Date: Thu, 28 Mar 1996 17:20:29 +0500 From: "Martha Vander Kolk" Subject: AIDS Daily Summary 03/28/96 AIDS Daily Summary March 28, 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 ************************************************************ "Across the USA: Tennessee" "Across the USA: Massachusetts" "Health-Insurance Measure Is Running Into Problems" "Zimbabwe's AIDS Orphans to Reach 600,000 by 2000" "Death Rates High Among New York Welfare Recipients--Study" "Influenza Immunization in HIV-Positive Children Does Not Enhance HIV Replication" "Zimbabwe's Maternal Mortality Deaths Rising" "Physicians' Experience with the Acquired Immunodeficiency Syndrome as a Factor in Patients' Survival" "Rogue Science or Reality?" "Principals in HIV Blood Scandal Should be Summoned by Diet" ************************************************************ "Across the USA: Tennessee" USA Today (03/28/96) P. 11A Tennessee's health care program Tenn-Care will cover protease inhibitors, new AIDS drugs that experts say are particularly promising. Tenn-Care covers about 2,000 HIV-infected individuals. "Across the USA: Massachusetts" USA Today (03/28/96) P. 11A AIDS-related deaths in Massachusetts increased 21 percent from 1993 to 1994, and doubled from 1990 to 1994, according to a new report. The 1994 total was 938. AIDS was the leading cause of death among Hispanics in the state that year. "Health-Insurance Measure Is Running Into Problems" Wall Street Journal (03/28/96) P. A4 The chances of a health-insurance reform bill, aiming to restrict insurance companies' ability to refuse coverage to people with pre-existing conditions and guarantee continued coverage to those who lose or change jobs, may be complicated by amendments from Senate Republicans. The bill's sponsors, Sens. Nancy Kassebaum (R-Kan.) and Edward Kennedy (D-Mass.), urged lawmakers not to amend the legislation. Amendments may be proposed to raise the health-insurance tax deduction for the self-employed and to add provisions for medical savings accounts and medical-malpractice awards. "Zimbabwe's AIDS Orphans to Reach 600,000 by 2000" Xinhua News Service (03/28/96) Zimbabwe will have more than 600,000 orphans due to AIDS by the year 2000, Margaret Mehlomakulu, deputy director of the National AIDS Coordinating Program, said at a workshop Wednesday. She said that AIDS would be a heavy burden on the government and the community as they would be forced to stretch available resources to take care of the orphans. Mehlomakulu called for health officials to work with the community to help prevent young people from becoming HIV-infected. An estimated 1 million Zimbabweans, of a total 10.5 million, have the virus. "Death Rates High Among New York Welfare Recipients--Study" Reuters (03/27/96) Rates of AIDS, tuberculosis (TB), and death are much higher among New York City welfare recipients and applicants who have been abusing alcohol, drugs, or both, an eight-year survey has found. The research, led by Lloyd Friedman of the Yale University School of Medicine, found that between 1984 and 1992, 5.5 percent of the 858 people studied developed TB, 10 percent had AIDS, and 21 percent died. All 858 had a history of abusing drugs, alcohol, or both. The TB rate for these individuals, the majority of whom are single black men, is nearly 15 times the usual rate in New York City, while the AIDS rate is 10 times the average, and the death rate is five times the usual. Ninety-three percent of the participants agreed to undergo a two-part medical exam, which the researchers hoped would result in treatment for people at high risk for AIDS or TB. "Influenza Immunization in HIV-Positive Children Does Not Enhance HIV Replication" Reuters (03/27/96) Although some researchers have suggested that influenza vaccination may activate T-cells and enhance HIV replication, new research has revealed only short-term increases in viral load in children following immunization. Octavio Ramillo and colleagues at the University of Texas Southwestern Medical Center in Dallas saw the increased HIV RNA in five of 16 children, and said the viral load returned to baseline in four of those five children within eight weeks. The findings add to the evidence that the viral burden increases after immunization more often in HIV-positive adults than in children. "Zimbabwe's Maternal Mortality Deaths Rising" PANA News Service (03/27/96) The incidence of maternal mortality has increased in Zimbabwe as the number of HIV-infected pregnant women has risen, a local gynecologist reported Wednesday. Kudakwashe Kangwende said the infant mortality rate has been made worse by pre-natal mortality associated with HIV infection and AIDS among pregnant women. Kangwende said that frequent and unwarranted pregnancies among women with AIDS contribute to the increasing maternal mortality rate, and suggested that women with AIDS should be allowed to have abortions. He also said the AIDS pandemic was causing the spread of other diseases uncommon in Zimbabwe, including genital herpes and cervical cancer. "Physicians' Experience with the Acquired Immunodeficiency Syndrome as a Factor in Patients' Survival" New England Journal of Medicine (03/14/96) Vol. 334, No. 11, P. 701; Kitahata, Mari M.; Koepsell, Thomas D.; Deyo, Richard A.; et al. Mari Kitahata and colleagues examined the link between physicians' experience with AIDS and the survival of their AIDS patients. They studied the cases of 403 men enrolled in a health maintenance organization who were diagnosed with AIDS between 1984 and mid-1994. The patients' 125 primary care physicians were separated into three levels of AIDS experience, based on experience with AIDS during residency training and the cumulative number of patients with AIDS they had treated in practice. The authors concluded that patients cared for by doctors with the most experience had a 31 percent lower risk of death than patients cared for by physicians with the least experience. Among the 224 patients diagnosed with AIDS between 1989 and 1994, the risk of death was 43 percent lower for patients of the most experienced doctors than for patients of the least experienced. The study suggests that physicians who treat AIDS patients go through a similar learning period and begin to improve their management skills early in their experience. The authors found that certain methods of treatment and a tendency to follow HIV-infected patients more closely were associated with higher levels of physicians' experience and longer patient survival. "Rogue Science or Reality?" Insight (03/11/96) Vol. 12, No. 10, P. 16; Goode, Stephen Peter Duesberg, biology professor at the University of California at Berkeley, member of the National Academy of Sciences, and federal grant recipient, is criticized by many scientists because he opposes the accepted belief that HIV causes AIDS. Duesberg's book "Inventing the AIDS Virus" outlines his arguments and challenges his colleagues to answer them. He says the HIV-AIDS theory was announced hastily by federal health officials in 1984 because groups like the National Institutes of Health were under intense pressure to come up with an answer to the growing AIDS epidemic. No one questioned the connection later, he says, because billions in federal funding was being spent on confirming it. Furthermore, Duesberg criticizes AIDS researchers for abandoning long-held principles about viruses. In other viral infections, antibodies are a sign of the body's defense, but with HIV, antibodies are looked at as a sign that the virus is still potent. AIDS researcher Robert Gallo has said that because AIDS was completely new, redefining the rules was necessary. Other researchers argue that HIV's ability to mutate rapidly makes it a special case. Duesberg says that lifestyle factors--including drug use, repeated cases of sexually transmitted diseases, and malnutrition--are to blame for AIDS. Duesberg is not alone in his beliefs--the 100-member Group for the Scientific Reappraisal of the HIV-AIDS Hypothesis supports him. "Principals in HIV Blood Scandal Should be Summoned by Diet" Nikkei Weekly (03/11/96) Vol. 34, No. 1713, P. 6 In an editorial in the Nikkei Weekly, the authors note the Diet's lack of involvement in Japan's tainted blood scandal, which caused some 1,800 Japanese hemophiliacs to be infected with HIV. An investigation by the Ministry of Health and Welfare revealed that contaminated blood products were distributed even though members of government and industry knew of the HIV threat. However, the investigation's interim report fails to answer whether or not the ministry proposed emergency imports of safe, heat-treated blood products. The editors question the actions of Takeshi Abe, who headed the AIDS task force, as well as those of his associate, Mutsumi Kazama, and the pharmaceutical companies who continued to ship the untreated products even after the threat of contamination was known. The editors claim that the ministry investigation is not likely to provide satisfactory answers and that the participants should testify before the Diet.