Date: Fri, 26 Jul 1996 10:01:01 -0400 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 07/26/96 AIDS Daily Summary July 26, 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 ****************************************************** "Pa. Program Offers 2 More AIDS Drugs for Working Poor" "Poor TB Care Worse Than None" "Courts Tough on Those Who May Expose Others to AIDS, Study Says" "The FDA Can Work Better" "Report Blasts FDA's Blood Regulation" "AIDS and Elderly: Age Is No Escape" "Tuberculosis on Rise in Kenya" "Venezuela Registers Nearly 3,500 Deaths from AIDS" "Serum HIV-1 RNA Levels and Time to Development of AIDS in the Multicenter Hemophilia Cohort Study" ****************************************************** "Pa. Program Offers 2 More AIDS Drugs for Working Poor" Philadelphia Inquirer (07/26/96) P. B2; Collins, Huntly Two more powerful new protease inhibitors will be provided at no cost to low-income, uninsured AIDS patients in Pennsylvania, the state Welfare Department announced Thursday. Crixivan and Norvir will be added to the list of 58 AIDS drugs, including the protease inhibitor Invirase, now provided by the $5.7 million program. To be eligible for the free drugs, HIV-infected patients must earn less than $30,000 a year. Each patient may receive just one of the protease inhibitors, which, when combined with older AIDS drugs, are able to suppress the level of HIV in the bloodstream. The drugs are covered by private insurers and Medicaid, but the uninsured are not covered in many states. "Poor TB Care Worse Than None" USA Today (07/26/96) P. 2D; Manning, Anita Tuberculosis (TB) programs that are not managed well do more harm than good, researchers at the University of California San Francisco and Stanford University Medical Center report today in the journal Science. UCSF's Sally Blower and Philip C. Hopewell, and Stanford's Peter Small, evaluated the World Health Organization's TB control programs and report that the number of TB cases could be reduced by 80-90 percent by 2000 if WHO meets its goals of identifying 70 percent of cases worldwide and curing 85 percent of those identified. In their report, the researchers warn that unless TB patients are treated with a full six-month drug regimen, they can develop and spread drug-resistant strains. Small called the report a vehicle to raise awareness about the need for increased resources. "Courts Tough on Those Who May Expose Others to AIDS, Study Says" Houston Chronicle (07/25/96) P. 21A; Epstein, Aaron The courts of the 1990s are ruling against HIV-positive individuals who expose others to the virus, even if the risk is remote, a new legal study says. Lawrence Gostin, a Georgetown University law professor, based his findings on 310 AIDS cases since January 1991. Judges have not discriminated against people with AIDS in schools, workplaces, and housing projects, but Gostin says they increasingly rule against HIV-positive individuals in insurance disputes and in health-care settings where exposure to blood is possible. For example, several courts have held that HIV-positive surgeons could be kept from operating despite a low risk of transmitting the virus to patients. At a briefing on the study on Wednesday, Gostin said that lawmakers and judges need to be educated about the risks of transmission. The study noted that in criminal cases, people with HIV have been convicted for spitting, biting, hitting, and other behaviors which did not carry significant risk of transmission. Moreover, Gostin said, insurance disputes involving access to care, ceilings on coverage, and other issues are generally decided in favor of the insurance company. "The FDA Can Work Better" Washington Post (07/26/96) P. A27; Mikulski, Barbara; Kassebaum, Nancy In a commentary in the Washington Post, Senators Barbara Mikulski (D-Md.) and Nancy Kassebaum (R-Kan.) object to a July 17 Post editorial that criticized their year-long efforts to reform the Food and Drug Administration. They argue that the legislation developed by the Senate Labor and Human Resources Committee has not been rushed to the Senate floor, as the editorial suggested, but is the result of careful consideration. They also note that the FDA's success in speeding-up approval of AIDS drugs, in response to pressure from the AIDS community, was a basis for further improvement. Objecting to the editorial's suggestion that the bill would put too much regulatory power in the private sector, the authors say it would only encourage cooperation throughout the approval process, thus avoiding costly delays. "Report Blasts FDA's Blood Regulation" Philadelphia Inquirer (07/26/96) P. A3; Shaw, Donna A new Congressional report criticizes the Food and Drug Administration for not regulating the blood-products industry effectively and not adequately protecting Americans from tainted blood. The report said that 15 years after AIDS was first identified, the agency still does not have an effective recall system for contaminated blood products. It recommended that a fund be created to help people who "suffer adverse consequences" from tainted blood- and plasma-based therapies, but fails to mention the estimated 10,000 hemophiliacs infected with HIV in the 1980s from blood-clotting products. Moreover, Corey Dubin, president of the Committee of Ten Thousand, an activist group for HIV-infected hemophiliacs, denounced the report for its exclusion of people already infected. Legislation is pending to provide $1 billion to compensate HIV-infected hemophiliacs, but the bill is said to have poor chances. "AIDS and Elderly: Age Is No Escape" Chicago Tribune (07/25/96) P. 1-1; Lade, Diane C. In Florida, at least 3,991 people over age 50 have contracted HIV from unprotected sex and died of AIDS. Sexual contact is the most common way people over age 50 are infected with HIV, accounting for 60 percent of cases in Florida since 1981. Heterosexual sex is the most common mode of transmission among those 65 or older and was responsible for 24.6 percent of all cases documented in Florida since 1981. While people aged 30-39 comprise 45 percent of the state's AIDS cases, the disease is spreading in the senior population at a rapid rate. Nationally, the percentage of AIDS cases in people over 50 increased 11 percent from 1993 to 1994. E. Bentley Lipscomb, secretary of Florida's Department of Elder Affairs, says the problem stems from lack of education as well as a neglect to target HIV programs to the elderly population. "Tuberculosis on Rise in Kenya" Xinhua News Agency (07/25/96) In Kenya, tuberculosis cases increased to 4,000 in 1995, up from 400 10 years earlier, a government official said Thursday. The Kenyan Minister for Health attributed the rise to the spread of HIV. An estimated 1 million Kenyans have the virus, which is often associated with TB. The minister was speaking at the opening of a new TB clinic. "Venezuela Registers Nearly 3,500 Deaths of AIDS" Xinhua News Agency (07/25/96) Out of 5,796 AIDS cases in Venezuela, 3,496 people have died, a health official announced Thursday. Alejandro Villarroel, medical director of the International Foundation of Combat Against AIDS in Venezuela, urged the public to be aware of the threat of the disease. "Serum HIV-1 RNA Levels and Time to Development of AIDS in the Multicenter Hemophilia Cohort Study" Journal of the American Medical Association (07/10/96) Vol. 276, No. 2, P. 105; O'Brien, Thomas R.; Blattner, William A.; Waters, David; et al. Research suggests that HIV-infected individuals with higher levels of viral RNA may develop AIDS more quickly than those with lower viral levels, but the time from infection to AIDS has not been quantified for various HIV-1 RNA levels. The link between the amount of HIV-1 RNA during early chronic HIV-1 infection and future disease progression is important to understand the pathogenesis of HIV-1. Dr. Thomas R. O'Brien of the National Cancer Institute and colleagues evaluated HIV-1 RNA levels and disease progression in 165 patients enrolled in the Multicenter Hemophilia Cohort Study. The patients' ages at time of seroconversion ranged from 1 year to 66 years. The viral levels were similar for patients younger than 17 and for those aged 18 to 34, but they were higher for individuals aged 35 or older. At 10 years after seroconversion, 72 percent of patients with the highest initial viral load had progressed to AIDS, while none of the patients with the lowest viral loads had developed the disease. The authors conclude that the HIV-1 RNA level during early chronic HIV-1 infection is a strong, age-independent predictor of disease progression.