Subject: CDC Summary Date: 3/30/93 (251 lines) From: National AIDS Info Clearinghouse Copyright 1993, Information, Inc., Bethesda, MD AIDS Daily Summary March 30, 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 "NIH Starts Safety Trials of HIV Vaccine for Young" Wall Street Journal (03/30/93), P. B6 The National Institutes of Health has announced that it has initiated the first trial of AIDS vaccines in HIV-positive children. The safety trial is intended to determine whether a therapeutic vaccine can postpone the onset of AIDS in HIV-infected children. The children involved in the clinical trial will be aged one month to 12 years. The vaccines are manufactured by Chiron Corp.'s Biocine joint venture with Ciba-Geigy, in Emeryville, Calif.; Genentech Inc. of South San Francisco, Calif.; and MicroGeneSys Inc. of Meriden, Conn. Secretary of Health and Human Services, Donna Shalala, said the study is "a hopeful milestone in our efforts to ameliorate the tragedy of HIV-infected children who now face the certainty that they will develop AIDS." In a separate issue, the NIH has verified that MicroGeneSys has withdrawn from a similar three-way therapeutic vaccine trial in adults, as a result of a disagreement over study design. Last fall, the company spurred controversy by lobbying Congress to appropriate $20 million for a Defense Department study of its product alone. Related Story: USA Today (03/30) P. 1D "Health and Behavior: HIV, Immigration, and Rise in Tuberculosis" USA Today (03/30/93), P. 4D Federal health officials said Monday that the growing number of HIV-positive patients and infected immigrants have contributed to the re-emergence of tuberculosis in the United States. In the mid-1980s, the prevalence of TB had declined to record lows. However, in 1991, there were 26,283 new cases, which is 18 percent higher than 1984. Dr. Anthony Fauci of the National Institutes of Health told a U.S. House subcommittee Monday that TB transmission often transpires in hospitals, prisons, and shelters, where those infected with HIV comprise an increasing population. Dr. William Roper, outgoing director of the Centers for Disease Control, cited several other groups also at high risk including: immigrants from countries with high rates of TB, elderly nursing home residents, children under five years of age, and the poor. "AIDS Benefit at Industria" New York Times (03/30/93), P. B10 (Spindler, Amy M.) A children's street fair benefiting the Pediatric AIDS Foundation will take place on April 18 in New York City at the Industria Superstudio photography complex. Paul Wilmot, Vogue's publicity agent, will set up booths operated by Christy Turlington, Veronica Webb, and Isabella Rossellini, while Kenny Scharf, Julian Schnabel, and Francesco Clemente will help children develop murals for hospitals. In addition, Mark Morris will teach dance; Brian McNally will organize the food, and Fabrizio Ferri will supervise the taking of family portraits by Eric Boman, Walter Chin, Annie Leibovitz, and Sheila Metzner. The event, called Kids for Kids, is chaired by Anna Wintour, editor-in-chief of Vogue, Donna Karan, and Elizabeth Glaser, a founder of the Pediatric AIDS Foundation. All proceeds will be given to the Ariel Project, an AIDS research group that is part of the foundation. "Senators Challenge State AIDS Actions" United Press International (03/29/93) Sacramento--California state senators chastised Gov. Pete Wilson's administration Monday for rescinding AIDS education and prevention funding in 12 Northern California counties. Sen. Mike Thompson (D-St. Helena) told the health subcommittee he chairs that even though there is a significant need for help, the budget allotted for AIDS education programs in rural counties was severely reduced by the state Office of AIDS. The money was for the fiscal year that begins July 1. Thompson said the state has virtually abolished funding for 11 counties, and that the decision does not recognize the fact that many HIV-positive people are moving from urban to rural areas. Karan Mackey, chairwoman of the Lake County Board of Supervisors, said AIDS education and prevention programs are essential in rural areas because many residents falsely believe it is a city problem. In addition, the rate of HIV infection in some rural counties is higher than several urban areas, said Mackey. Frank McGarvey, an AIDS education official from Mendocino County, said that without state support "there will be no AIDS education-prevention in the county" even though the prevalence of AIDS there is exceeded by only nine other areas in the state. But AIDS Office chief Wayne Sauseda told the committee that rural California counties would be allotted a total of $800,000 under the proposed budget, or about $1 million less than in the current year. He admitted that the competitive process resulted in funding gaps, but said, "We simply did not have enough money to fund all the applications that received a passing score." "AIDS--A Test of Faith III" Associated Press (03/30/93) (Briggs, David) When it comes to AIDS and the church there is some disagreement about whether those with the disease deserve their fate, but some faithful individuals seek solutions that are both compassionate and true to their own beliefs. Ronald H. Sunderland of the Foundation for Interfaith Research and Ministry in Houston, said, "This is a response of God's people to people being sick. That, to me, has always been the bottom line. If you force (other) issues together, you're going to confront over and over again problems we don't need to face, and the people who are going to suffer are people with AIDS." Although the Roman Catholic church teaches sexual abstinence before marriage, Judy Hunter, who was a consultant for the Catholic AIDS education curriculum, discusses condoms and homosexuality when she gives AIDS education seminars in diocese around the country. However, she says "there is no such thing as safe sex," and describes a case in which one spouse infected another despite practicing protected sex. The Rev. Rodney DeMartini, executive director of the San Francisco-based National Catholic AIDS Network, said he can relate to the frustration by AIDS activists, but he said they also need to acknowledge there is probably not one Catholic Charities agency in the nation that does not have an AIDS ministry, while several of the larger dioceses have full-time AIDS programs. "Researchers at UC San Francisco and The Gladstone Institute Map Key Protein Interaction Believed to Control HIV Growth Inside Cell" Business Wire (03/25/93) San Francisco--The direction of a cellular protein interaction which plays a key role in controlling the growth of HIV inside human T-cells has been tracked by University of California-San Francisco researchers at the Gladstone Institute of Virology and Immunology. The proteins, called NF-Kappa-B and I-Kappa-B, are inactive when the T-cell is in a resting state. However, once an HIV-positive T-cell is activated, these proteins incite the series of events that leads to reproduction of the virus inside the cell nucleus, the researchers report in the March 26 issue of Science. The scientists also found a unique relationship between the proteins, in which NF-Kappa-B is initially inhibited by I-Kappa-B but is released and later spurs new production of its own inhibitor. Warner C. Greene, M.D., Ph.D., UCSF professor of medicine, microbiology, and immunology, and chief author of the report, said I-Kappa-B's normal function is to help regulate cell growth and monitor how the cell responds to all kinds of outside invaders, such as bacteria and viruses. As a result of understanding the inner workings of HIV, researchers may reveal new ways to block the virus' destructive path. Researchers in Greene's lab monitored the action of I-Kappa-B over a few hours, noting its presence, disappearance, and then re-emergence inside an activated human T-cell. The researchers discovered that the protein initially serves as an anchor for NF-Kappa-B, which normally sits outside the nucleus of the cell. When the cell is subjected to an outside offender, I-Kappa-B releases its captive NF-Kappa-B, which then moves to the nucleus to activate genes which help fight off the invader. "CDC-TB" Associated Press (03/25/93) Atlanta--Federal health officials announced Thursday that more than 200,000 people released from prisons and drug-treatment centers may spread tuberculosis every year if those institutions don't test and treat every one who enters the facilities. Christopher Hayden of the Centers for Disease Control conceded that attempting to get prisoners and clinic patients "to complete a full, uninterrupted course of preventive therapy unless they are in a supervised setting would be almost impossible. About 10 million Americans are carriers of TB, and about 20,000 active cases are diagnosed each year. However, the prevalence of TB is three times higher in prisons than the general population. It is also high at drug-treatment centers because drug users and HIV-positive patients are most at risk. HIV-positive patients with TB must receive 12 months of medication, while HIV-negative patients must receive only six months. The CDC said that every year, 540,000 inmates are released and 645,000 people finish treatment at drug clinics. Also, about 240,000 of them have latent TB infection and spread the germ. The federal agency issued the first concrete evidence that those facilities not only are important test sites, but also can succeed in helping those at high risk for TB to complete treatment and prevent the spread of disease. Nevertheless, the American Correctional Health Services Association told the CDC two weeks ago that most prisons cannot afford to even test for TB, much less provide preventive treatment. Hayden said that the CDC funded TB programs at 25 prisons and drug clinics in 1990 and 1991 and has added another 13 prisons and clinic TB programs to the list this year. "NIH Awards SBIR Grant to Progenics Pharmaceuticals to Study HIV Life Cycle" PR Newswire (03/29/93) Tarrytown, N.Y.--The National Institutes of Health has awarded biopharmaceutical company Progenics Pharmaceuticals, Inc. $50,000 under Phase I of a Small Business Innovation Research Program (SBIR) Grant. Progenics specializes in the development of therapeutics, vaccines, and diagnositics to treat diseases, particularly HIV infection. The grant will allow the company to expand its therapeutic discovery program by developing a new model system to study HIV's entry into target cells. A key component of the viral life cycle is HIV entry. This is mediated by two crucial events--attachment and fusion--that result in the entry of the viral genetic information into the target cell. HIV-positive cells can attach to and fuse with uninfected CD4 cells, as well as viral particles, thereby forming multinucleated giant cells known as syncytia. The presence of syncytia strongly suggests the development of AIDS-related complex and AIDS. Stephen P. Goff, Ph.D., of Columbia University, the chairman of Progenics' Scientific Advisory Board, said, "Progenics is developing a new model system to study HIV entry that will be extremely valuable in analyzing its role in the biology of HIV infection and the pathogenesis of HIV disease." Paul J. Maddon, M.D., Ph.D., Progenics' chairman and CEO, said, "This grant, our third from the SBIR program, will allow Progenics to expand its HIV research program and will lead to a more comprehensive understanding of the viral life cycle. Our goal is to accelerate the company's effort to design new therapeutic strategies to block HIV infection." "How Clean Needles Are Saving Lives" U.S. News & World Report (03/29/93) Vol. 114, No. 12, P. 24 (Friedman, Dorian) As the debate continues over the distribution of clean needles to IV-drug users, there is increasing evidence that these programs are preventing new cases of HIV infection and saving lives. Many conservative politicians and some religious and black leaders oppose the programs, claiming they promote drug use. But a study by Yale University researchers started in 1990 has shown that the share of returned used needles testing positive for HIV has dropped significantly--from 68 percent to 41 percent. It has also found that more addicts are trading in more needles and they are holding on to them a shorter time, indicating they are sharing them less. Moreover, the Yale group predicts a reduction of at least 33 percent in the rate of new HIV infections. The study's findings have prompted similar efforts in the United States. San Francisco Mayor Frank Jordan declared a public health emergency last week so his city could implement a successful--but until now, illegal--needle exchange program despite opposition from some state officials. Also, in New York City, Mayor David Dinkins moved to legalized needle-exchange programs last year. The early findings suggest that needle sharing is down, referrals to drug treatment are increasing, and there is no evidence that the programs have attracted new drug users. Prof. Edward Kaplan, head of the Yale research team, said, "All evidence strongly suggests that these programs can work well. So the idea that they shouldn't even be considered strikes me as very bad public policy." This week, the federal General Accounting Office is expected to reinforce the positive findings in a review.