Date: Thu, 10 Oct 1996 10:43:22 -0400 From: "Vaux, Lenore" Subject: CDC AIDS Daily Summary, 10/10/96 AIDS Daily Summary Thursday, October 10, 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 1995, Information, Inc., Bethesda, MD ****************************************************** "Some AIDS Cases Defy New Drug 'Cocktails'" "But Success in Many Others Is Cutting Hospital Costs" "Home Drug Test Kits" "Pact Signed to Sell Policies in $8.7 Million Transaction" "Nationline: AIDS Confidentiality" "AIDS Is a Bi-Partisan Issue" "Indonesia, Vietnam Face AIDS Pandemic" "The Quilt" "Antibodies to Human Herpesvirus Type 8 in the General Population and in Kaposi's Sarcoma Patients" "A New Focus on Primary HIV Infection" ****************************************************** "Some AIDS Cases Defy New Drug 'Cocktails'" Wall Street Journal (10/10/96) P. B1; Waldholz, Michael Although new AIDS drug combinations including protease inhibitors have shown promise in reducing levels of HIV and boosting immune cells, doctors say that the therapies do not work for many patients. Perhaps up to 10 percent of patients taking the drug combinations do not have lasting results. Experts are debating which combinations are most effective and when treatment should be initiated. Moreover, because the new drugs were rushed to market, researchers do not fully understand how they work, and patients are essentially testing the therapies in on-going studies. "But Success in Many Others Is Cutting Hospital Costs" Wall Street Journal (10/10/96) P. B1; Waldholz, Michael The use of new AIDS drug therapies seems to be reducing the cost of in-patient health services by AIDS patients, medical officials say. As a result, the government and private agencies could be forced to transfer some of their spending from medical care to drug therapies. Hospitals could increase out-patient services to provide the drugs and monitor their use. The drug therapies can cost $16,000 a year per patient, compared to an estimated $24,000 each patient generates in hospital costs. Doctors in hospitals in New York and California note that acute-care is declining more than it ever has in the past 12 years of the epidemic, and most credit the introduction of protease inhibitors for the trend. At St. Vincent's Hospital in Greenwich Village, New York, for example, AIDS-related admissions are down 8 percent this year, and the length of each hospital stay is shorter as well. "Home Drug Test Kits" Washington Post (10/10/96) P. A20 A new home testing kit that allows parents to determine if their children are using drugs should not be kept off the market unless it is unsafe or inaccurate, contend the editors of the Washington Post. The editors compare the FDA's concern over the drug test to the agency's reluctance to approve a home HIV test kit--for fear that telephone counseling is not adequate for patients being told they have HIV. The writers argue that "this concern for the emotional and psychological impact of test results on patients and their families may be admirable. But it is not a reason for denying FDA approval on grounds of safety and efficacy." "Pact Signed to Sell Policies in $8.7 Million Transaction" Wall Street Journal (10/10/96) P. B4 Dignity Partners has made a deal with an undisclosed viatical settlement company to sell 197 policies with a total face value of $14.2 million for $8.7 million. All of the policies insure the lives of people with HIV or AIDS. After seeking stockholder approval, Dignity intends to sell all or nearly all of its assets. "Nationline: AIDS Confidentiality" USA Today (10/10/96) P. 3A; Bacon, John A Florida public health worker has been fired for taking computer disks which listed nearly 4,000 HIV-infected individuals to a gay bar and offering to look up names for his friends. William Calvert also used the list to check out his dates. "AIDS Is a Bi-Partisan Issue" Washington Times (10/10/96) P. A2; Driscoll, James The issue of AIDS is being used by Democratic AIDS activists to diminish the Republican record and the accomplishments of the private-sector in an effort to promote President Clinton, AIDS Activist James Driscoll argues in a commentary in the Washington Times. Driscoll, the national AIDS policy advisor to the Log Cabin Republicans, points out that the Republican-controlled Congress reauthorized the Ryan White CARE Act, increasing funding for the program by 30 percent. He also says that the Republicans influenced regulatory reform at the Food and Drug Administration, all for the rapid approval of new AIDS drugs. AIDS activists, meanwhile, credited Clinton with the Ryan White reauthorization and funding increase, Driscoll says, and overlooked the influence of the GOP congress on the FDA. Driscoll urges bipartisan leadership and solutions for AIDS policies, saying that the Republicans deserve credit for their contributions and that the White House should provide more leadership on AIDS. "Indonesia, Vietnam Face AIDS Pandemic" Washington Times (10/10/96) P. A16 The number of people infected with HIV in Indonesia and Vietnam could be more than 1 million by the year 2000, increasing the number of infected people in Southeast Asia to more than 2 million, a regional task force reported Wednesday. Factors contributing to the spread of HIV in Indonesia include high-risk sexual behavior, poverty, widespread sexually transmitted diseases, and increasing population and mobility. "The Quilt" Washington Times (10/10/96) P. M3 The NAMES Project AIDS Memorial Quilt will be on display from Friday through Sunday on the Mall in Washington, D.C. In addition, a program called The Quilt will be sponsored by the Smithsonian Associates on Saturday at 3 p.m. The program will feature the co-founders of the NAMES Project, Cleve Jones and Michael Smith, and others who will discuss the quilt's history and the cause. "Antibodies to Human Herpesvirus Type 8 in the General Population and in Kaposi's Sarcoma Patients" Lancet (09/28/96) Vol. 348, No. 9031, P. 858; Lennette, Evelyne T.; Blackbourn, David J.; Levy, Jay A. Human herpesvirus type 8 (HHV-8) has been detected in individuals with all forms of Kaposi's sarcoma (KS), as well as HIV-seropositive individuals with and without KS, and individuals with other diseases, suggesting that the virus may be widely distributed in the population. Previous seroepidemiological studies of the virus have been hindered by unreliable tests. Evelyne T. Lennette, of Virolab in Berkeley, Calif., and colleagues at the University of California, San Francisco, used a immunofluorescence assay to measure HHV-8 seroprevalence in the general population and in KS patients and individuals at risk for HIV infection. They report that all patients with African endemic KS and 96 percent of American patients with AIDS-associated KS tested positive for HHV-8 antibodies. Additionally, 90 percent of American homosexual men with HIV tested positive, compared to 23 percent of HIV-seropositive drug users and 21 percent of HIV seropositive women. In the general U.S. population, about 25 percent of adults and 2 percent to 8 percent of children had antibodies to HHV-8. The authors say the data support the theory that HHV-8 is associated with sexual transmission, but that the rate of infection in children suggests another route of transmission exists as well. "A New Focus on Primary HIV Infection" AIDS Clinical Care (09/96) Vol. 8, No. 9, P. 72; Hecht, Frederick The initial period of HIV infection is thought to be an important time for treatment--to possibly improve a patient's survival, or to eradicate the virus completely. Recent research suggests that HIV production stabilizes after primary infection, and that if replication is high at this point, AIDS is more likely to progress quickly. Early treatment may reduce viral production and slow disease progression. Early treatment may also help eradicate the virus, if long-term damage to the immune system can be prevented and drug resistant strains do not develop. Martin Markowitz, of the Aaron Diamond AIDS Research Center, reports that, among 9 patients who started treatment during the initial phase of infection, viral load decreased to undetectable levels within 12 weeks. AIDS researcher David Ho estimates that from 30 weeks to 120 weeks are needed for a patient's HIV-infected cells to die out. This suggests that HIV could be eradicated from the body, if HIV replication can be completely stopped and the virus does not infect cells in areas where drugs are ineffective. Patients may have to continue drug therapy to remain disease-free, however. A patient in San Francisco was treated successfully for 80 weeks, but when he stopped treatment, his viral load quickly rebounded.