Date: Fri, 7 Jun 1996 10:46:30 -0400 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 06/07/96 AIDS Daily Summary June 7, 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 ************************************************************ "Monkey Study Accents Risks of Oral Sex" "H.I.V. Virus Still Spreading Rapidly, U.N. Says" "AIDS Drugs Urged for Health Workers" "Younger People Withstand AIDS Better, Study Finds" "BioChem's Fortunes Rise" "F.D.A. Rejects Sale of Drug for Shingles" "TV Clash Upsets French Anti-AIDS Campaign" "Namibia Calls for Help to AIDS Orphans" "HIV Viral Load Markers in Clinical Practice" "Circle of Friends" "Update: Provisional Public Health Service Recommendations For Chemoprophylaxis After Occupational Exposure to HIV" ************************************************************* "Monkey Study Accents Risks of Oral Sex" New York Times (06/07/96) P. A18; Altman, Lawrence K. In a surprising study involving the Simian immunodeficiency virus (SIV), scientists say they have found evidence that HIV may be transmitted via oral sex. Six of seven monkeys tested contracted SIV when it was applied to the backs of their mouths, even though they did not have open sores, cuts, or gum disease. Ruth M. Ruprecht and colleagues at the Dana-Farber Cancer Institute and Tulane University reported the findings in today's issue of Science. The researchers were surprised by their findings because epidemiological studies have shown that oral-genital exposure is a rare form of transmission. Also surprising was the finding that the amount of SIV needed for infection was one six-thousandth of the amount needed for infection through the rectum. The findings do not impact the government's recommendation to use condoms during oral sex, according to Ann Duerr, an epidemiologist for the Centers for Disease Control and Prevention. "H.I.V. Virus Still Spreading Rapidly, U.N. Says" New York Times (06/07/96) P. A3; Simons, Marlise HIV is spreading rapidly around the world, especially in Asia and southern Africa, and the number of people with full-blown AIDS has also increased sharply, the United Nations said Thursday. Peter Piot, director of the United Nations Joint Program on HIV/AIDS, said that an estimated 1.3 million people are sick with AIDS, up 25 percent from 1994 to 1995. About 21 million adults are infected with HIV, and about 42 percent of them are women, the agency reported. Piot added that "at least several million" children are infected, with 7,500 more people becoming infected daily. The largest increases in AIDS cases are expected in China and Vietnam, with widespread infection already impacting India and southern Africa. An estimated 10 percent of the adult population in South Africa is infected, while only 0.5 percent of adults in North America and 0.2 percent in Western Europe are infected. Officials from the United Nations said that governments' responses to prevention programs are still mixed despite the obvious threat. "AIDS Drugs Urged for Health Workers" Washington Times (06/07/96) P. A5 Health care workers exposed to HIV should be treated with antiviral drugs, the Centers for Disease Control and Prevention said Thursday, making the recommendation for the first time. The agency said recent studies proved the usefulness of the antivirals, recommending that AZT or 3TC be administered to health care workers exposed to HIV while on the job. "Younger People Withstand AIDS Better, Study Finds" Reuters (06/07/96) Younger people are better able to fight off HIV infection than older people, researchers at Britain's Imperial Cancer Research Fund in Oxford report in today's issue of the journal Lancet. Sarah Darby and colleagues studied 1,200 HIV-infected hemophiliacs aged from eight months to 79 years. They found that only 12 percent of those infected with HIV when they were over 55 years old survived 10 years, compared to 86 percent of those under the age of 15 at the time of infection. Different treatments for infection in older patients may be indicated, according to Paul Volberding, an AIDS expert at the University of California. "BioChem's Fortunes Rise" Toronto Globe and Mail (06/06/96) P. B7; Swift, Allan BioChem Pharma said Wednesday that its anti-AIDS drug 3TC has captured 35 percent of the North American market only five months after it was introduced. Sales of the drug now exceed those of AZT, even though sales of AZT increased 50 percent last year. Sales of 3TC, Epivir, reached $54 million in the United States since it was approved last November, and $2 million in Canada since its approval in December. The company expects that its 1997 introduction of Lamivudine, a version of 3TC for hepatitis B, will further boost profits. "F.D.A. Rejects Sale of Drug for Shingles" New York Times (06/07/96) P. A15 A Food and Drug Administration panel voted against approving Bristol-Myers Squibb's new anti-shingles drug Sorivudine, saying that the drug's benefits were not great enough to outweigh the risk of a lethal drug interaction. Although Sorivudine heals shingles about a day faster than other treatments, and requires only one dose a day instead of multiple doses, it was implicated in the deaths of 15 Japanese who took the drug in combination with certain common anti-cancer drugs. Bristol-Myers had contended that by cautioning physicians not to prescribe Sorivudine with the cancer drugs, U.S. patients--especially the AIDS patients most at risk from the painful disease--could use the drug safely. The committee urged Bristol-Myers to conduct further research into the drug, saying that it might eventually prove to be useful for treating certain seriously ill patients. "TV Clash Upsets French Anti-AIDS Campaign" Reuters (06/06/96); Tran, Pierre An AIDS activist disrupted a live television show aimed at raising money for AIDS on Thursday, when he denounced the government's plan to deport illegal immigrants with HIV. The show was part of an AIDS fund-raising day supported by the media and charities. Christophe Martet of the group ACT-UP criticized Culture Minister Philippe Douste-Blazy over the plan to return a mother with HIV and her child to Zaire. An argument in the studio between Martet and Douste-Blazy was shown on the television program. "Namibia Calls for Help to AIDS Orphans" Xinhua News Agency (06/06/96) Nickey Iyambo, Namibia's health and social services minister, asked the community for help on Wednesday for children orphaned by AIDS. He made the plea at a hospital where healthy children were being cared for after their mothers died as a result of childbirth. An estimated 500 Namibians are infected with HIV each day, and the total number of infected people is 20,177. President Sam Nujoma also asked the people of Namibia not to discriminate against AIDS patients and called on those with HIV to warn others about the disease. "HIV Viral Load Markers in Clinical Practice" Nature Medicine (06/96) Vol. 2, No. 6; P. 625; Saag, M.S.; Holodniy, M.; Kuritzkes, D.R.; et al. The ability to detect HIV RNA in the bloodstream has allowed for more detailed studies of how the virus replicates and impacts the body's immune system. Plasma HIV RNA levels are associated with varying stages of disease and have been found useful in predicting disease progression. CD4 cell counts, however, are the best predictor of short-term risk for new opportunistic infections. Three plasma HIV RNA assays are available commercially, but none have been approved by the Food and Drug Administration for use in patient management. Plasma HIV RNA assays are also useful for monitoring the effect of antiretroviral drugs. Many clinicians are using such measurements to treat patients, though some remain uncertain of the best use of the information. A panel of the International AIDS Society-USA made recommendations for the clinical use of these assays, advocating routine use of the tests for patient management. The panel said that antiretroviral therapy should be used to minimize viral replication, which can be monitored with HIV RNA assays. A three-fold or larger reduction or the plasma HIV RNA level is the minimal response that demonstrates an antiviral effect. "Circle of Friends" People (06/10/96) Vol. 45, No. 23; P. 91 Facing losses of loved ones in 1993 and hoping to do something positive in their grief, Dana Cappiello and Kathy Scutchfield of Woodside, Calif., started selling bracelets to benefit AIDS services and research. The bracelets, which cost from $20 to $500 for silver plate, sterling silver, or gold, bear the slogan "Until There's a Cure," and proceeds are given to the Until There's a Cure Foundation. Cappiello and Scutchfield even persuaded some retailers, including Macy's, Bloomingdale's, and The Body Shop, to donate their profits from the bracelet sales. An estimated 108,000 bracelets have been sold, and wearers include Robert Redford, Bette Midler, and Julia Roberts. "Update: Provisional Public Health Service Recommendations For Chemoprophylaxis After Occupational Exposure to HIV" Morbidity and Mortality Weekly Report (07/07/96) Vol. 45, No. 22 Although preventing blood exposures is the primary means of preventing occupationally acquired human immunodeficiency virus (HIV) infection, appropriate post-exposure management is an important element of workplace safety. Information suggesting that zidovudine (ZDV) postexposure prophylaxis (PEP) may reduce the risk for HIV transmission after occupational exposure to HIV-infected blood prompted a Public Health Service (PHS) interagency working group, with expert consultation, to update a previous PHS statement on management of occupational exposure to HIV. The update includes six recommendations, which are provisional because they are based on limited data regarding efficacy and toxicity of PEP and risk for HIV infection after different types of exposure. When possible, these recommendations should be implemented in consultation with persons having expertise in antiretroviral therapy and HIV transmission.