Date: Wed, 24 Jul 1996 10:13:44 -0400 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 07/24/96 AIDS Daily Summary July 24, 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 ****************************************************** "Clinton Seeks $65 Million for State AIDS Programs" "Emory Gets Patent for AIDS Drug 3TC, but Glaxo, BioChem Question Validity" "AIDS Drug Trial Result Boosts Glaxo" "Hospice Care Often Starts Too Late" "AIDS Cases Increase Rapidly in India" "Econews: AIDS-Development: AIDS Pandemic Retards [Human Development]" "Prevalence of HIV Infection in the United States, 1984 to 1992" "Drug Resistance: The Next AIDS Crisis" ****************************************************** "Clinton Seeks $65 Million for State AIDS Programs" New York Times (07/24/96) P. A16; Dunlap, David W. Under a budget request announced Tuesday, President Clinton is seeking a $65 million increase in spending on the AIDS Drug Assistance Programs. The programs allow states to provide AIDS drugs for people who cannot afford them and who are not covered by either Medicaid or private insurance. The programs, which receive about two-thirds of their money from the federal government, provided aid to 69,000 people last year. Under the budget request, which must be approved by Congress, federal spending on the programs would increase to $195 million in the next fiscal year, from $115 for the current fiscal year. The proposed increase comes partly in reaction to reports released at the XIth International Conference on AIDS which suggested that a combination of three costly drugs could improve a patient's health and survival. "Emory Gets Patent for AIDS Drug 3TC, but Glaxo, BioChem Question Validity" Wall Street Journal (07/24/96) P. B6; Chipello, Christopher J. Glaxo Wellcome and BioChem Pharma say they will challenge a U.S. patent for 3TC, or Epivir, an AIDS drug made by the two companies, that has been granted to Emory University. Emory said it plans to seek licensing arrangements with Glaxo and BioChem, who said earlier this year that they had all necessary patents on the drug and claim that the new patent is invalid. According to Emory, 3TC is one of two elements in BCH-189, which was discovered by BioChem Pharma, but while the latter company's patent details how to obtain BCH-189, Emory's patent specifically covers 3TC. BioChem receives a royalty of about 14 percent of Glaxo's sales of 3TC, and under their deal, a third party would receive royalties out of BioChem's share. Analysts say first-year sales of 3TC, which was approved for sale in the United States in November, could reach $250 million. "AIDS Drug Trial Result Boosts Glaxo" Financial Times (07/24/96) P. 18; Green, Daniel Due to the high success rate, a clinical trial of Glaxo Wellcome's AIDS drug Epivir has been halted so that all trial participants can be given the drug. Interim results of the trial, which was scheduled to end in March 1997, found that 54 percent fewer patients who received the drug progressed to AIDS or died compared to those who received a placebo. The trial, started in March 1995, involved 1,892 HIV-positive patients in Canada, Australia, Europe, and South Africa. "Hospice Care Often Starts Too Late" New York Times (07/24/96) P. C8 People dying of terminal illnesses who enter hospices die a more comfortable and less expensive death, but patients often enroll too late to receive much benefit, a new study suggests. Nicholas Christakis of the University of Chicago Medical Center, and colleagues studied the cases of 6,451 hospice patients. They report in the current issue of the New England Journal of Medicine that only 14.9 percent of the patients lived longer than 180 days after entering hospices. The results suggest that doctors and patients are reluctant to seek hospice care. "AIDS Cases Increase Rapidly in India" Xinhua News Agency (07/23/96) The number of AIDS cases in India is increasing rapidly, the Indian government said Tuesday. The Minister of State for Health and Family Welfare said that as many as 1,458 AIDS patients are being treated in hospitals. So far 60 cases of AIDS in children have been reported to the National AIDS Control Organization. The minister added that the government was implementing a comprehensive awareness and prevention program for high risk groups and the general public. "Econews: AIDS-Development: AIDS Pandemic Retards [Human Development]" PANA Wire Service (07/23/96) HIV and AIDS took an average toll of 1.3 years of human development progress in 56 countries between 1980 and 1992, the United Nations Development Program reported. The impact was especially severe in developing countries, where 90 percent of the world's estimated daily 6,000 HIV infections occur. Researchers at Columbia University and the Harvard Institute for International Development found that the AIDS epidemic adversely affected the human development index, a measure of basic human capabilities ranked by country. The study compared the 1980 and 1992 index for the 56 countries, and found that, without the impact of HIV, the countries would have had an additional average of 1.3 years of human development. "Prevalence of HIV Infection in the United States, 1984 to 1992" Journal of the American Medical Association (07/10/96) Vol. 276, No. 2, P. 126; Karon, John M.; Rosenberg, Philip S.; McQuillan, Geraldine; et al. Researchers at the Centers for Disease Control and Prevention have developed new estimates of HIV prevalence in the United States, including estimates by gender, race, geographic region, and behavioral risk. The report, by John M. Karon and colleagues, is the first to combine numerical estimates of HIV prevalence from multiple sources. The authors estimated past HIV infection rates based on national AIDS case surveillance data and estimates of the time from HIV infection to AIDS diagnosis. They also incorporated HIV prevalence data from two national surveys, a survey of childbearing women, and a household survey of current health status. They report that an estimated 0.3 percent of U.S. residents were infected with HIV in 1992. Approximately 0.6 percent of the male population was infected, including about 2 percent of non-Hispanic black men and 1 percent of Hispanic men. About 0.1 percent of women were infected, including an estimated 0.6 percent of non-Hispanic black women. About half of all those individuals infected with HIV in 1992 were men who had sex with men, and one-fourth were injection drug users. The overall prevalence of HIV increased from 1984 to 1992, with a greater relative increase in women than in men. "Drug Resistance: The Next AIDS Crisis" Village Voice (07/09/96) Vol. 41, No. 28, P. 15; Schoofs, Mark While new HIV therapies have the potential to suppress viral replication in patients, they also carry the threat of allowing drug-resistant viral strains to develop. If a strict regimen is not followed, an individual could develop resistance to their current medication as well as to other drugs. About 10 percent of people becoming infected with HIV now contract a strain resistant to AZT. As resistance spreads, people could become infected with strains that are resistant to several drugs. Treating the infection effectively depends on the ability of patients to follow a strict dosing schedule, says Julio Montaner, co-chair of the 11th International Conference on AIDS. New HIV regimens are especially difficult to take and must be continued for longer periods of time, maybe for life. Other conditions also make the dosing difficult. For example, one protease inhibitor must be refrigerated, another must be taken on an empty stomach, and the side effects can include diarrhea and nausea. Moreover, researchers do not know how long patients may have to stay on the drugs, or if they will cause harm in the future. Making the drugs widely available, which could happen under expanded government funding efforts, would enhance the potential for misuse and resistance.