Date: Tue, 12 Mar 1996 15:18:43 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 03/12/96 AIDS Daily Summary March 12, 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 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 ************************************************************ "New Issue Update: Gilead Sciences" "John-John Dies of AIDS at 11 Still Speaking of Hope" "Unusual Molecules Could be Key to Cancer Patients' Weight Loss" "Portraits of Lives with AIDS" "Thalidomide Returns With New Hope, Old Fear" "Neurex SNX-111 in the Treatment of Neuropathic Pain Caused by AIDS; Early Results Promising" "Identification of Levels of Maternal HIV-1 RNA Associated With Risk of Perinatal Transmission" "Syringe Exchange in the United States: 1995 Update" "JAMA, Glaxo Wellcome Create HIV/AIDS Site on Web" ************************************************************ "New Issue Update: Gilead Sciences" Investor's Business Daily (03/12/96) P. A6 Gilead Sciences Inc. has announced that preliminary results from an independent clinical trial of VISTIDE indicate the drug is effective in treating CMV retinitis. The study was carried out by SOCA, a research group founded by the National Eye Institute. "John-John Dies of AIDS at 11 Still Speaking of Hope" Baltimore Sun (03/12/96) P. 1B; Olksker, Michael Eleven-year-old John-John Cummings, who was infected with HIV by his mother, died of AIDS recently, but was still full of hope. His grandmother Ethel Jackson, who lives in Baltimore and is a retired nurse's assistant, took care of him. His mother died in August. Jackson described John-John as a typical boy who loved to play and sing. A study by the Centers for Disease Control and Prevention found that 1 percent of women on child-bearing age in Baltimore are known to have HIV. Vicki Tepper of the University of Maryland School of Medicine, who was John-John's psychologist, says that about 250 Baltimore children under the age of 13 are infected with HIV. John-John was not found to have HIV until he was 7, but he suffered from illnesses throughout his life. When John-John was dying, Jackson said, he knew, but he told her he had talked to the angels, and they said he was going to be allright. "Unusual Molecules Could be Key to Cancer Patients' Weight Loss" New York Times (03/12/96) P. C3; Grady, Denise British researchers report that they have found a clue to the process of wasting, or the extreme weight loss that plagues cancer and AIDS patients. Their finding is specific to wasting in cancer patients, but, Dr. Carl Grunfield, a medical professor at the University of California at San Francisco, who was not involved in the research, says he will begin a study to look for the same factor in AIDS patients. Wasting affects about half of all cancer patients, and has a significant impact on the health of people with AIDS. The cancer study, led by Dr. Michael Tisdale at Aston University, reveals the role of a substance made by tumor cells that seems to cause the weight loss. A treatment to block the chemical may be developed to combat the problem. Cancer patients with wasting live about half as long those with the same tumor and no wasting. Patients lose their appetite, burn extra calories, and lose muscle mass, but giving a patient more food does not help and may cause the tumor to grow faster. "Portraits of Lives with AIDS" New York Times (03/10/96) P. 33; Alvarez, Lizette AIDS has become a growing problem among teen-agers, a problem emphasized in a report from the White House Office of AIDS Policy released last week. The report called for community leaders and the medical establishment to increase education and treatment efforts for young people. One of every four people who are infected with HIV is under the age of 20, the report said. Poor inner-city teens, who are having sex at younger ages and live in areas where AIDS is more prevalent, are especially susceptible to the virus. In New York City, nearly 11,000 people aged 13 to 29 have died of AIDS. Fifteen percent of the AIDS cases in Newark, N.J., are among 20- to 29-year-olds. Complicating the problem is the fact that most young people are not likely to be tested or see a doctor, and may not even know they have the virus. Young people who grew up learning basic HIV prevention methods seem to be ambivalent about their sexual behavior. Dealing with poverty, grief, and feelings of abandonment, they turn to sex for comfort and seem to think they can defy AIDS, and that if they cannot, it is beyond their control. "Thalidomide Returns With New Hope, Old Fear" Chicago Tribune (03/11/96) P. 1-1; Goering, Laurie Thalidomide, the infamous sedative that caused severe birth defects in babies of mothers who took the drug in the late 1950s and early 1960s, is still prescribed in Brazil as the only effective treatment for leprosy and is gaining popularity again in the West as a treatment for AIDS-associated wasting and mouth ulcers. The drug may also be effective as a treatment for tuberculosis, cancer, degenerative eye disease associated with diabetes, and autoimmune diseases such as lupus and multiple sclerosis. To use such a potentially dangerous drug again, however, U.S. Food and Drug Administration policy experts and other health officials are searching for ways to get the drug to those who need it without repeating the tragedies of the past. Efforts to make thalidomide less likely to fall into the hands of pregnant women include new labeling which makes it clearer that the drug is dangerous for pregnant women and is not able to induce abortion, as some mistakenly believe, and distribution methods that limit prescriptions to small amounts of the drug. "Neurex SNX-111 in the Treatment of Neuropathic Pain Caused by AIDS; Early Results Promising" Business Wire (03/11/96) Neurex Corp. has announced the promising results of treating two patients with HIV-related neuropathic pain with SNX-111, a calcium channel blocker. Both patients had failed opiate treatment, but responded well to initial treatment with SNX-111. Severe neuropathic pain, which is thought to be caused by the HIV infection invading the nervous system, is a common clinical problem, and not easily treated. The company added that it needs to confirm the response in controlled studies. "Identification of Levels of Maternal HIV-1 RNA Associated With Risk of Perinatal Transmission" Journal of the American Medical Association (02/28/96) Vol.275, No.8, P. 599; Dickover, Ruth E.; Garratty, Eileen M.; Herman, Steven A.; et al. Zidovudine has been shown to reduce the risk of perinatal transmission of HIV by two-thirds in asymptomatic HIV-infected women who had not taken the drug previously. Dickover and colleagues followed 92 HIV-positive pregnant women to determine if the amount of virus in maternal blood can predict perinatal HIV transmission, how zidovudine prevents HIV transmission, and why it sometimes fails. Of the 92 women, 42 received zidovudine therapy during pregnancy, labor, and delivery. Twenty of the 97 infants were perinatally infected with HIV. The mothers' HIV-1 RNA levels were found to be highly predictive of the risk of perinatal transmission, and zidovudine showed a major protective effect by reducing maternal HIV-1 RNA levels before delivery. Transmission was most likely to occur in women with plasma HIV-1 RNA levels above 50,000 copies per milliliter. According to the researchers, intervention strategies should try to reduce the maternal HIV-1 RNA levels to at least below 20,000 copies per milliliter. Further strategies are needed, the authors say, to prevent perinatal transmission in women with high or increasing virus levels or zidovudine-resistant virus. "Syringe Exchange in the United States: 1995 Update" The U.S. Conference of Mayors: HIV Capsule Report (02/96) No.1, P. 1 Syringe exchange programs (SEPs) provide sterile syringes and other services to injection drug users, reducing the risk of HIV transmission through shared needles. Programs are now in operation in 46 cities in 21 states. In 1994, 8 million new syringes were exchanged for used ones, compared to 2.4 million in 1993. However, laws that require prescriptions to obtain syringes or that criminalize having syringes often make SEPs illegal. Of 60 SEPs that responded to a 1995 survey, 55 percent reported that they operated legally; 32 percent said a local group or council supported the program, despite laws against it; and 13 percent said they operated illegally. Among other services offered, 45 of the programs offer condoms and 23 provide HIV counseling and testing. In addition, 85 percent of the programs counsel drug users about medical hygiene relating to injection drugs. Furthermore, a recent study by the Chemical Dependency Institute at Beth Israel Medical Center in New York found that SEPs are cost-effective, with the average yearly cost for programs about $131,000. The average estimated lifetime cost of treating one HIV-positive individual is $120,000. Federal funds cannot be used for syringe distribution. In short, although 53.3 percent of the AIDS cases reported to the Centers for Disease Control and Prevention in 1994 were associated with injection drug use, SEPs are continually opposed by communities leaders and lawmakers. Communities should therefore investigate whether SEPs are appropriate for the needs of their region, but should also consider effective prevention strategies can be implemented at the local level "JAMA, Glaxo Wellcome Create HIV/AIDS Site on Web" American Medical News (02/19/96) Vol. 39, No. 7, P. 9 The Journal of the American Medical Association and Glaxo Wellcome Inc. have created an HIV- and AIDS-related World Wide Web site which is intended to serve both patients and health care workers. Information on the site, located at "http://www.ama-assn.org," is peer reviewed by HIV/AIDS experts, and a community advisory panel will also be created to assist the site editors. The site features information on a range of topics including clinical protocol, training information for health care workers, answers to common questions about HIV/AIDS, and a lexicon of HIV/AIDS terminology.