Subject: CDC AIDS DAILY SUMMARY 03/02/94 Date: Wed, 02 Mar 1994 09:39:22 CST (217 lines) Approved: phil (J. Philip Miller) Archive-number: 13226 From: "ANNE WILSON, CDC NAC" Note: Copyright 1994, Dan R. Greening. Non-commercial reproduction allowed. Copyright 1993, Information, Inc., Bethesda, MD AIDS Daily Summary March 02, 1994 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, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1993, Information, Inc., Bethesda, MD "Man With HIV Guilty of Raping Boy, and of Attempted Felony Murder" Baltimore Sun (03/02/94) P. 3A In a landmark jury decision, an HIV-positive Miami man has been convicted of attempted murder for the kidnapping and rape of a boy. A Dade County jury found that when Ignacio Perea kidnapped and repeatedly had forced anal intercourse with the 11-year-old, his sexual behavior was comparable to the use of a loaded gun--a deadly weapon. The prosecutors proved that Perea was aware of his condition, knew its fatal consequences, and realized the danger of anal sex--which presents the greatest risk of infection. Perea faces a minimum 25-year sentence. The case had been closely watched by those concerned about the implications the outcome would have on AIDS education and prevention. It also raised questions as to whether an HIV patient could be charged with attempted murder even though there was no claim that intent to kill was present. "I know there were some people who thought we were criminalizing a disease," said Assistant State's Attorney Susan L. Dechovitz. "All that we ask is that people act responsibly, be it with a gun or if they have a deadly virus." "Tuberculosis Vaccine Found Surprisingly Effective in Studies" New York Times (03/02/94) P. C14 (Altman, Lawrence K.) A vaccine to prevent tuberculosis that is rarely used in the United States, largely because federal health officials considered it unreliable, has been found to be surprisingly effective. A new statistical study by the Centers for Disease Control and Prevention reports that the vaccine, known as BCG, reduced the risk of full-fledged tuberculosis of the lung by 50 percent and death by 71 percent. The CDC in 1988 stopped recommending the virus for health care workers and other adults at risk for TB, but the new finding renews old public health policy debates about the use of BCG. "This is the most promising data on the effectiveness of BCG and it deserves a careful re-look, particularly for health care workers in this era of drug resistant tuberculosis," says Dr. Michael Tapper, an expert on infectious diseases at Lenox Hill Hospital in Manhattan and head of the AIDS and tuberculosis committee for the Society for Hospital Epidemiology of America. Skin tests have shown that as many as 50 percent of previously uninfected health care workers contracted TB during outbreaks of multiple-drug-resistant strains. TB is common among HIV patients, but the CDC advises against administering the vaccine to them. Therefore, if BCG is recommended for wider use among health care workers, it will raise the issue of not identifying such individuals for fear of violating the confidentiality of those with HIV. "Portuguese Company to Challenge Wellcome's AZT Patent" United Press International (03/01/94) Lisbon, Portugal--A small pharmaceutical firm in Portugal says it intends to challenge Great Britain's Wellcome Co. on its patent for AZT, which is used in the treatment of AIDS patients. Farma APS says it will distribute a Canadian drug that is "identical" to Wellcome's AZT, but is "significantly cheaper." "Committee Rejects Blood Donation Bill" Baltimore Sun (03/02/94) P. 2B A House committee has killed legislation that would have required physicians to inform patients that they can donate their own blood for use during elective surgery. The Blood Safety Act of 1994, which had passed the Senate, would also have allowed a friend or relative to donate blood for transfusions. Opponents contended that statistically, a patient is more likely to contract HIV through blood donated from someone close to them as opposed to blood from an anonymous donor. "Orthopedic Surgery Patients Who Are HIV-Positive Have Greater Risk of Infection and Other Complications, UC San Francisco Researchers Find" Business Wire (02/28/94) New Orleans--Asymptomatic HIV-positive individuals who undergo surgery for bone injuries face a significantly greater risk of infection than do orthopedic patients who are not infected, according to a new study from the University of California at San Francisco. Reviewing the medical records of 39 HIV patients and 667 uninfected patients, the researchers found that people with HIV were more than three times more likely to develop infections near the injured area. They were also more apt to experience other complications from the surgery, such as unexplained high fevers. "We have always thought that people with asymptomatic HIV infection were not at high risk of surgical infection," noted Dr. Guy D. Paiement, associate professor of orthopedic surgery at UCSF and chief of the Division of Orthopedic Surgery at San Francisco General Hospital. "That's not true." Paiement speculated that HIV patients are more prone to surgical infections and other complications because of limited immune system reserves. High infection rates are a major concern because infected patients risk the loss of a limb or the development of painful and lasting bone infections, he said. Paiement recommended that orthopedic surgeons closely observe HIV patients and treat them aggressively, possibly with different antibiotics. "Tainted Tuna Got More Attention, Blood Victims Say" Toronto Globe and Mail (Canada) (02/28/94) P. A7 (Mickleburgh, Rod) Through two weeks of public hearings, the Krever inquiry has digested disquieting verbal re-enactments of the events that led to the HIV infection of more than 1,000 Canadians through the country's blood supply from 1978 to 1985. Hemophiliacs, the overwhelming majority of those who were infected, were reassured instead of warned by their doctors and scientific advisors. Also, many Canadians who did contract HIV were not aware of their infection until long after the fact. This delayed treatment and placed their partners at significant risk of contracting the virus as well. However, hospitals have not made concerted efforts to notify all patients who received blood transfusions in that critical time period and recommend that they undergo HIV testing. Witnesses at the Krever inquiry hearings bitterly testified that while hospitals failed to scan records for patients who may have been at risk of HIV infection, significant efforts were made in tracing shipments of tainted tuna and strange-tasting candy. "Elton John to Host Second Annual Academy Awards Viewing Party to Benefit The Elton John AIDS Foundation; Oscar Night Fundraiser Is in Memory of Patrick Lippert" Business Wire (03/01/94) Los Angeles--A celebrity lineup including Whoopi Goldberg, Tom Hanks, Anthony Hopkins, Elizabeth Taylor, and Jane Fonda will join host and honorary chair Elton John on March 21 at The Second Annual Academy Awards Viewing Party to Benefit The Elton John AIDS Foundation. The organization was established in December 1992 as a nonprofit group providing funds for direct patient care services and prevention education projects nationwide. By the end of 1993, The Elton John AIDS Foundation had distributed grants worth more than $1.9 million. Last year's Oscar Night fundraiser raised more than $150,000. This year's event is in memory of longtime activist Patrick Lippert, producer of last year's event, who died of AIDS in July 1993. "Legal Briefs: PWA Asks for Right to Die" Washington Blade (02/18/94) Vol. 25, No. 7, P. 27 A homosexual man with AIDS is one of three people who in January lodged a lawsuit in Washington State challenging a state law that prohibits assisted suicide. Identified only as John Doe, the 44-year-old gay artist cared for his longtime companion, who recently died of AIDS. Kathryn Tucker, Doe's attorney, said that because he fully realizes what awaits him during the late stages of AIDS disease, Doe has decided to end his life. The lawsuit contends that prohibition of assisted suicide is a violation of the 14th amendment, which guarantees "liberty." "Tuberculosis and HIV Infection" Lancet (Great Britain) (02/12/94) Vol. 343, No. 8894, P. 416 (Reeve, Paul) In response to Godfrey-Faussett et al.'s implication that he may have been too quick in saying that tuberculosis chemoprophylaxis is not economically or practically feasible in Africa, Paul Reeve of Taumarunui Hospital in New Zealand adheres to his original argument. He finds it "simplistic" of Godfrey-Faussett et al. to use the price of drugs alone to estimate the cost of therapy. It costs much more than the $275 year's supply of isoniazid, says Reeve, to screen, counsel, and investigate to discover individuals co-infected with TB and HIV. And because HIV-related deaths in Africa are occurring much sooner, Reeves says he would not use data taken from a study of HIV-positive intravenous drug addicts in New York to predict that one-third of Africans infected with both MAC and HIV would develop TB within five years. In Africa, HIV is usually not diagnosed until the patient presents symptomatic disease, and few patients live longer than five years after diagnosis. While Godfrey-Faussett and colleagues contend that it may be cost-effective to screen people to exclude active disease before beginning preventive treatment, Reeves maintains that HIV is a terminal illness and the palliative treatment of HIV-related conditions must remain low priority in African countries with limited health budgets. "AIDS Law" Journal of the American Medical Association ( 02/16/94) Vol. 271, No. 7, P. 558 (Jurgens, Ralf) In the time since "AIDS and the Law: A Guide for the Public" went to press in 1988, AIDS has become one of the most litigated diseases in American history. Designed for the public rather than lawyers, the guide included a medical background on AIDS, a comparison to other epidemics, an analysis of the relationship between doctors and attorneys, and 16 essays on a wide range of issues related to HIV and AIDS. The 1993 edition, "AIDS Law Today: A New Guide for the Public," is viewed by the editors as an improved and updated version of the first book. This edition includes new chapters on HIV/AIDS issues related to privacy, reproduction and parenting, criminal law, travel, and immigration, as well as old chapters which have been rewritten, adapted slightly, or left unchanged. While there are many new additions to the book, several chapters have been omitted--in particular, those addressing communities that have been disproportionally affected in the HIV/AIDS epidemic. In response to criticisms, the editors defend the decision by saying that it is now clear that "[o]ne cannot talk meaningfully about AIDS without confronting issues of race, class, gender, and sexual orientation.... We have sought to treat them as integral aspects of everything we address." Still, these issues have all but disappeared in the new edition. Nevertheless, the book is sensible, humane, and able to present the issues in language understandable to non-lawyers, the editors conclude.