Subject: CDC Summary Date: 4/2/93 (244 lines) From: National AIDS Info Clearinghouse Copyright 1993, Information, Inc., Bethesda, MD AIDS Daily Summary April 2, 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 "New Study Questions Use of AZT in Early Treatment of AIDS Virus" New York Times (04/02/93), P. A1 (Altman, Lawrence K.) Early treatment with the AIDS drug AZT for HIV infection may not be necessary, according to a large European study published in this Saturday's issue of The Lancet. The drug is prescribed to people infected with HIV long before they develop full-blown AIDS. However, the new study did not find an evident benefit in taking AZT early in the course of infection. The research, which was conducted in England, France, and Ireland between October 1988 and October 1991, is known as the Concorde study. It was carried out at 65 medical centers in the three countries, and involved a total of 1,749 HIV-positive people. Half of the volunteers were given AZT, while the other half were given a placebo. The survival rate was 92 percent among those who were treated immediately after diagnosis, and 93 percent among those who were given a placebo. The study found the rate of progression from infection to AIDS or death to be 18 percent in both groups involved. Dr. Dan Hoth, an AIDS expert at the National Institute of Allergy and Infectious Diseases in Bethesda, Md., said American scientists were expecting to meet soon with the researchers who conducted the study to examine all the data. The meeting is scheduled to be held in June in Washington, but until then, he said, "we see no basis for making a change in the use of AZT in the current clinical practice in the United States." Nick Partridge, head of the Terrence Higgins Trust, an AIDS charity and advocacy group in Britain, said the new findings could deter some people from getting tested for HIV if they believe there is not an effective early treatment. Related Stories: Washington Post (04/02) P. A1; Philadelphia Inquirer (04/02) P. A3; Financial Times (04/02) P. 1 "36 Haitians With AIDS Virus to Get Treatment in U.S." Washington Post (04/02/93), P. A10 A total of 36 HIV-positive refugees detained at the U.S. Naval base in Guantanamo Bay, Cuba, will be admitted into the United States for treatment, the Justice Department announced yesterday. The department noted that the move was taken to comply with a court order issued last week and does not indicate a policy change. The department said, "Under the terms of the order, 36 Haitians will be brought to the United States as soon as the appropriate arrangements can be made. This action is taken to comply with the court's order and does not represent a change in general policy." The 36 refugees allowed in the United States are among 250 others held at the naval base because either they or their family members are infected with HIV. Officials have conceded that the 250 have legitimate political asylum claims, but must be held at the base because HIV infection prohibits them from being admitted into the United States. U.S. District Judge Sterling Johnson Jr. in New York ruled last Friday that the U.S. government had 10 days to comply with his ruling that the government must provide medical treatment for those refugees or send them where they can be treated. The judge did not mention where the refugees should be taken for treatment but specified that they should not be repatriated to Haiti. An attorney representing the Haitians, Joseph Tringali, said there were 35 refugees who have developed AIDS, while the government earlier said that there were only 15 to 20. The department's decision to bring 36 to the United States suggests it agrees with Tringali's figure. "Federal Payments Ending for Hemophiliacs With AIDS" Toronto Globe and Mail (04/01/93), P. A1 (Picard, Andre) Canadian government funds compensating people who contracted HIV during the tainted blood scandal will soon come to an end, leaving many hemophiliacs to die without any money. The blood scandal transpired before 1985 when blood products contaminated with HIV were distributed to hemophiliacs and people receiving transfusions without adequate warning about a potential problem. Hemophiliacs and former blood transfusion recipients with HIV say the end of government aid when they are dying in record numbers emphasizes how they have been abandoned by the health-care system. Most likely, within the next few years, the nearly 800 hemophiliacs and 300 transfusion recipients who received the infected blood will die. On Dec. 14, 1989, Perrin Beatty, the federal health minister at the time, announced a "catastrophe relief plan" to compensate those who became infected as a result of the government's negligence. He emphasized that the $30,000-a-year payment was only a partial solution. "I have invited the provinces to do their part in responding to those needs in view of their role in the national blood-supply system ... and I support the society's efforts for obtaining additional assistance from the provinces," Beatty wrote to the Canadian Hemophilia Society. He decided that the victims of the tainted blood scandal deserved compensation of about $380,000--the federal government contributed $120,000. The provinces were expected to give the other $260,000 as a sort of disability insurance. However, in 1990, the provincial health ministers decided that they would act in unison or not at all, effectively thwarting any opportunity of a settlement with the victims of the scandal. "Law Notes: AIDS Exclusion" Wall Street Journal (04/02/93), P. B6 The American Civil Liberties Union and a South Carolina AIDS group have filed a lawsuit against South Carolina's insurance risk pool. The legal action claims that the risk pool, which insures people who have been rejected by private health insurers, infringes upon the Americans with Disabilities Act by denying coverage to people with AIDS. State legislators excluded AIDS patients when the pool was created. James C. Gray, a lawyer for the insurance pool, said the program is complying with state law. "AIDS Care for Inmates Is Called Satisfactory" Boston Globe (04/01/93), P. 34 (Hernandez, Efrain) A preliminary survey of Massachusetts prison inmates shows that their medical treatment seems to parallel what is provided for the general public, a member of a state task force said Wednesday. Medical records of more than half of about 320 inmates being treated for HIV were examined in preparation for the first meeting of a prison AIDS task force formed in February by state Public Safety Secretary Thomas C. Rapone, said officials. The task force consists of 178 members, who gathered in Rapone's office on Wednesday for the initial session. They were briefed on basic data discovered in the records of 173 prisoners. "Most of the charts looked very good. There were gaps in certain institutions that require further analysis," said Dr. Alfred DeMaria, director of the communicable disease control bureau for the state Department of Public Health. DeMaria said none of the flaws involved life-threatening situations, and that 85-90 percent of the inmate charts were satisfactory. Some of the institutions, however, did not keep up with inmates who were moved from one place to another, and failed to provide adequate counseling for inmates with HIV. DeMaria said that two institutions were found lacking in the routine immunization of inmates for illnesses like pneumonia. "Arrest Made in HIV Hoax" United Press International (04/01/93) Youngstown, Ohio--Federal Bureau of Investigation agents have arrested a man who allegedly called police claiming he injected HIV-infected blood into packages of beef at two area supermarkets. The FBI said Curtis Burley of Campbell, Ohio, admitted that the call was a hoax. On Wednesday, he was charged in Akron's U.S. District Court for knowingly communicating false information that a consumer product had been contaminated. Burley could receive up to five years in prison and a $25,000 fine if he is convicted. The man, who made the calls to police officers in Austintown and Boardman, said he had injected HIV into meat at two supermarkets because he was black and was prompted by hatred of white people. However, FBI agents said they had determined "incontrovertibly" that the incident was not racially motivated and they were convinced no products were affected. "N.Y.'s "Must Insure" Takes Effect, and 50,000 Lose Their Coverage" Investor's Business Daily (04/02/93), P. 27 After New York became the first state to prohibit small-group health insurers from charging different rates based on age, sex, or health yesterday, nine companies informed 50,000 customers that their policies were being dropped because they were abandoning the state. Other companies have raised rates as much as 170 percent. Chris Petersen, assistant general counsel at the Health Insurance Association of America, says, "When people see what happens in New York, I think it will dampen some enthusiasm for community rating in other states." Supporters of the law say it will help the elderly and the sick, especially those with AIDS, get coverage. "AIDS Conferees Get Berlin Assurance" Science (03/19/93) Vol. 259, No. 5102, P. 1698 (Amato, Ivan) The organizers of the 1993 International Conference on AIDS scheduled to take place in Berlin on June 7-11 are currently dealing with the implications from recent outbreaks of racial violence in Germany. A letter was sent to journalists who registered for the conference stating that in the wake of "recent violence against foreigners," people have been questioning the safety of guests in Germany. "We deeply regret and condemn the racist conflicts within Germany in the past few months," says conference chair Karl-Otto Habermehl, a virologist at the Free University of Berlin. However, he added, "The cosmopolitan open-mindedness and great tradition of tolerance which are so characteristic of Berlin have not been affected." According to Habermehl, the World Health Organization, the International AIDS Society, and other non-governmental groups asked him to "inform the whole world" that attendees at the conference--which typically attracts more than 10,000 researchers--are not in danger. He says the recent violence comes from "very small extremist groups acting against people who come from abroad to work." "French Drug Developers Face HIV Fallout" Science (03/19/93) Vol. 259, No. 5102, P. 1698 (Amato, Ivan) As a result of the French HIV-tainted blood scandal that prompted a widespread public anxiety in the country, French pharmaceutical companies are planning clinical trials of drugs made by recombinant DNA technology or derived from human or animal tissues. The blood scandal recently incited fear about the safety of medicines among French people. This led the French health ministry to stop clinical trials involving "products of biological origin" last December. Such studies were to proceed only after being approved by a new 10-member panel of experts on viral contamination. Because most of the stalled trials have not yet been approved, the drug industry has been up in arms. One senior executive said that the delay has seriously slowed the development of vaccines, monoclonal antibodies, and other medicinal products. One member of the new panel even admitted the health ministry was setting up the group of experts as a "panic reflex," before checking to ensure that clinical protocols would be assessed quickly. But Jean-Hugues Trouvin, a Paris-Sud University pharmacologist who chairs the panel, said that it has taken time to develop a standard questionnaire about company procedures for excluding live viruses from their products. He said the panel is now reducing its backlog. A total of 10 initial trials were approved when his group met on Feb. 24, and he expects to review the rest--up to 30 planned trials--within the next few months. Nevertheless, industry sources worry that the new regulatory process will continue to result in lengthy delays. "HIV Ambush: Studies Show the AIDS Virus Hides Out in Lymph Nodes Before it Attacks" Time (04/05/93) Vol. 114, No. 14, P. 19 The belief that HIV lies dormant in HIV-positive individuals for the greater part of infection has been disproved in two studies published in Nature. The studies found that once infection has been established, the virus immediately replicates millions of times in the lymph nodes--pea-size organs located throughout the body. After main parts of the immune system are eradicated, the excess amounts of the virus in the lymph nodes move into the blood. Due to the massive hidden attack, it may make it impossible to eliminate the virus from the body. The researchers suggest that these findings emphasize the importance of preventing HIV infection as a means to fight the spread of the deadly virus.