Date: Wed, 20 Mar 1996 10:21:35 +0500 From: ghmcleaf{CONTRACTOR/ASPEN/ghmcleaf}%NAC-GATEWAY.ASPEN@ace.aspensys.com Subject: CDC AIDS Daily Summary 03/20/96 AIDS Daily Summary March 20, 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 ************************************************************ "Senate Votes to Repeal Requirement That GIs With AIDS Virus Be Released" "'Philadelphia' Makers Settle Suit Over Source" "Survival of the Nastiest" "Vital Statistics: AIDS Orphans" "Living with AIDS" "Tuberculosis Rise Adds to Vietnam's AIDS Problem" "Family Role Increasing as Deaths of HIV-Positive Mothers Increase" "HIV-1 Langerhans' Cell Tropism Associated with Heterosexual Transmission of HIV" "National Academy of Sciences Endorses Syringe Exchange as an HIV Prevention Strategy" "HIV Rate in CA Prisons Higher Than in Community" ************************************************************ "Senate Votes to Repeal Requirement That GIs With AIDS Virus Be Released" Washington Post (03/20/96) P. A12; Pianin, Eric The Senate voted Tuesday to repeal the new law that requires HIV-positive members of the military to be discharged. The repeal was part of a spending bill passed to keep the government funded through the remainder of the year. To eliminate the measure, however, the House would also have to agree to the repeal when the spending bill is considered in a conference committee later this week. The new law was part of the defense authorization bill that President Clinton signed last month, even though he opposed the HIV provision. Clinton and several AIDS groups sought the repeal, which 56 Democrats and Republican senators co-sponsored. Related Stories: New York Times (03/20) P. D22; Baltimore Sun (03/20) P. 9A "'Philadelphia' Makers Settle Suit Over Source" New York Times (03/20/96) P. B5; Pristin, Terry The makers of the movie "Philadelphia" admitted Tuesday that the film "was inspired in part" by the experiences of a New York lawyer who was fired when his employer discovered he had AIDS. Tristar Pictures announced an undisclosed settlement after five days of testimony in the lawsuit brought by the family of the lawyer, Geoffrey Bowers, who died in 1987. The company had previously said the movie was a fictional work drawn from various sources including personal experiences of the screenwriter and director, who were named as defendants in the case. Bowers' family had argued that by refusing to pay them, Tristar had violated an agreement with a producer who told them he wanted to use the discrimination case in a movie. The family cited more than 40 similarities between the movie and Geoffrey Bowers' life, and said the film makers had based scenes on what they were told by the family. "Survival of the Nastiest" New York Times (03/20/96) P. B1; Johnson, Kirk A collection of more than 4,500 samples of drug-resistant tuberculosis (TB) bacteria is kept in New York at the TB Center at the Public Health Research Institute, marking the city as a research clearinghouse for the disease. Dr. Barry N. Kreiswirth heads the center, which has been involved in tracking down the origin of resistant TB strains that emerged during the outbreak in 1991 and 1992. The disease is especially prevalent among the poor, immigrants, people with AIDS, and intravenous drug users. Kreiswirth's researchers test pharmaceutical companies' drugs against the collected pathogens--thus far, six firms have sent their anti-TB drugs for testing, including two compounds from Pathogenesis in Seattle. "Vital Statistics: AIDS Orphans" Washington Post--Health (03/19/96) P. 5 A growing number of children are being orphaned by AIDS, which has become the leading cause of death among women of childbearing age in the United States, according to a new study in the Journal of the American Medical Association. Experts project that about 144,000 children and young adults will have lost their mothers to AIDS by the year 2000, unless the current trend shifts dramatically. "Living with AIDS" Miami Herald (03/19/96) P. 1B; Rogers, Peggy A new study has found that, for AIDS patients, having a primary physician with a lot of experience treating AIDS, may mean a longer life. The study, which is reported in the New England Journal of Medicine, was conducted by researchers at the University of Washington and a regional health maintenance organization. Medical experts say the conclusion makes sense, but that it is rare for doctor experience alone to make a significant difference to the patient. "Since things change so quickly with HIV, even the HIV physicians have a hard time keeping up," said Dr. Corkin R. Steinhard, a Coconut Grove, Fla. HIV doctor. In South Florida, an epicenter for AIDS, many patients do not have access to the most experienced doctors, who do not always take Medicaid patients. More experienced doctors are more likely to order more expensive drugs and tests, an editorial accompanying the study suggests. Many AIDS patients do not get to the experts until the disease has progressed too far. Other patients fight to get treated by the best doctors, thereby becoming experts in their own care. "Tuberculosis Rise Adds to Vietnam's AIDS Problem" Reuters (03/20/96) About 25,000 people in Vietnam are dying from tuberculosis (TB) each year, with the highest death rate among people with AIDS, a senior doctor with the Institute of Tuberculosis and Lung Diseases said. He estimated that 130,000 people are infected with TB every year. The doctor said the disease is difficult to control because people who are not aware that they are infected can easily infect others. He said that the rate of infection was as high as 50 percent among AIDS patients, although the National AIDS Protection Committee said the figure was only 30 percent to 35 percent. "Family Role Increasing as Deaths of HIV-Positive Mothers Increase" Reuters (03/19/96) The importance of family involvement in caring for children who lose their mothers to AIDS has increased along with the AIDS epidemic, French researchers report in the American Journal of Public Health. Dr. Stephanie Blanche at the Hopital Necker in Paris and colleagues followed nearly 1,500 HIV-positive mothers and their children for eight years. Between 2 percent and 3 percent of the total group of children were separated from their mothers each year by the mother's death from AIDS. Blanche found the cumulative risk of long-term separation was 37 percent at 60 months, and higher when the mother used drugs. In 57 percent of the cases, the child was placed by welfare services. The role of the family tended to increase with the age of the child. "HIV-1 Langerhans' Cell Tropism Associated with Heterosexual Transmission of HIV" Science (03/01/96) Vol. 271, No. 5253, P. 1291; Soto-Ramirez, Luis E.; Renjifo, Boris; McLane, Mary F.; et al. Soto-Ramirez and colleagues suggest that some strains of HIV-1 have more potential for heterosexual transmission than others. Vaginal intercourse is the most common route of HIV-1 transmission in Thailand, sub-Saharan Africa, and India, where HIV-1 subtype E is the predominant strain. Most transmissions in the United States and Europe are associated with anal intercourse among homosexual men or injection drug use, and HIV-1 subtype B is the most common strain. Epithelial Langerhans' cells (LCs), found on oral and genital mucosa, but not in rectal mucosa, are a possible source of contact for heterosexual transmission. The researchers inoculated LC samples with HIV from 15 U.S. homosexuals and 18 Thai heterosexuals. All the viruses from the Thai group, which were subtype E, grew more efficiently in the LCs than any of the viruses from the U.S. group, which were subtype B. The authors say their results suggest that LCs are primary targets for heterosexual infection and could explain the differences in the epidemics in Asia and Africa, compared to those in the United States and Europe. They say that, if introduced in the West, subtype E could be a greater threat than subtype B. "National Academy of Sciences Endorses Syringe Exchange as an HIV Prevention Strategy" The U.S. Conference of Mayors: HIV Capsule Report (02/96) No. 1, P. 4 A National Academy of Sciences study, conducted by 15 experts at Congress' request, has found that syringe exchange programs can reduce the spread of HIV among drug users without encouraging drug use. The panel reviewed all available research and released its report, recommending in Sept. 1995 that the ban on the use of federal funds for exchange programs be lifted. The report also called for states to rescind laws that restrict the sale and possession of syringes. According to the report, injection drug use accounts for a major proportion of the new HIV infections in the United States, and sharing of injection equipment is the main mode of transmission among addicts. The authors of the report also recommend that the Surgeon General should make the requisite determination to lift the current ban on using any federal funds for needle exchange programs. "HIV Rate in CA Prisons Higher Than in Community" AIDS Alert (02/96) Vol. 11, No. 2, P. 23 Health officials in California have found that the HIV rate among the state's prison population has remained relatively stable since 1988. The most recent figures, which were gathered during a massive communicable disease screening of 118,000 inmates and employees of the state correctional system, indicate that 2.5 percent of male inmates and 3.2 percent of female inmates are HIV positive. The health care workers were particularly concerned because both hepatitis B virus (HBV) and hepatitis C virus (HCV) are at significant levels in the prison population. HBV was found in 47 percent of the women and 32 percent of the men, while HCV was in 54 percent of the women and 39 percent of the men. Because both hepatitis and HIV are spread through sex and needles, the high hepatitis infection rate may indicate a future increase in the rate of HIV infection and AIDS cases, concluded Susan Steinberg, chief medical officer for the California Department of Corrections.