Date: Mon, 8 Jul 1996 13:26:55 -0400 From: "Martha Vander Kolk" Subject: CDC AIDS Daily Summary 07/08/96 AIDS Daily Summary July 8, 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 ****************************************************** "India Quickly Leads in H.I.V. Cases, AIDS Meeting Hears" "New AIDS Drugs Spawn a Global Pill Chase" "Combined-Drug Therapy Being Hailed as Promising Weapon in AIDS Battle" "Clinton's AIDS Panel Criticizes His Efforts" "First Known U.S. Case of Rare AIDS Strain Found in Los Angeles" "A Realistic Hope for an AIDS Cure" "With Fanfare, Global AIDS Conference Gets Underway in Vancouver" "Lifeline: Drug Cocktails" "Antiviral Effect and Ex Vivo CD4+ T Cell Proliferation in HIV-Positive Patients as a Result of CD28 Costimulation" "Lethal Infection by a Previously Unrecognized Metazoan Parasite" ****************************************************** "India Quickly Leads in H.I.V. Cases, AIDS Meeting Hears" New York Times (07/08/96) P. A3; Altman, Lawrence K. Although India was not hit by the AIDS epidemic until a few years ago, it has become the country with the largest number of people infected with HIV, said Peter Piot, head of the United Nations AIDS program, at the 11th international AIDS meeting on Sunday. Piot reported that more than 3 million infections have been diagnosed in the country, which has a population of 950 million. While the meeting will be marked by much positive information concerning the prevention and the treatment of the disease, meeting co-chairman Martin T. Schechter of Vancouver warned that many governments "are drifting toward indifference at this critical juncture." Eric Sawyer, an advocate for AIDS patients, criticized researchers for suggesting that AIDS could be cured with a combination of drugs. Following India, the greatest number of infections are in South Africa, Uganda, Nigeria, and Kenya, respectively. "New AIDS Drugs Spawn a Global Pill Chase" Wall Street Journal (07/08/96) P. A6 AIDS patients around the world are desperate for the promising new protease inhibitors now available in the United States. To obtain the new drugs, patients or their doctors are traveling to America, using mail-order pharmacies, or purchasing the drugs on the black market. Some countries, including Germany, Brazil, and Japan, are taking unusual steps to make the drugs available even if they have not yet been approved, while activists in France have succeeded in speeding provisional approval. The drug makers who manufacture the three protease inhibitors say they are stepping up production to meet the growing worldwide demand. "Combined-Drug Therapy Being Hailed as Promising Weapon in AIDS Battle" Wall Street Journal (07/08/96) P. A3; Waldholz, Michael Results from more than a dozen clinical trials, demonstrating the promise of new combinations of HIV drugs, will be presented this week at the 11th International Conference on AIDS in Vancouver. The drug therapies, combining older drugs with the new protease inhibitors, offer hope of someday treating AIDS as a long-term, manageable disease. Martin Schechter, co-chair of the conference, said it is unlikely, however, that the new therapy will soon get to 90 percent of the estimated 22 million people who are infected with HIV. David Ho, of the Aaron Diamond AIDS Research Center, said that his research suggests that the new therapy should be used as soon as a person is infected. In another study, Martin Markowitz, also of the Aaron Diamond Research Center, will report today that Viracept, a protease inhibitor that is not yet approved, seems to be as effective in the combination as the three drugs already available. Two other studies to be presented have demonstrated that attacking HIV with high levels of combination therapy may keep HIV from developing resistance and keep the viral load down for as long as 48 weeks. "Clinton's AIDS Panel Criticizes His Efforts" Washington Times (07/08/96) P. A1; Bedard, Paul The Presidential Advisory Council on HIV/AIDS has concluded that President Clinton has not met campaign promises to fight the disease and that he should support needle exchange programs for drug addicts. In his favor, the panel said that Clinton had increased AIDS funding, but it also pointed to a lack of "leadership" and "courage" in several areas. The group, 40 percent of which is infected with HIV, is composed of administration officials and private-sector representatives and said that the administration should complete a national AIDS program, promised four years ago. The panel also reported that federal HIV prevention programs are lacking and that the administration should support needle-exchange programs, which law currently bans the federal government from supporting. "First Known U.S. Case of Rare AIDS Strain Found in Los Angeles" Wall Street Journal (07/08/96) P. B2 A rare strain of HIV, called Group O, was found in a U.S. patient for the first time, the Centers for Disease Control and Prevention reported last week. The strain had previously been reported in West and Central Africa, France, Belgium, and Germany only. The patient, located in Los Angeles, is a native of West Africa, and the CDC believes that she became infected before she came to the United States. The agency said the U.S. blood supply is still safe, because most group O strains are detected by test kits currently used to screen blood. "A Realistic Hope for an AIDS Cure" Wall Street Journal (07/08/96) P. A8; Groopman, Jerome In a commentary in the Wall Street Journal, Jerome Groopman, a professor of medicine at Harvard Medical School, describes the promising avenues for HIV treatment to be discussed at this week's 11th International AIDS Conference. Combining older HIV drugs with new protease inhibitors is one potential therapy, as are methods to block the virus from attaching to the T-cells it attacks. A viral enzyme called integrase, which HIV uses to inset its DNA into T-cells, is also being targeted. The Rev protein, which is necessary for HIV genes to be transported from the cell nucleus to the cytoplasm, is another potential target. Groopman notes that while not all avenues will result in therapies, they offer promise in the fight against AIDS. "With Fanfare, Global AIDS Conference Gets Underway in Vancouver" Washington Post (07/08/96) P. A4; Brown, David The 11th International Conference on AIDS opened in Vancouver on Sunday with fanfare and controversy. Jean Chretien, Canada's prime minister, refused to open the conference, causing protest before the meeting even began. Chretien apparently refused because he was reluctant to put pressure on his government to continue funding Canada's National AIDS Strategy, a $42 million program for research and prevention. Canadian Health Minister David Dingwall spoke instead. Doreen Millman, a Vancouver woman infected with HIV; representatives of four West Coast Indian tribes; an Inuit rock singer and dancers; a pianist; and the Vancouver Lesbian and Gay Choir also appeared. About 15,000 delegates, journalists, and commercial exhibitors will attend the meeting, the largest such conference so far. "Lifeline: Drug Cocktails" USA Today (07/08/96) P. 1D A combination of HIV drugs is extending survival for AIDS patients, researchers reported Sunday at the 11th International Conference on AIDS. Hoffmann-La Roche reported a study of 940 patients that showed that those given a combination of Invirase, its version of saquinavir, and its ddC, called Hivid, were 70 percent less likely to die than those who took Hivid only. "Antiviral Effect and Ex Vivo CD4+ T Cell Proliferation in HIV-Positive Patients as a Result of CD28 Costimulation" Science (06/28/96) Vol. 272, No. 5270, P. 1939; Levine, Bruce L.; Mosca, Joseph D.; Riley, James L.; et al. Stimulation of CD4 T cells activates HIV-1 replication, viral spread, and cell death, making adoptive CD4 T cell therapy impossible. The interaction of CD28 on T cells is the most important of the known costimulatory signals for T-cell activation. Carl H. June, of the Naval Medical Research Institute, and colleagues, conducted an experiment to determine if costimulation could improve T-cell proliferation in cultures from HIV-infected patients. The researchers treated T cells taken from 10 HIV-infected patients with CD3 and CD28 monoclonal antibodies. They reported exponential cell proliferation for 50 days and discovered that viral production and proviral DNA decreased to undetectable levels. The same effect was found with peripheral blood mononuclear cells and purified T cells. The level of HIV-1 even decreased in the absence of antiretroviral agents. The researchers also report that CD28 stimulation of CD4 T cells from uninfected donors rendered the cells highly resistant to HIV-1 infection. The authors suggest that their results may be used to facilitate immune reconstitution and gene therapy approaches in people infected with HIV. "Lethal Infection by a Previously Unrecognized Metazoan Parasite" Lancet (06/29/96) Vol. 347, No. 9018, P. 1797; Santamaria-Fries, Monica; Fajardo, Luis Fellipe; Sogin, Mitchell L.; et al. Researchers at Stanford University have identified a new micro-organism as the cause of death in a man with AIDS. DNA analysis of a fragment of the organism demonstrated that it was a previously uncharacterized cestode. The man developed a rapidly growing abdominal mass, similar to a neoplasm, that invaded his liver. The tissue could not be matched with any known disease process. While analysis revealed that the pathogen was a parasite, its features were different from those of any known eukaryotic pathogen. The researchers caution that the parasite may not infect only immunocompromised patients. They also note that being aware of the infection may permit early diagnosis, which could in turn allow successful treatment of subsequent cases.