Date: Fri, 8 Mar 1996 11:35:23 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 03/08/96 (correct AIDS Daily Summary March 8, 1996 (corrected edition) 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 Clearinghouse, or any other organization. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD ************************************************************ "Persistent Lack of Detectable Antibody to HIV-1 in an Individual with HIV infection, Utah 1995" "Man With AIDS Tested Negative, U.S. Says" "Physician-Aided Suicide Issue Expected Before High Court" "Fighters to Undergo H.I.V. Testing in New Jersey" "In Brief: Amgen Inc." "New Drugs Raise Hope that HIV Manageable" "Krever Denies Hiding Papers" "Japan Courts Unveil Fresh Compromise in HIV Case" "Collapse of Communism Brings Disease Threat--WHO" "Health Secretary Backs AIDS Office's Budget Authority" "Danish Haemophiliacs Win in European Court" ************************************************************ "Persistent Lack of Detectable Antibody to HIV-1 in an Individual with HIV infection, Utah 1995" Morbidity and Mortality Weekly Reports (03/08/96), Vol. 45, No. 9 CDC, in collaboration with the Utah Department of Health (UDH) and the Food and Drug Administration (FDA), has investigated the case of a 36-year-old Utah man diagnosed with AIDS who persistently tests negative for HIV-1 antibodies. Additional tests by CDC and FDA for HIV antigen (a protein in the virus itself) and for HIV genetic material confirmed that the man is infected with HIV. After learning of his diagnosis, the man reported that he had previously sold plasma to a plasma center. The investigation was therefore expanded from the original objective of assessing the reason for the unusual test result to determine if there was possible HIV transmission through the donated plasma. The investigation confirmed that recipients of plasma products were never threatened. Routine processing procedures for plasma in the United States have been shown to inactivate HIV, and a thorough review of this centergs records confirmed that this mangs plasma was treated before any derived products were used. Therefore, the plasma products were free of HIV. While it has not yet been determined why this individualgs antibody tests were negative, the investigation has revealed that it is most likely due to a rare immune reaction by the patient. In extraordinarily rare cases, an unusual immune response in an individual may result in the lack of detectable antibodies to HIV by standard enzyme immunoassay (EIA) tests. (A fact sheet regarding the findings is available from the CDC National AIDS Clearinghouse). "Man With AIDS Tested Negative, U.S. Says" New York Times (03/08/96) P. A25; Altman, Lawrence K. Health officials at the Centers for Disease Control and Prevention reported the unusual case Thursday of a Utah man with AIDS who repeatedly tested negative for HIV. The man was a long-time blood plasma donor, but an investigation found no proof that his plasma had infected anyone. The Food and Drug Administration (FDA) is about to license a new HIV test that is significantly different from the one used since 1985, one that would have probably detected the man's HIV infection. The new test detects the p24 antigen, an HIV protein, while the current one detects HIV antibodies. The test is controversial, though, because it would add millions of dollars to testing costs, but only detect a few more cases. However, the new test can detect HIV about six days before the standard one does, catching four to six contaminated blood donations per year that the standard test would have missed. "Physician-Aided Suicide Issue Expected Before High Court" Washington Post (03/08/96) P. A2; Biskupic, Joan A constitutional right to physician-assisted suicide, which has been compared to a right to an abortion, could be a subject for the Supreme Court. A federal appeals court in California decided Wednesday that a Washington state law that makes physician-assisted suicide a felony violates the 14th Amendment's guarantee of personal liberty. Judge Stephen Reinhardt wrote the decision, which may serve as a guide for other appeals courts and eventually the Supreme Court. Reinhardt wrote that "prohibiting a terminally ill patient from hastening his death may have an even more profound impact on that person's life than forcing a woman to carry a pregnancy to term." No other appeals court has ruled on the issue, but a New York circuit court is considering a challenge to a New York law that prohibits physicians from helping dying patients end their lives. Related Story: New York Times (03/08) P. A14 "Fighters to Undergo H.I.V. Testing in New Jersey" New York Times (03/08/96) P. B19; Eskenazi, Gerald New Jersey's Athletic Control Board decided Thursday to make HIV testing mandatory for boxers competing in the state. Following the news that fighter Tommy Morrison tested positive for the virus in Las Vegas, New York made the test mandatory, and California and Florida are close to similar decisions. Larry Hazzard, the New Jersey board's commissioner, said he has been trying to impose testing since the 1980s, but gave up because he "became bogged down with so many issues and groups: the ACLU, then there was the Americans with Disabilities Act, and the idea of confidentiality." Hazzard said that, since the 1980s referees and handlers have been required to wear gloves, and boxers were made to change mouthpieces if there was blood on them. "In Brief: Amgen Inc." Investor's Business Daily (03/08/96) P. A1 Amgen Inc. has announced that Neupogen, a drug for the treatment of people with advanced HIV infection, has received regulatory approval in the United Kingdom. "New Drugs Raise Hope that HIV Manageable" Toronto Globe and Mail (03/07/96) P. A1; Immen, Wallace New AIDS drugs and technologies are bringing hope that people with HIV will be able to live with it as a chronic, manageable illness. Drugs now exist to begin treating the infection immediately and keep the virus at low levels for long period of time, preventing the immune system's decline. Such drugs, including the new protease inhibitors, may cost between $17,000 and $24,000 a year. There also appears to be progress on the prevention front, as studies have now show that AZT may prevent babies of HIV-infected mothers from getting the virus. "Krever Denies Hiding Papers" Toronto Globe and Mail (03/07/96) P. A3 Canadian Justice Horace Krever said he is not keeping documents from the individuals involved in Canada's tainted blood tragedy, as they have charged. Krever issued notices of potential findings of misconduct to the Red Cross, the federal government, provinces, and pharmaceutical companies, and these groups are now seeking the documents he used in determining who might be blamed in his final report. Krever said he relied on inquiry testimony and documents, and discussions with his lawyers in coming up with the findings. Lawyers say they need the information to help their clients when they demand a judicial review of Krever's findings and ask that the misconduct notices be quashed. "Japan Courts Unveil Fresh Compromise in HIV Case" Reuters (03/07/96) Courts in Osaka and Tokyo have presented a final proposal for an out-of-court settlement in a suit filed by 400 hemophiliacs who contracted HIV through tainted blood. The courts recommended the state and five pharmaceutical companies pay $1,428 per month to each of the plaintiffs, with the government paying 40 percent of the total payments. An earlier plan called for the state and companies together to pay a total of $428,000 to each individual. The courts urged the parties to reach an out-of-court settlement by the end of March. The drug companies and the government were blamed for not taking action after the threat of HIV infection through contaminated blood products was known. "Collapse of Communism Brings Disease Threat--WHO" Reuters (03/07/96); Fox, Maggie The World Health Organization (WHO) reported Thursday that the collapse of communism six years ago has caused the spread of infectious diseases like tuberculosis (TB) and diphtheria, and sexually transmitted diseases that now threaten the rest of the world. The group said that, while a vaccination program would only cost about $20 million, the world is not taking the disease threat seriously. Cholera, diphtheria, and syphilis cases increased in eastern Europe after the economic and political changes following the fall of communism. The diseases, which the rest of the world had considered conquered, began crossing borders into western Europe. When the Soviet Union collapsed, preventive services declined, and disease increased. The greatest threat, however, came from TB. Jo Asvall, the regional director of the WHO in Europe, said, "Tuberculosis in the next 10 years worldwide will infect 300 million people." In addition to establishing vaccination programs and clean water programs, the WHO recommend setting up a network of laboratories to coordinate emerging disease detection. "Health Secretary Backs AIDS Office's Budget Authority" Nature (02/15/96) Vol.379, No.6566, P. 570; Wadman, Meredith Donna Shalala, Secretary of Health and Human Services, recently told a meeting of the National Association of Science Writers in Baltimore that she and President Clinton are committed to maintaining the Office of AIDS Research's (OAR's) authority over AIDS research spending. Republicans in Congress have tried to take away the OAR's control over the National Institute's of Health (NIH) $1.4 billion AIDS budget, but NIH director Harold Varmus has supported keeping the OAR's budgetary powers. Some institute directors object to the OAR's role, but Shalala said the law that gives the office its authority should take precedence over a stop-gap funding measure passed in January to fund NIH up to the end of the fiscal year. The measure has been interpreted to mean that the OAR should be bypassed, sending 1996 funds directly to the individual institutes. Rep. John Porter (R-Ill.) called NIH's decision to bypass the OAR entirely "mechanical." AIDS activists and researchers say the move could limit the OAR's authority in AIDS research. "Danish Haemophiliacs Win in European Court" Lancet (02/17/96) Vol. 347, No. 8999, P. 462; Skovmand, Kaare The European Court of Human Rights has awarded judgment to the plaintiffs in a case brought against the Danish government by seven hemophiliacs who became HIV-infected through factor VIII transfusions. The plaintiffs had alleged that their original seven-year trial was in violation of human rights under article 6 of the Geneva Convention which says that court hearings must be completed "within a reasonable time." In response to this decision, Danish politicians have ordered a review of the court system to prevent such prolonged trials in the future.