Subject: CDC Summary Date: 3/26/93 (263 lines) From: National AIDS Info Clearinghouse Copyright 1993, Information, Inc., Bethesda, MD AIDS Daily Summary March 26, 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 "Weld, Flaherty Pledge to Increase Funds for AIDS Prevention, Treatment" Boston Globe (03/25/93), P. 27 (Locy, Toni) Massachusetts Gov. William Weld and House Speaker Charles F. Flaherty signed a pledge Wednesday to increase spending for AIDS prevention and treatment. Project ABLE--the AIDS Budget Legislative Effort--conducted a State House news conference during which Weld said, "We wish to do more to ensure that AIDS and HIV treatment are given the public attention and funding they so obviously need." According to Weld, government officials are responsible for doing "everything we can to support the battle against this...hideous disease." In addition, Weld encouraged state residents to use the checkoff on Massachusetts tax returns to contribute to AIDS research funding. Michael Savage, vice chairman of Project ABLE, said AIDS funding has been lacking compared with the increase in the number of people with HIV or AIDS over the past four years. The number of AIDS cases has grown 115 percent over the past four years, even though funding for prevention and treatment has increased only 35 percent, says Project ABLE. The state Department of Public Health projects there are nearly 33,000 HIV-positive people living in Massachusetts. Savage said that because funding has not paralleled the number of cases, AIDS treatment providers have had to cut back on programs and have established waiting lists for AIDS-related services. The proposed fiscal 1994 budget includes a $5.5 million increase in AIDS prevention and treatment funding. "Red Cross Feared Losing Donors, Man Says" Toronto Globe and Mail (03/25/93), P. A6 (Downey, Donn) The Canadian Red Cross was reluctant to implement a high-profile effort in 1985 to safeguard its blood supply because it was afraid of discouraging people from donating blood, said a former Ontario director of the Canadian Hemophilia Society. Robert O'Neill, who testified Wednesday in a civil action against the Red Cross, The Toronto Hospital, and Dr. Stanley Bain, said that in mid-1985 he told the national director of donor recruitment for the Red Cross that high-risk donors should be warned that they could be HIV-positive. But, said O'Neill, the Red Cross gave the impression it did not want a high-profile campaign to scare away high-risk donors, and it did not want to prompt "public hysteria." The case involves Kenneth Pittman, who died of AIDS in March 1990 after receiving an HIV-infected blood transfusion in 1984 at the hospital. His widow, Rochelle, subsequently tested HIV-positive about five months after Pittman died. The three parties have been named as defendants in the $2 million lawsuit initiated by the family of Kenneth Pittman. O'Neill said that in 1985 he encouraged the Red Cross to provide its brochure on AIDS to potential donors before they gave blood. He said he first saw the brochure in May of 1985 after he donated blood at the Manulife Center in Toronto. O'Neill said he always read a donor questionnaire before giving blood, but in 1985 none of the eight questions it asked referred to AIDS, HIV, or high-risk donors. A second witness, only known as Mr. E., testified that he discovered his HIV-infection after his blood donation was rejected in December 1985. He testified that he had donated blood many times and had between 200 and 300 homosexual partners, but did not recall ever seeing the brochure. "City Criticized for Not Housing People With AIDS" United Press International (03/25/93) New York--Nearly 150 AIDS patients recently had to stay in city welfare offices overnight, according to a group of AIDS activists and city officials. They criticized the city for not using the available subsidies even when apartments are identified, and for increasingly using the offices known as Emergency Assistance Units. Virginia Shubert of the AIDS advocacy group Housing Works said at a news conference in the City Hall rotunda that she and other advocates met earlier with city officials and were told they expected too much from the city. However, Ellen Alpert, director of AIDS housing for the city who also attended the meeting, said the city is trying to cope with an overwhelming amount of new AIDS cases. "We are always working on that issue and they should not get frustrated, certainly with this mayor's office," she said, conceding that about 150 AIDS patients each week are referred to EAUs for assistance, while only a few end up spending the night in the offices. In addition, she said about 1,700 AIDS patients must now live in SRO housing, many without private kitchen and bathroom facilities, but the city was developing a plan that would provide housing for 300 AIDS patients within several years. Manhattan Borough president Ruth Messinger said, "It is unconscionable that the city is now sending homeless persons with HIV and AIDS to spend nights sleeping on plastic chairs in crowded and often filthy Emergency Assistance Units." Shubert also said that her agency did not expect to take legal action against the city. "Magic Johnson Urges Japan to Fight AIDS" United Press International (03/25/93) Tokyo--Former basketball star Magic Johnson spoke at an international symposium at which he urged Japan to join in the fight against AIDS with increased research and education, in addition to more compassion for those who have the disease. Johnson, who retired from the Los Angeles Lakers in 1991 after testing HIV-positive, addressed the symposium called "Living Together in the Age of HIV and AIDS." He said he was widely supported when the public learned of his condition, but that was a result of his celebrity status. "It is important to treat people the same way as before they were diagnosed as HIV-positive," said Johnson. He called for Japan to be more supportive of HIV-infected people and emphasized the significance of candid discussion about AIDS and safe sex with teenagers. He said, "Prevention is the key. You have to have safe sex. You can put on a condom just like you've put on that Lakers jersey," he said to a high school student wearing a Lakers shirt. All of the speakers at the symposium said that people with AIDS/HIV fight two battles: one against the tragic disease and the other against the social stigma attached to it. "FDA Grants Permission for Independent Clinical Study of Experimental Treatment for HIV Infection" Business Wire (03/24/93) Houston--The Burzynski Research Institute (BRI) has announced that the Food and Drug Administration on March 19 released from clinical hold Burzynski's Investigational New Drug Application (IND) for Antineoplaston AS2-1 capsules. The release means the drug can be tested in a phase I clinical study called "Treatment of Asymptomatic HIV Infection With Antineoplaston AS2-1." Burzynski's research shows that antineoplastons are naturally occurring peptides and amino acid derivatives that are components of a biochemical defense system which parallels our immune system. Burzynski suspects that the biochemical defense system protects us by reprogramming, or normalizing, defective cells, unlike the immune system, which protects us by eradicating invaders or defective cells. As a result of errors in cell programming, diverse conditions such as cancer, AIDS, autoimmune diseases, benign tumors, certain skin diseases, and Parkinson's disease may develop. According to Burzynski, without this corrective system, our immune systems would soon submit to damaging forces, such as viruses and dangerous environmental factors that are continually inciting abnormal cell development. "Recommendations for Prophylaxis Against Pneumocystis Carinii Pneumonia" Lancet (03/20/93) Vol. 341, No. 8847, P. 758 (Veugelers, Paul J.) The number of men at risk of pneumocystis carinii pneumonia (PCP), who are not treated according to current recommendations, can be reduced by adding CD4 cells below 20 percent of total circulating lymphocytes to the eligibility criteria, write Paul J. Veugelers et al. of the Department of Public Health in Amsterdam, Netherlands. Since October 1984, 513 HIV seropositive homosexual men have participated in the researchers' cohort study in Amsterdam. CD4 cells were examined every three months and, since February 1990, primary prophylaxis against PCP was recommended when CD4 cells fell below 200/uL. A total of 150 participants progressed to AIDS by January 1993, of whom 49 had PCP as their primary index diagnosis. When reviewing these cases, in 11 men the number of CD4 cells never dropped below 200/uL up to 14 days before PCP diagnosis. The researchers examined CD4 cells as a percentage of total circulating lymphocytes in these 11 cases. In seven, the percentage had decreased below 20 percent preceding their PCP diagnosis. These seven cases would have received PCP prophylaxis when this percentage was part of the eligibility criteria. Kaplan-Meier analysis among the 184 men who ever had a CD4 count less than 20 percent while their absolute number of CD4 cells was still above 200/uL showed that the median time from the date of their first CD4 count less than 20 percent to eligibility for treatment according to the current criteria (less than 200 CD4 cells per uL) was 21 months. When two assessments below 20 percent was taken as a criterion, the median time to treatment was 17 months. The researchers conclude that in some cases the criteria for primary prophylaxis against PCP are not effective. "Mycoplasmas in HIV-1 Seropositive Patients" Lancet (03/20/93) Vol. 341, No. 8847, P. 758 (Bebear, Christiane et al.) Mycoplasma fermentans DNA is present in different specimens from HIV-positive patients, write Christiane Bebear of the Centre Hospitalier Regional de Bordeaux in Bordeaux, France. In the Jan. 30 issue of the Lancet Dr. Katseni and colleagues report the detection of M. fermentans by a semi-nested polymerase chain reaction (PCR) in peripheral-blood mononuclear cells (PBMC), throat swabs, and urine samples, in similar proportions from HIV-1 seropositive or seronegative patients recruited from a sexually transmitted diseases clinic. Bebear et al. studied the detection of several mycoplasma species by culture and PCR in different specimens of 105 HIV-1 seropositive inpatients and outpatients recruited from two infectious diseases departments. Throat swabs, urethral or endocervical swabs, urine samples, and PBMC were cultured in media adapted to the growth of all mycoplasma species. All PBMC cultures were negative. No M. fermentans strain was isolated by culture from any specimen. PCR assay was performed on all lysed throat and genital samples, and on DNA extracted from PBMC, for the detection of M. fermentans, M. genitalium, and M. pneumoniae. Out of 105 patients, 28 (26.7 percent) had M. fermentans DNA detectable in at least one site. No difference was found between patients with or without M. fermentans DNA according to sex, age, source of contamination, antibiotic therapy, or stage of disease. Katseni et al. reported similar observations in blood in a smaller number of patients, and in blood, throat, and urine specimens. But the absence of positive cultures can be explained by the insensitivity of the approach for this microorganism, the researchers conclude. "News in Brief: California" Advocate (03/23/93) No. 625, P. 25 An AIDS patient who on Feb. 8 shot three doctors at the Los Angeles County-University of Southern California Medical Center in Los Angeles told television interviewers that he was irate over the inadequate AIDS treatment he received while at the hospital. The man, Damacio Ybarra Torres, was arraigned Feb. 10 after allegedly shooting the doctors and holding two staff members hostage during a four-hour standoff with police. Torres pleaded not guilty to attempted-murder and kidnapping charges during the arraignment. He told television station KABC in Los Angeles, "I was the victim of a medical conspiracy. They refused me treatment for ten years. I'm in ill health, and they don't give a damn. Where can I go?" AIDS activists have long claimed that AIDS care at the hospital is poor and blame the Los Angeles County board of supervisors with neglecting to earmark enough funds for AIDS programs. "Screening Blood Donors by Computer Interview" Journal of the American Medical Association (03/24/93-03/31/93) Vol. 269, No. 12, P. 1505 (Wright, Michael P. and Silberstein, Fred B.) The sensitivity of Locke et al.'s study in the Journal of the American Medical Association on screening blood donors by computer interview is questionable, write Michael P. Wright and Fred B. Silberstein of the Scientific Social Research in Norman, Okla. and the University of Oklahoma--Norman, respectively. Locke et al. show that potential blood donors are more apt to disclose personal risk factors for HIV infection in private computer interviews than they do in response to written questionnaires and face-to-face encounters. Locke et al. claim that their computer interview is "more sensitive" than the conventional method. But a case of error could be declared for any subject who was assessed not at risk by the computer interview process. Using a computer interview incorporating a refined probability analysis, this experimental method has been demonstrated using a group of HIV-positive subjects who reported personal behavior experience prior to their antibody tests. Locke et al. reported that 96 percent of their subjects were without HIV risk factors. They did not say for certain that no members of this group were infected. All subjects were HIV-negative, but because of the latency period, it is unknown that they were all uninfected. Unless this question is discussed, comments about sensitivity seem premature. A complete assessment of sensitivity would involve HIV-positive subjects in order to measure the success rate of the computer interview procedure in recognizing risk factors from those who were obviously at risk, conclude Wright and Silberstein.