Date: Wed, 19 Jun 1996 10:27:56 -0400 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 06/19/96 AIDS Daily Summary June 19, 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 ****************************************************** "40,000 New AIDS Cases Recorded in Zimbabwe" "HIV Prevention in Asia: A Business Opportunity" "Risks Quantified for Neoplasms in Children With AIDS" "Namibia to Promote AIDS Program" "Zambian President Praises NGOs' AIDS Fight" "Atovaquone Effective Against Microsporidiosis in HIV-Positive Patients" "Zimbabwe to Reduce STDs" "U.S. Beefs up CDC's Capabilities" "Brief Report: Rifampin-Resistant Tuberculosis in a Patient Receiving Rifabutin Prophylaxis" "Blood Samples Called Safe for Mail Handlers" "HIV/AIDS Clinical Trials Videotape Package Now Available" ****************************************************** "40,000 New AIDS Cases Recorded in Zimbabwe" Xinhua News Agency (06/19/96) In Zimbabwe, at least 40,000 new AIDS cases were reported last year, the National AIDS Coordination Program said. The agency added that the actual number could be greater than 40,000 and that the estimated total cases could be as high as 150,000. The agency also reported an increase in tuberculosis cases, with more than 22,000 reported from January to September of 1995, compared to 17,000 during the same period in 1994. More than 1 million people in Zimbabwe are believed to be infected with HIV, out of a population of 10.5 million. "HIV Prevention in Asia: A Business Opportunity" Reuters (06/18/96) In a commentary in this week's issue of the Lancet, Ann Marie Kimball of the University of Washington at Seattle and Myo Thant, an economist at the Asian Development Bank in Manila, suggest that the Asian business community should join the fight against the spread of HIV. The authors say that because businesses stand to lose many valuable workers to the epidemic, they should help to increase AIDS awareness and HIV prevention education. "Risks Quantified for Neoplasms in Children With AIDS" Reuters (06/18/96) Unlike adults with AIDS, children with the disease are more likely to get non-Hodgkin's lymphoma than Kaposi's sarcoma, researchers say. This agrees with incidence rates of the cancers in the general pediatric population, however. Diego Serraino and Silvia Franceschi of the Aviano Cancer Center in Aviano, Italy, based their conclusions, reported recently in the journal AIDS, on cases of almost 11,000 children and adolescents with AIDS. Both Kaposi's sarcoma and non-Hodgkin's lymphoma were found more often at AIDS diagnosis in U.S. children than in European children. Overall, 0.4 percent of the children, and 2.7 percent of the adolescents, had Kaposi's sarcoma at AIDS diagnosis. Non-Hodgkin's lymphoma was reported in 0.9 percent of the children in Europe and 1.5 percent of the children in the United States. The researchers also found a higher incidence of Kaposi's sarcoma in adolescents with AIDS who reported homosexual intercourse with other males. "Namibia to Promote AIDS Program" Xinhua News Agency (06/18/96) A team of officials from the government, non-government organizations, the United Nations joint program on AIDS, and the European Union has been assembled to review Namibia's AIDS program and to promote its implementation. In Namibia, the number of people infected with HIV rose from four in 1986 to 21,737 in April 1996. An estimated 20 percent increase in infections from 1995 to 1996 is expected by the end of the year, National AIDS Control Program Chairman Markus Sivute said. Nine percent of all deaths in the country last year were attributed to AIDS. "Zambian President Praises NGOs' AIDS Fight" Africa News Service (06/18/96) ; Phiri, Reuben Zambian President Frederick Chiluba praised non-governmental organizations (NGOs) on Tuesday for their part in fighting the spread of AIDS. In a speech read on his behalf at the opening of the sixth NGO AIDS Conference, he said that because NGOs are grass roots-based, they are an effective channel of communication between the people being targeted, donor agencies, and the government. Chiluba promised that the government would "make AIDS a top priority for external resource allocation so that Africa benefits from the maximum international cooperation and solidarity in overcoming the epidemic and its impact." Dr. Clarence Mini, chairperson of the Southern African Network of AIDS Services Organizations, asked the government to re-affirm its pledge to ensure that everyone is educated about AIDS and HIV prevention. "Atovaquone Effective Against Microsporidiosis in HIV-Positive Patients" Reuters (06/18/96) Atovaquone may be a potential alternative treatment for gastrointestinal microsporidiosis, a common cause of chronic diarrhea, wasting, and death in patients with advanced AIDS, researchers report in the journal AIDS. Jeffrey L. Lennox of Emory University and colleagues found that of 22 HIV-infected patients with intestinal microsporidial infection, the most common agent causing diarrhea was Enterocytozoon bieneusi. There is no generally accepted treatment for E. bieneusi infection, but the researchers found that atovaquone was effective against the patients' diarrhea. The treatment, however, did not decrease the parasite burden in most patients. "Zimbabwe to Reduce STDs" Xinhua News Agency (06/18/96) In Zimbabwe, a country with 10.5 million residents, more than 39 million condoms were distributed in 1995, according to the National AIDS Coordination Program. Only 25.6 million condoms were distributed in 1994. The agency said that the control of sexually transmitted diseases is a key to the prevention of sexual HIV transmission. More than 1 million of the country's citizens are thought to be infected with HIV, and an estimated 300 are dying each week from AIDS-related diseases. "U.S. Beefs Up CDC's Capabilities" Science (06/07/96) Vol. 272, No. 5267; P. 1413; Pennisi, Elizabeth In 1967, health officials in the United States and other developed countries thought they were on their way to conquering infectious diseases with vaccines and antibiotics. However, now tuberculosis, cholera, and other diseases previously under control have re-emerged, and, along with AIDS and other new infections, caused deaths in the United States from infectious diseases to increase by 58 percent between 1980 and 1992. Officials at the Centers for Disease Control and Prevention concede that they became complacent and two years ago began taking steps to become more vigilant. A $125-million plan was proposed, calling for increased monitoring for emerging infections, improvements in local and state public health facilities, and enhanced international efforts. Congress allocated $6.7 million for the effort in 1995 and $10.7 million this year, and President Clinton wants to increase the amount to $27 million in 1997. The CDC has also said it will provide $200,000 a year to 13 states, as well as to New York City and Los Angeles, to improve their efforts against disease. Experts say that the funding pledged is not sufficient for preventing problems and will likely be used to deal with crises rather than the more cost-effective method of catching outbreaks early and preventing the spread of an epidemic. "Brief Report: Rifampin-Resistant Tuberculosis in a Patient Receiving Rifabutin Prophylaxis" New England Journal of Medicine (06/13/96) Vol. 334, No. 24; P. 1573; Bishai, William R.; Graham, Neil M.H.; Harrington, Susan; et al. Drug-resistant tuberculosis (TB) is a growing problem in the United States, and resistance to rifampin, a popular TB prophylactic drug for HIV-infected patients, is especially threatening. Nine percent of TB cases in New York City in 1991 were rifampin-resistant, up from less than 1 percent in 1979. Furthermore, prophylactic use of rifabutin, introduced in 1993, may induce rifampin-resistant TB. Dr. William R. Bishai, of Johns Hopkins University, and colleagues present the case of a 35-year-old man with HIV who was hospitalized and treated for TB. He was cleared of M. tuberculosis after six months of treatment, including treatment with rifampin. The patient then began seeing a private doctor and began taking rifabutin as prophylaxis against TB. Two months later, the patient developed symptoms of TB and died; a strain of M. tuberculosis resistant to rifampin and rifabutin was found to be the cause. The man's first and second episodes of TB were caused by strains that were identical except that the second one was resistant to rifabutin and rifampin. The researchers conclude that it is important to screen all patients for active TB before starting rifabutin prophylaxis, as is recommended by the Public Health Service. "Blood Samples Called Safe for Mail Handlers" Federal Times (06/10/96) Vol. 32, No. 18; P. 10; Bridger, Chet Following the recent approval of the country's first mail-in HIV test kit comes approval for postal workers to carry the blood samples. Both the U.S. Postal Service and Johnson & Johnson, the maker of the Confide HIV test, said carrying the packages was not a health risk for postal workers. The Confide sample to be mailed consists of three dried blood spots on a card. The card will be sealed in a plastic container, sealed in a cardboard container, sealed inside a shipping box. The boxes will be handled manually and will be labeled as clinical specimens, carrying a green border that identifies them as HIV tests. All packages will be sent to Laboratory Corporation of America near Bridgewater, N.J. Johnson & Johnson says the kits could account for more than 5 million pieces of mail next year. The test kit will be available in Texas and Florida this summer and will be offered nationwide in 1997. "HIV/AIDS Clinical Trials Videotape Package Now Available" AIDS Clinical Trials Information Service (ACTIS) (06/18/96) The new HIV/AIDS Clinical Trials: Knowing Your Options videotape package is now available from the AIDS Clinical Trials Information Service (ACTIS). ACTIS is a national information and referral service that provides the latest details on federally and privately sponsored clinical trials for experimental drugs and other HIV-related therapies for adults and children. The HIV/AIDS Clinical Trials: Knowing Your Options package includes a VHS videotape, a discussion leader's guide, and a brochure. The 19-minute videotape clearly explains what HIV/AIDS clinical trials are and presents a simple "Learn, Consider, and Choose" approach for making personal decisions related to trials. The video features interviews with people who have participated in clinical trials as well as doctors and nurses who work in medical research programs. The HIV/AIDS Clinical Trials: Knowing Your Options package and additional copies of the brochure can be ordered from ACTIS (1-800-874-2572). There are nominal fees for the video package and extra brochures to cover shipping and handling costs. The videotape package costs $15 and extra brochures are 10> per copy. Discounts are available for bulk orders.