Date: Mon, 16 Sep 1996 10:04:01 -0400 From: "Flynn Mclean" Subject: CDC AIDS Daily Summary 09/16/96 AIDS Daily Summary September 16, 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 ****************************************************** "Agouron Pharmaceuticals to Give Away Experimental AIDS Drug to Some People" "HIV Home Test Kit Picks up on Market" "In Changing Face of Illness, an Optimistic Prognosis Emerges" "Drug War Isn't About Marijuana as Medicine" "AIDS Patients Slipping Through Safety Net" "AIDS Claims Five Each Day in Northern Thailand" "White House Releases Clinton Health Information" "Botswana Faces Serious Threat of AIDS" "Frequent Infection of Peripheral Blood CD8-Positive T-Lymphocytes With HIV-1" "Drug Therapy: Ganciclovir" ****************************************************** "Agouron Pharmaceuticals to Give Away Experimental AIDS Drug to Some People" Wall Street Journal (09/16/96) P. B6; Rundle, Rhonda L. Patients in the advanced stages of AIDS will be eligible to receive the experimental protease inhibitor Viracept (nelfinavir) free of charge under an expanded-access program to be announced today. Agouron Pharmaceuticals will offer the drug, which has not been approved by the Food and Drug Administration, to AIDS patients who have stopped using the three commercially available protease inhibitors. The number of patients expected to enroll in the program is estimated to be between several hundred and several thousand. Patients and doctors should call 1-800-621-7111 for information about the program. "HIV Home Test Kit Picks up on Market" USA Today (09/16/96) P. 4B; Wells, Melanie While Johnson & Johnson's home HIV test kit, Confide, is now becoming available at stores outside of Texas, its introduction has not been widely advertised due to a conflict in the company. J&J has been ordered to relinquish its rights to the test to its creator, Elliott Millenson, who was fired by the company in 1993. In the meantime, the company has filed a lawsuit, but has limited advertising of the test since it does not have much of an incentive to kick off a huge campaign--one which some say could have cost $20 million. Some commercials have appeared, and J&J says more national advertising is coming soon. "In Changing Face of Illness, an Optimistic Prognosis Emerges" Washington Post (09/16/96) P. A3; Brown, David Deaths from infectious diseases will continue to decline between now and 2020, while deaths from noncommunicable diseases and accidents will rise, according to a new report from the World Health Organization. Although the rate of AIDS has not yet peaked in some countries, the fraction of deaths caused by infection, childbirth, and malnutrition, is expected to drop by more than half by 2020. The authors of the study assumed that the AIDS epidemic will reach a plateau in 25 years, with regional death rates attributed to the disease about half of what they are now. The trend is expected due to changes in demographics, economics, and technology. "Drug War Isn't About Marijuana as Medicine" New York Times (09/16/96) P. A14; Szasz, Thomas Financier George Soros' support for the medical use of marijuana appears inconsistent with his efforts to support the war on drugs, claims Dr. Thomas Szasz, a psychiatrist at the State University of New York. In a letter to the editor of the New York Times, Szasz says that legalizing marijuana for medical use would shift the responsibility to the physician who would prescribe it. Marijuana would simply become another "dangerous drug" controlled by the government, he concludes. "AIDS Patients Slipping Through Safety Net" New York Times (09/15/96) P. 24; Kolata, Gina Due to increased demand for new AIDS drugs, and the high cost of the treatments, government programs designed to provide the drugs free to needy patients are failing. The AIDS Drug Assistance Program was established by Congress to give states money to provide the drugs to uninsured or underinsured people. Recently, however, states have been forced to limit the drugs they provide, or make applicants wait for treatment. Nearly half of all states are limiting, or are expected to limit, access to the new protease inhibitors. A lobbying group for AIDS patients estimates that the $190 million appropriated for the program in the 1996 budget is less than half of what is needed. "AIDS Claims Five Each Day in Northern Thailand" Xinhua News Agency (09/15/96) In northern Thailand, five AIDS patients die each day, and 100,000 people in the country contract HIV each year, the Population and Community Development Association reports. The two provinces hardest hit by the disease are Chiang Mai, with 6,370 patients, and Chiang Rai, with 4,802. An estimated 900,000 people in Thailand have AIDS, 70 percent of whom are between the ages of 15 and 24. "White House Releases Clinton Health Information" Reuters (09/13/96) In response to challenges from Republican presidential candidate Bob Dole, the White House released on Friday President Clinton's medical records. The documents included a report that Clinton, as part of an insurance physical, tested negative for HIV in 1990. The medical summary also said Clinton "has no history of hypertension, diabetes, tuberculosis, sexually transmitted disease, cancer, stroke, or heart disease." "Botswana Faces Serious Threat of AIDS" Xinhua News Agency (09/13/96) Botswana's growing AIDS rate has prompted the government to urge people to change their sexual attitudes and habits. Last year, an estimated 12 percent of the country's 2 million people were thought to have AIDS. Doctors are struggling to handle the increase in demand from the disease; some 40 percent of the hospital beds in the country are occupied by AIDS patients, according to Botswana President Ketumile Marire. "Frequent Infection of Peripheral Blood CD8-Positive T-Lymphocytes With HIV-1" Lancet (09/07/96) Vol. 348, No. 9028, P. 649; Livingstone, W.J.; Moore, M.; Innes, D.; et al. Patients infected with HIV-1 suffer the loss of CD4 T-cells, which are critical to the body's immune system. However, while CD4 cells have been identified as the main target for HIV-1, the extent of infection of other immune cell types remains unknown. Scottish researchers, along with the Edinburgh Heterosexual Transmission Study Group, studied both the types of cells infected in 16 HIV-infected individuals and the relation of viral load to disease progression. In seven of the eight patients who were asymptomatic for AIDS, CD4 T-cells were the main reservoir of HIV. In five of the eight patients with AIDS, infection of CD8 cells accounted for 66 percent to 97 percent of the total proviral load. This finding contradicts previous studies which found that CD8 cells remain uninfected. The authors say their results provide evidence that HIV-1 more broadly infects different cell types in vivo than described in laboratory tests. They suggest that the decline in CD8 cells may be attributed to HIV's impact as AIDS develops. "Drug Therapy: Ganciclovir" New England Journal of Medicine (09/05/96) Vol. 335, No. 10, P. 721; Crumpacker, Clyde S. In the New England Journal of Medicine, Dr. Clyde S. Crumpacker, of Beth Israel Hospital in Boston, Mass., discusses ganciclovir, the first antiviral drug effective against cytomegalovirus (CMV) disease. CMV retinitis is a common and potentially blinding infection in AIDS patients. In a study of 157 AIDS patients, CMV retinitis was the initial AIDS-defining opportunistic infection in 3 percent, and it developed later in an additional 26 percent. The disease progressed from unilateral to bilateral in 60 percent of patients who did not receive ganciclovir. Among 18 patients with unilateral disease, none progressed to bilateral disease while taking the drug. Studies with AIDS patients with CMV retinitis have found that ganciclovir and foscarnet are equally effective, and that a combination of the two drugs is superior against the disease, but neither therapy offered a clear survival benefit. Oral and intravenous ganciclovir were found to be similarly effective for maintenance therapy. Moreover, those AIDS patients in whom disseminated CMV infection is associated with weight loss have gained weight while taking ganciclovir. Oral ganciclovir has also shown promise in preventing CMV disease in AIDS patients.