Date: Thu, 29 Feb 1996 10:33:13 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 02/29/96 AIDS Daily Summary February 29, 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 ************************************************************ "Surgeon Infected Patients Despite Hepatitis Precautions" "Making Case for Safer Needles" "Bill Is Passed to Block Loss of Insurance" "Helping a Family Care for a Child with H.I.V." "Public Protector or Persecutor?" "France Rules Out Lottery for Rare AIDS Drug" "Japan Ministry Report Fails to Answer AIDS Issue" "Voluntary Inpatient HIV Screening: Cost-Effective" "New Studies Say Viral Burden Tops CD4 as a Marker of HIV Disease Progression" "Up in Asia" ************************************************************ "Surgeon Infected Patients Despite Hepatitis Precautions" Washington Post (02/29/96) P. A4 A heart surgeon who apparently caught the hepatitis B virus from a patient during surgery, unknowingly infected at least 19 patients, even though he wore gloves and followed safety precautions, according to a report in the New England Journal of Medicine. An investigation, directed by Rafael Harpaz of the Centers for Disease Control and Prevention, found that the infections could have been prevented if the doctor had taken the hepatitis B vaccine. About 1 percent of U.S. surgeons are estimated to be infected with the virus, which is highly infectious and can be fatal. The infections occurred four years ago at two Los Angeles hospitals. Safety rules of operating rooms have been tightened in recent years to protect patients and health care workers from HIV, which is less infectious than hepatitis B. Related Story: USA Today (02/29/96) P.1D "Making Case for Safer Needles" Philadelphia Inquirer (02/29/96) P. B1; McCullough, Marie Lynda Arnold, a nurse who was infected with HIV when a patient's sudden move forced the needle she was using into her own palm, began a campaign Wednesday to convince hospitals to use safer needles. Arnold was wearing latex gloves and practicing recommended precautions when she was infected three years ago. For her campaign, she plans to ask every health care facility in the nation to promise to adopt safer needle devices. Occupational transmission of HIV has been documented in 45 other health care workers, and 97 more cases are suspected, according to the Centers for Disease Control and Prevention. Many devices are already available to make blood-drawing needles and intravenous catheter needles safer, including protective shields that can be slipped over the needles, and needles that retract into protective shields. The hospital where Arnold worked in Lancaster, Pa. was introducing a safer IV catheter when she was injured by one that did not have the protective shield. "Bill Is Passed to Block Loss of Insurance" New York Times (02/29/96) P. B6; Barron, James New York state lawmakers passed a bill Wednesday to prevent Empire Blue Cross and Blue Shield from canceling longstanding health insurance for 650 of the state's sickest residents, including those with AIDS, multiple sclerosis, and hemophilia. Gov. George Pataki has not said if he will sign the bill, which was designed to eliminate a legal technicality that had threatened coverage for chronically ill patients who purchased their own insurance. Empire notified the State Insurance Department that it was going to cancel the policies, which cover medication, home care, and some doctors' bills, because the company had lost some $70 million last year. Empire expected that the affected policyholders would be able to switch to other plans, which was not possible because of a Federal Medicare law that prohibits insurers from selling coverage that duplicates Medicare benefits to individuals eligible for Medicare. Without the bill, the 650 people would have been forced to seek Medicaid benefits, which has strict financial ceilings. "Helping a Family Care for a Child with H.I.V." New York Times (02/29/96) P. B2; Jay, Sarah Selina H. lost one sister to AIDS and when another sister was diagnosed last summer, she took in her 6-year-old nephew Calixto who had just tested positive for HIV. Selina has three children of her own, and when the Children's Aid Society offered her a homemaker to help with household chores, she was reluctant to accept the assistance. She soon realized, however, that the help was needed to manage the extra care required by her nephew. The Children's Aid Society, one of the seven charities supported by the New York Times Neediest Cases Fund, has also provided a bed and clothes for Calixto. The fund has received $4,564,503 so far this year. "Public Protector or Persecutor?" Washington Post (02/28/96) P. A3; Schwartz, John Patients of physician Stanislaw R. Burzynski--whose treatment of patients with unproven "antineoplastons" derived from urine has been the focus of much controversy--have been invited to testify at a Congressional hearing about FDA reform on Thursday. Although Burzynski has never conducted clinical trials of his therapy--which he claims might be able to treat about 300 illnesses, including cancers of the breast, brain and prostate, AIDS, multiple sclerosis, baldness, and neurofibromatosis--some Republican members of Congress consider him a symbol of excessive FDA regulation and his patients say the FDA has a "vendetta" against him for not permitting him to ship his experimental drugs. Canadian cancer experts, however, said in a 1992 article in the Journal of the American Medical Association that there is no evidence that his compounds work. "France Rules Out Lottery for Rare AIDS Drug" Reuters (02/28/96) French Prime Minister Alain Juppe rejected a controversial proposal on Wednesday that called for a lottery to determine which AIDS patients should receive a new drug in limited supply. Juppe said the ministers should make further efforts to provide the drug to all eligible patients, at whatever the cost. The National AIDS Council, a government group, was criticized by AIDS activists and doctors Tuesday for proposing that a computer lottery be used to select a small group of patients to receive the protease inhibitor ritonavir. A 100-person supply of the drug, made by Abbott Laboratories, will arrive in France next month, followed by significantly larger shipments in April, May, and June. About 18,000 people in France have AIDS, and more than 150,000 are infected with HIV. "Japan Ministry Report Fails to Answer AIDS Issue" Reuters (02/28/96) A new report from Japan's health ministry does not provide answers to some critical questions about why health officials could not prevent the spread of HIV through tainted blood products in the early 1980s. A panel was set up last month to study the issue and explain a 1983 decision to postpone emergency imports of safer treated blood products. The report states that there was conflicting information about whether the government considered emergency imports of safer blood products. Health and Welfare Minister Kan Naoto admitted earlier this month that the government was responsible for the spread of HIV through the tainted blood products. An estimated 1,800 to 2,000 hemophiliacs were infected with the virus, and some are suing the government and five drug companies for compensation. "Voluntary Inpatient HIV Screening: Cost-Effective" Reuters (02/28/96) Voluntary, inpatient HIV screening is cost-effective under certain conditions, report researchers at Stanford University. Douglas Owens and colleagues found that when the HIV seroprevalence rate was 1 percent, the cost-effectiveness of screening for the virus was "within the range of other accepted interventions." With that seroprevalence rate, Owens estimated that about 110,000 cases of HIV could be identified in the first year, and the cost-effectiveness of screening would be "$47,200 per year of life saved." Owens said that public health and quality of life would benefit further from testing and counseling if the measures influence risk behaviors. "New Studies Say Viral Burden Tops CD4 as a Marker of HIV Disease Progression" Journal of the American Medical Association (02/14/96) Vol.275, No.6, P. 421; Voelker, Rebecca Preliminary results of two new studies show that the change in the amount of HIV in a patient's blood before and after therapy is a better predictor of AIDS progression than the CD4 cell count. The studies, sponsored by Pharmacia & Upjohn, confirm the value of viral load. Both trials, which were conducted in Canada and the United States, were designed to assess the anti-HIV efficacy of delavirdine mesylate, a non-nucleoside reverse transcriptase inhibitor. The results were based on 1,740 HIV patients. The study is continuing, but a computer model was used to determine the relationship between changes in viral load and disease progression. Researchers found that a 70 percent decrease in viral load lasting more than eight weeks resulted in a 55 percent reduction in the risk of progressing to AIDS or dying. A person's immunity also figures into their future health status, scientists said. The drug delavirdine has shown promise in the studies and the company hopes to make it available to patients outside the trial in a few months. The value of viral load to predict disease progression is still controversial, however the measure is considered more credible now. Dr. Calvin Cohen, research director of the Community Research Initiative of New England, says doctors want a predictive test, and that viral load appears to be promising. "Up in Asia" Economist (02/10/96) Vol.338, No.7952, P. 42 While the spread of HIV has slowed in Europe, the Americas, and Africa, it continues to rise in Asia, according to the Global AIDS Policy Coalition of Harvard University, which recently reported higher figures than the World Health Organization. The new figures show that 30.6 million individuals are HIV-infected, a figure which the researchers predict may double by the end of the century. In addition, of the 4.7 million people who became infected last year, more than half were in Southeast Asia while less than 4 percent were in industrialized nations. The researchers estimate that with 19.2 million infected persons, Africa now represents some 60 percent of the global number of infections. A total of 7.6 million of the 9.2 million AIDS-related deaths in 1995 occurred in Africa.