workers at a Philadelphia post office were tested for tuberculosis (TB) Friday and Monday after a fellow employee was suspected of having an active TB infection. The employee was tested by her doctor, who notified the Public Health Department, who then notified the Postal Service. The employee was placed in isolation while tests are being performed to determine if she is contagious. No other suspected cases were found at the post office. "White House Criticizes Plan for Welfare" New York Times (02/27/96) P. A16; Pear, Robert The Clinton Administration is planning to raise objections to changes in welfare and Medicaid that were proposed by the National Governors' Association. The White House will try to change the proposals to guarantee benefits to the poor, increase legal protections for beneficiaries, and limit states' freedom to curtail aid. The governors' plan calls for guaranteed medical care for certain groups, including pregnant women and children under the age of 13 in low-income families. Donna Shalala, the Secretary of Health and Human Services, said the plan could prevent some groups--including individuals with HIV, certain physical disabilities, or mental illness--from getting necessary care under Medicaid. "A Chance for AIDS Action" Boston Globe (02/26/96) P. 10 In a Boston Globe editorial, the authors urge readers to contribute to the Massachusetts AIDS Fund, which was set up by the state in 1990 to support AIDS research, treatment, and education. State taxpayers, they note, can donate a portion of their refund to the effort, which has received nearly 25 percent less in annual contributions since 1992. The editors claim that while knowledge about AIDS has increased, so has the feeling that the crisis has passed. Still, more than 650,000 Americans are estimated to have HIV, including some 36,000 in Massachusetts alone. AIDS is the leading cause of death for people aged 25 to 44. The Massachusetts AIDS Fund helps projects not otherwise supported by the government, including those involving community-based research and peer-based AIDS education. "Prognostic Factors For HIV Disease Progression Identified" Reuters (02/26/96) A new study at Stanford university has found that high viral load, resistance to zidovudine, and low CD4 levels are strong predictors of disease progression in asymptomatic HIV patients. Thomas Merigan and colleagues studied four factors: virion reverse transcriptase codon 215 mutation, a marker of zidovudine resistance; serum HIV RNA level; CD4 T-cell count; and immune complex dissociated p24 level. All the factors except immune complex dissociated p24 level were identified as good predictors of disease progression. The research also revealed that treatment with "thymopentin slows progression [of HIV infection] in the presence of zidovudine resistance mutations as well as high viral load," according to Merigan's team. "Experimental Prodrug Shows Activity Against Both HIV and CMV" Reuters (02/26/96) A new compound, reported to be active against both HIV and cytomegalovirus (CMV), is undergoing Phase I and Phase II trials. The compound, made by Gilead Sciences Inc., is called adefovir dipivoxil, or GS 840, and is an antiviral nucleotide. In preliminary studies, the drug resulted in significant sustained improvements in surrogate markers of HIV, including decreased HIV viral load and increases in CD4 cell counts. The drug also resulted in reduced CMV levels in semen, and had limited side effects. "Support Group Helps Physicians Cope with AIDS" Reuters (02/26/96) Seven years ago, a support group was created in Dallas for physicians who treat HIV-infected patients, have an HIV-positive spouse, or are themselves HIV-positive. The group, which was formed when most doctors had little knowledge about HIV and felt helpless as medical providers, may be one-of-a-kind. Participants initially used the group setting to exchange information about treating HIV patients, as well as a source of psychological support. "Changes in Plasma HIV-1 RNA and CD4+ Lymphocyte Counts and the Risk of Progression to AIDS" New England Journal of Medicine (02/15/96) Vol.334, No.7, P. 426; O'Brien, William A.; Hartigan, Pamela M.; Martin, David; et al. Studies of the efficacy of anti-HIV drugs can take years because the outcomes measured are progression to AIDS or death. However, if other endpoints were used, such as CD4 cell count and the level of HIV-1 RNA in the plasma, the usefulness of new drugs could be assessed more quickly. To determine if these surrogate markers are valid predictors of AIDS, O'Brien et al. compared the results of immediate versus deferred treatment with zidovudine. Among the 129 patients who received the drug immediately, 34 progressed to AIDS, compared to 57 of the 141 that received deferred treatment. Changes in CD4 cell count and plasma levels of HIV-1 RNA strongly predicted the patients' progression to AIDS, whereas base-line levels of (Beta 2)-microglobulin did not. A 75 percent decrease in HIV-1 level along with a 10 percent increase in CD4 count accounted for 79 percent of the benefit, or absence of disease progression. The authors therefore conclude that the change in plasma HIV-1 RNA may provide the best predictor of the effect of treatment and that changes in the CD4 cell count provide added information. They further concluded that the goal of anti-HIV therapies should be to reduce the level of HIV in the plasma by as much and for as long as possible. "Sleeping AIDS" POZ (02/96-03/96) No.12, P. 74 Melatonin has recently been touted by the media as a "wonder drug," a powerful antioxidant that will help people with cancer, heart disease, cataracts, diabetes, insomnia and HIV infection. Russel Reiter--a neuroendocrinologist at the University of Texas Health Science Center at San Antonio, and author of the book "Melatonin: Your Body's Natural Wonder Drug"--says that the hormone may destroy free radicals in the body, molecules that harm the immune system, and thus help fight HIV. Reiter contends that while taking melatonin may not help every HIV positive person, it probably will not hurt either. The hormone is not regulated by the Food and Drug Administration, although the agency did issue a warning about it in 1994. It has not been formally studied in humans, though studies with mice have shown positive results for the immune system.