Date: Tue, 9 Jan 1996 12:05:53 +0500 From: "Vaux, Lenore" Subject: CDC AIDS Daily Summary (01/09/96) AIDS Daily Summary January 9, 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 1995, Information, Inc., Bethesda, MD ************************************************************ "State Health Department's Most Aggressive HIV Prevention Media Campaign Hits Airwaves" "Tomorrow's Medical Leaders Welcomed to AMA Meeting" "Bartonella-Associated Infections in HIV-Infected Patients" "At Risk, Infected, and Invisible: Older Gay Men and HIV/AIDS" "Large Pharmaceutical Firms Place Long-Term Bets on Gene Therapy" "Natural History of Untreated Cytomegalovirus Retinitis" "Research Capsules: Unimed Pharmaceuticals Inc." *** SPECIAL BULLETIN *** ************************************************************ "State Health Department's Most Aggressive HIV Prevention Media Campaign Hits Airwaves" Business Wire (01/09/96) The California Department of Health Services (CDHS) launched its most comprehensive and aggressive HIV awareness campaign to date on Monday. The three-year advertising, community relations, and marketing campaign focuses on the 18-24 age group, and emphasizes that HIV does not discriminate based on race, ethnicity, or sexual orientation. It also targets other Californians most at risk for contracting the disease, including men who have sex with men and their female partners plus injection drug users and their sexual partners. The first part of the campaign includes two television commercials, one radio commercial, and a variety of billboards. "Tomorrow's Medical Leaders Welcomed to AMA Meeting" American Medical News (01/01/96) Vol. 39, No. 1, P. 20 At the American Medical Association's 1995 Interim Meeting in December, several physicians-in-training were recognized for strong community commitment, as seen through their voluntary activity. Among those receiving awards were at least four individuals who deal with AIDS. During his residency, Conrad Fischer of Memorial Sloan-Kettering Cancer Center in New York educated city teenagers about AIDS and other sexually transmitted diseases, and also prepared a dinner each week for 100 AIDS patients. The University of Oklahoma's William D. Jones works at a free health clinic in Oklahoma City which specifically deals with HIV treatment and prevention. Meanwhile, Larissa V. Rodriguez of Stanford University Hospital has counseled paroled criminals about HIV risk factors and Sam Shing-Hua Wu of New York's Bellevue Medical Center helped obtain funding for medical students to teach high school students about HIV. "Bartonella-Associated Infections in HIV-Infected Patients" AIDS Clinical Care (12/95) Vol. 7, No. 12, P. 97; Koehler, Jane E. Infections from the Bartonella bacterium can be fatal to HIV-infected individuals, though they are treatable with reasonably priced antibiotics, notes Jane E. Koehler of the University of California at San Francisco in AIDS Clinical Care. Koehler writes that it is therefore critical that AIDS caregivers consider bartonella when diagnoses of vascular cutaneous lesions, osteomyelitis, hepatosplenomegaly, thrombocytopenia, and fever of unknown origin are given. Patients at particular risk are those who own cats, are homeless, or have a CD4 level less than 50. The two Bartonella species that are known to cause disease in HIV-infected persons are B. henselae and B. quintana. Manifestations of these infections in HIV patients include bacillary angiomatosis (BA), bacillary peliosis hepatis, bacteremia, and cat scratch disease. Koehler's recommended course of treatment for isolated cutaneous BA infection is three months of erythromycin. Doxycycline can be substituted if this therapy is not well tolerated. Patients with more severe infection should receive one or two antibiotics for a minimum of four months. Some individuals may require suppressive therapy for the rest of their lives. "At Risk, Infected, and Invisible: Older Gay Men and HIV/AIDS" Journal of the Association of Nurses in AIDS Care (11/95-12/95) Vol. 6, No. 6, P. 13; Grossman, Arnold H. Gay men over the age of 50 continue to be an invisible part of the AIDS epidemic, in part because of inaccurate assumptions about ageism and homophobia. Some of these faulty beliefs are that: older people do not engage in sex; all gay men are young; all married people and those in long-term relationships are heterosexual and monogamous; and women cannot transmit HIV to men. Another reason is that HIV infection is occasionally misdiagnosed in older individuals as its characteristics often imitate other illnesses that they might have. Factors which contribute to HIV infection in older homosexual males include internalized homophobia, denial of risk, substance abuse, and anonymous sexual activities. Healthcare providers therefore need to reach, educate, and help these men to have safe behaviors when they are participating in potentially HIV-infecting sexual and drug activities. The education programs should focus on information and include such services as the distribution of condoms and bleach kits, and should be ongoing so as to motivate the men to sustain their positive behavioral changes and to readopt such changes if they relapse. "Large Pharmaceutical Firms Place Long-Term Bets on Gene Therapy" Chemical & Engineering News (12/04/95) Vol. 73, No. 49, P. 15; Thayer, Ann M. Despite criticism and little evidence of success, pharmaceutical companies have agreed to invest almost $1 billion in gene therapy companies since the summer. Large drug firms have entered into collaborations with or acquired small gene therapy firms. Even established biotechnology companies--such as Biogen, Chiron, Genentech, Genetics Institute, and Genzyme--are partnering with gene therapy firms. The trend has some critics concerned that the new technology might be pushed too far too fast, especially when it comes to human clinical trials. Gene therapy has the potential to one day offer treatments for genetic conditions such as cystic fibrosis or hemophilia; boost the immune system to fight viral diseases like AIDS or hepatitis; or deliver drugs to treat cancer or cardiovascular disease. In order to achieve those aims, small companies need to hook up with larger companies that can offer funding and resources. But gene therapy is still in its early stages and many improvements need to be made. Despite the disappointments, however, executives at both the small gene therapy companies and the large pharmaceutical firms believe gene therapy products will be sold before the end of the century. Furthermore, an August 1994 report by U.K. research firm Frost & Sullivan predicts that a market for gene therapy treatments will exist as early as 1997 and the new technology will produce $2.6 billion in worldwide revenues by the year 2000. Frost & Sullivan estimates that 48 percent of that market will be for cancer treatments, 30 percent for genetic diseases, 11 percent for viral diseases, 7 percent for anemias, and 4 percent for others. "Natural History of Untreated Cytomegalovirus Retinitis" Lancet (12/23/95-12/30/95) Vol. 346, No. 8991/8992, P. 1671; Bowen, E.F.; Wilson, P.; Atkins, M.; et al. Bowen et al. report in the Lancet the case of a 35-year-old homosexual man with AIDS who was diagnosed with cytomegalovirus (CMV) retinitis. The man declined any treatment, but agreed to attend the eye clinic for follow-up. After six months, the man's vision had deteriorated to counting fingers in both eyes because of optic disc involvement. He also experienced severe dizziness, fatigue, weight loss, as well as apparent hyperpigmentation and severe postural hypotension. At seven months, the man was admitted with severe ataxia, nausea, and vomiting, and was found to be deaf in one ear and had clear cerebellar signs. He died within 72 hours of admission. The researchers note that the overall increase in viral load in the blood during the six months after CMV retinitis diagnosis was 3600-fold. "Research Capsules: Unimed Pharmaceuticals Inc." Pharmaceutical Representative (12/95) Vol. 25, No. 12, P. 11 Unimed Pharmaceuticals Inc. has been given a green light by the FDA to proceed with a Phase II clinical trial of nitazoxanide--a potential treatment for Cryptosporidium parvum, a parasitic infection, in AIDS patients. The clinical trial will test the safety and efficacy of the product. "SPECIAL BULLETIN: AIDS Clinical Trials Information Service" (ACTIS) The AIDS Clinical Trials Information Service has received word that all NIH sponsored clinical trials are closed to enrollment until NIH recieves a budget from Congress. When ACTIS receives notification that these trials are once again open to enrollment, we will post that information to NAC ONLINE and to the CDC NAC web CDCNAC.ASPENSYS.COM:\86. If you have questions concerning this announcement, call ACTIS at 1-800-TRIALS-A.