Subject: CDC Summary 3/25/93 Date: Thu, 25 Mar 1993 08:13:35 PST (215 lines) Archive-Number: 497 From: Billi Goldberg Note: Copyright 1993, Dan R. Greening. Non-commercial reproduction allowed. sold. Copyright 1993, Information, Inc., Bethesda, MD AIDS Daily Summary March 25, 1993 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. Copyright 1993, Information, Inc., Bethesda, MD ==================================================================== "AIDS Virus Replicates on a 'Massive' Scale Soon After Infection" Washington Post (03/25/93), P. A3 (Brown, David) Two new studies published in today's Nature suggest that HIV replicates in lymph nodes on a "massive" scale shortly after infection, even though it was previously believed that the virus went into a "latent" stage. This latent stage was thought to last years, during which time it damaged relatively few cells and could not be detected in the blood. But the two articles say a patient's absence of symptoms or lab test abnormalities is a poor indication of what is actually transpiring. Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases and co-author of one of the studies, said, "Clinical latency does not mean disease latency." The new discoveries indicate that--theoretically, at least--it might be useful to treat HIV patients much earlier than they are now. Fauci said if there were a perfect drug that never conferred resistance in the virus, such treatment would be practicable. However, he added, no antiretroviral drugs are now available for such long-term use, and current guidelines for drug treatment should still be followed. The two studies examined evidence of viral infection in lymph nodes of patients at various stages of HIV infection. It now seems that soon after HIV enters the bloodstream, it is transported to a nearby lymph node, at which point it is filtered out by a complex of cells that incite the immune system to attack HIV. Subsequently, the virus' genetic code, in the form of RNA, is displayed prominently on the surface of a particular kind of cell in the node. As a result, it is available to infect white blood cells that travel through the node and carry the virus to other areas. Related Stories: Wall Street Journal (03/25) P. B12; Washington Times (03/25) P. A5; USA Today (03/25) P. D1; Los Angeles Times--Washington Edition (03/25) P. A8; Philadelphia Inquirer (03/25) P. A4 ==================================================================== "Enzo Biochem's Test for HIV" Wall Street Journal (03/25/93), P. B12 A new test to detect HIV in the blood by finding viral genes instead of antibodies' reacting to the virus has been developed by a unit of Enzo Biochem Inc. "BioChem to Test AIDS Drug" Toronto Globe and Mail (03/24/93), P. B12 Montreal pharmaceutical company BioChem Pharma Inc. has announced it will start PhaseII/III clinical trials of its AIDS drug 3TC next month. This phase of testing is the last before the company applies for regulatory approval of the drug. The company claims the drug causes fewer adverse effects than other AIDS treatments. The tests will be conducted on 320 HIV-positive patients in Europe and about 500 subjects in North America, including Montreal. The trials will use 3TC alone or in combination with other HIV therapies, including AZT. BioChem expects to have a complete analysis of the trial findings before the end of the year. ==================================================================== "Metro Firms: Viral Technologies Lands Vaccine Patent" Washington Times (03/25/93), P. C3 Viral Technologies Inc., the jointly-owned subsidiary of CEL-SCI Corp. of Alexandria and Alpha 1 Biomedicals Inc. of Washington, D.C., has been awarded a European patent for an AIDS vaccine, the companies have announced. Viral Technologies developed the HGP-30 vaccine, which is unique because it is a synthetic copy of part of the core protein of HIV. ==================================================================== "House Panel Rejects Needle Exchange Plan" Baltimore Sun (03/25/93), P. 1B (Bowman, Tom) A proposal to implement a pilot needle exchange program in Baltimore, Md., as a way to thwart the spread of HIV among IV-drug users was rejected yesterday by a state House panel. The House Judiciary Committee voted 11 to 13 against the legislation, which Baltimore Mayor Kurt L. Schmoke and other proponents patterned after effective programs in U.S. and European cities. The majority of those who opposed the bill said they did not approve of the concept of allowing IV-drug users to turn in dirty hypodermic syringes in exchange for clean ones. The panel's decision signifies the second time in two years such a proposal has been rejected. Advocates of the needle exchange program said that needle exchanges have proven effective in the seven states and eight foreign nations that have established such programs. A study at Yale University discovered that the New Haven needle exchange program reduced HIV infections by one-third without evidence of increased drug use. State Attorney General J. Joseph Curran Jr. and Health Secretary Nelson J. Sabatini supported the program even though Gov. William Donald Schaefer opposed it. The governor believes such a program would result in more drug use. The three-year pilot would have cost $50,000 in city funds and donations. The proposed program would have involved up to 700 addicts, who would have been offered anti-drug and AIDS counseling in addition to clean needles. Also, the city Health Department was expected to monitor and evaluate the program. The measure required approval by the General Assembly because an exemption was needed from the state's drug paraphernalia law, which prohibits unauthorized ownership of hypodermic syringes. ==================================================================== "Kentucky Dentist Plans to Bring Self-Sheathing Needle Invention to Market" Knight-Ridder (03/23/93) (Johnson, Darragh) Lexington, Ky.--Because the threat of AIDS is an everyday occurrence for some health-care professionals, a needle has been developed that automatically re-covers itself. Dentist Dr. Bart McFarland invented SafeMate, the self-sheathing device, and hopes that it will be on the market and selling to doctors nationwide within a couple of months. Before McFarland's invention, doctors had to implement several sloppy and slow methods for re-covering the fronts of their needles. These methods diverted attention away from the patient the health-care worker had just pricked. Also, these techniques were not foolproof--they only covered the fronts of the needles, leaving the backs open. McFarland's needle comes with a plastic case that fits over the needle and locks into place. The physician screws the needle into the syringe before injection, then unhooks the case and slides it back onto the syringe. After the needle has been used, the doctor slides the case back over the needle. This device covers the needle from behind, so it can never prick the doctor's skin. The SafeMate self-sheathing needle also covers the back of the needle. McFarland was granted a patent in 1987 and has been working with designers and business professionals to ensure that the cover will lock into place in order to obtain Food and Drug Administration approval. ==================================================================== "Governor Tucker Announces Conference on 'Business Responds to [AIDS]'" PR Newswire (03/23/93) Little Rock, Ark.--Arkansas Gov. Jim Guy Tucker announced Tuesday that a Conference on "Business Responds to [AIDS]" will be held on April 23 at the Statehouse Convention Center in Little Rock. The governor's office, in conjunction with the Arkansas business community and the Centers for Disease Control will conduct the meeting. At the conference, health professionals, business owners, and managers will address better ways to prepare the business community to cope with major health problems created by HIV infection. Information will be discussed candidly and advice will be given on dealing with the crisis within personnel systems. Topics addressed will include prevention education, workplace policies, volunteerism, and community support. Gov. Tucker said, "Educating the workforce about this disease is the best way to stem the tide of AIDS-related illness." He added, "Arkansas currently ranks fifteenth in the nation in incidence of HIV/AIDS per capita. Business must act now in decisive ways to prevent the spread of the disease among the state's workforce and to protect our social and economic health." Most people who are infected with HIV throughout the nation fall within the age group of 25-44 year olds. Tucker said that half the nation's workforce falls within this category and that AIDS is the third leading cause of death in this age group. ==================================================================== "The Prevention Game" Science (03/12/93) Vol. 259, No. 5101, P. 1537 (Flam, Faye) A new HIV/AIDS educational game has been developed specifically for classroom use. "AIDS Is No Game" teaches teenagers about HIV and AIDS by asking questions like, "Can HIV be spread by sharing eye make- up?" or "A drop below what number of T-4 helper cells usually marks the early stages of AIDS?" The game separates the class into two teams, which are then questioned about AIDS research, medicine, prevention strategies, and social issues. The game is designed and marketed by Programming Concepts Inc. of San Antonio, Texas. The "AIDS is No Game" features buttons with pictures of HIV, an "Epidemic Watch" poster that lets students follow track the spread of HIV throughout the United States, dice playing cards, and pre- and post-game tests. The game, which costs $300, is being promoted as an "educational vaccine," on the basis that education is the best means to avoid HIV infection. ==================================================================== "Phosphorodithioate DNA as a Potential Therapeutic Drug" Science (03/12/93) Vol. 269, No. 5101, P. 1564 (Marshall, W.S. and Caruthers, M.H.) A deoxyoligonucleotide inhibitor, which binds strongly to the primer-template active site of HIV-1 reverse transcriptase (RT), provides another type of potential therapeutic agent against HIV-1, write W.S. Marshall and M.H. Caruthers of the University of Colorado-- Boulder. Mechanistic studies suggest that phosphorodithioate DNA oligomers interfere with enzyme function by binding tightly to the active site for primer-template, which results in low or subanomolar inhibitory constants. While many of these studies have used deoxyoligocytidine analogs, a rationally designed approach has led to the discovery of a very active phosphorodithioate deoxyoligonucleotide inhibitor. Since HIV-1 RT is a bireactant enzyme, in order to complete the kinetic analysis the pattern of inhibition with respect to deoxynucleotide triphosphates (dNTPs) was determined for dithioate tetradecadeoxycytidine by using a similar analysis. The results of kinetic analysis suggest that both thioate and dithioate deoxyoligocytidine inhibit HIV-1 RT by specifically binding to the active site for primertemplate, thereby precluding the binding of the natural substarate and subsequent polymerization. Phosphorodithioate- containing deoxyoligonucleotides should be further explored as DNA therapeutic drugs, the researchers conclude. ==================================================================== "USA: Reorganization of AIDS Research" Lancet (03/20/93) Vol. 341, No. 8847, P. 747 (Rowe, Paul M.) Significant changes in the management of AIDS research at the National Institutes of Health will occur as a result of the NIH Revitalization Act of 1993, which has neared completion in Congress. The Senate passed its version of the act last month, and the House passed a very similar bill last week. The two versions will be incorporated into one, which will be on President Clinton's desk within weeks. The Senate bill, sponsored by Sen. Edward Kennedy (D-Mass.) and written along with scientists and AIDS activists, extends the power of the Office of AIDS Research (OAR), and upgrades its directorship to a full-time position. The new director of OAR will be under the authority of the NIH director. The OAR will be in charge of evaluating the AIDS research that is currently conducted by 21 of the institutes, centers, and divisions (ICDs) of NIH, both intramural (in Bethesda, Md.) and extramural (most NIH dollars go to universities via grants), and to identify redundancies and deficiencies in current programs. The OAR will develop a plan, which includes work in pathogenesis and basic science, natural history, and epidemiology, vaccine development, clinical research, and social and behavioral research. The director of the OAR will have the authority to encourage the ICDs to collaborate wherever duplicated efforts waste resources. Also, within two years, the OAR is scheduled to develop an overall AIDS budget to accompany the strategic plan. This budget will be formulated earlier than the rest of the NIH budget, and goes to the President separately. All objectives of the final bill except those dealing with future budgets will be enacted as soon as the bill is signed.