Subject: CDC AIDS Daily Summary Date: Fri, 17 Jan 1997 11:11:31 PST (182 lines of text) From: National AIDS Info Clearinghouse Copyright 1997, Information, Inc., Bethesda, MD AIDS Daily Summary January 17, 1997 The CDC National Center for HIV, STD, and TB Prevention makes available the following information as a public service only. Providing this information does not constitute endorsement by the CDC. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC National AIDS Clearinghouse should be cited as the source of this information. Copyright 1996, Information, Inc., Bethesda, MD ****************************************************** "A Few AIDS Vaccines Are Ready for Testing; Now, Who Goes First?" "French Doctor With AIDS Reportedly Infected Patient in Surgery" "Roche's Sales Rose 11 Percent in 1996" "Sheathed Needles Safer for Health Workers" "Hopkins to Offer HMO for AIDS" "Across the USA: New Hampshire" "Red Cross Could Still Collect Blood" "One Gala's Purpose Is to Frustrate Dornan" "This Doctor Wants to Help You Die" "Is Death Inevitable With Multiresistant TB Plus HIV Infection?" ****************************************************** "A Few AIDS Vaccines Are Ready for Testing; Now, Who Goes First?" Wall Street Journal (01/17/97) P. A1; Tanouye, Elyse AIDS experts agree that an AIDS vaccine is critical for ending the epidemic, but concerns about safety and liability have stalled human testing of viable vaccines. The argument is divided between those who favor going ahead with human tests despite a lack of confidence and those who say such tests would be unethical and wasteful. One key reason for the lack of confidence in the vaccines available is that the pharmaceutical companies have shown little interest in the effort. Some firms say their apparent lack of commitment to an AIDS vaccine is due to the lack of basic research. "We may have appeared to slow down," said Merck's Emilio Emini, "but that's because we're groping around in the dark." "French Doctor With AIDS Reportedly Infected Patient in Surgery" New York Times (01/17/97) P. A5; Simons, Marlise A French woman almost certainly contracted HIV from her doctor during surgery at a hospital near Paris, the French Health Ministry reports. If proven, it would mark the second time a patient was thought to be infected by a doctor through a medical procedure. The surgeon, Dr. Patrick Cohen, who claims he was infected by a patient he operated on in 1983, was not tested for HIV until 1994. The ministry has contacted 5,000 patients Cohen had operated on since 1983, and out of 986 former patients who were tested for HIV, only this woman was found to be infected. Dr. Luc Montagnier, director of the National Center of Virology and a co-discoverer of HIV, says that tests indicate it was "highly probable" that the virus was passed on from the doctor to his patient. The incident has renewed the debate over whether both doctors and patients should be screened for HIV before surgery. "Roche's Sales Rose 11 Percent in 1996" New York Times (01/17/97) P. D4 The Swiss pharmaceutical firm Roche Holding reported Thursday that its 1996 sales were up 11 percent, to $11.6 billion, and profits are expected to increase again. The company attributed the increase to sales of its leading products, such as the injectable antibiotic Rocephin, and the success of new drugs like the AIDS drug Invirase. "Sheathed Needles Safer for Health Workers" Philadelphia Inquirer (01/17/97) P. A18 Two government studies found that needles with safety sheaths or blunt tips may be the best tools to reduce healthcare workers' risk of contracting HIV and other diseases. Among the 51 documented cases of HIV infection among U.S. healthcare workers, 20 were caused by needlestick injuries while drawing blood. The first study found that the workers' risk of being pricked was reduced 76 percent by using hypodermic needles with plastic sheaths or small metal tubes that protect the needle tip as it is withdrawn. The second study showed that blunt suturing needles caused no injuries, compared to 56 injuries caused by sharp needles. The studies were conducted by the Centers for Disease Control and Prevention at several hospitals in major U.S. cities. "Hopkins to Offer HMO for AIDS" Baltimore Sun (01/17/97) P. 1B; Sugg, Diana K. In an effort to improve the efficiency of AIDS care without sacrificing quality, Baltimore's Johns Hopkins Hospital is planning to offer a managed care plan for AIDS patients only. In one of the first programs of its kind, the plan will involve the hospital's experienced AIDS specialists, who have a proven record of providing better care to AIDS patients at a lower cost than other Maryland hospitals. The program, which will start in March, will first enroll people in the state's Medicaid program. "Across the USA: New Hampshire" USA Today (01/17/97) P. 5A Tests for hepatitis and HIV are being given to 11 ninth graders in Concord, N.H., who pricked themselves with a lancet brought to school. "Red Cross Could Still Collect Blood" Toronto Globe and Mail (01/16/97) P. A3; McIlroy, Anne Despite its involvement in Canada's tainted blood tragedy on the 1980s, the Canadian Red Cross Society may be contracted by the federal government to continue collecting and distributing blood for up to three more years. The government previously announced that a National Blood Authority would be created to take over the blood system by September, but the agency may involve the Red Cross in the system. The Red Cross, however, would be required to separate blood collecting from its other operations and establish a separate board of directors. Ontario has opposed the plan and is calling for the Red Cross to have a much more limited role. "One Gala's Purpose Is to Frustrate Dornan" Washington Times (01/17/97) P. A11; Bedard, Paul Among the inaugural balls being held this weekend is the controversial Red Ribbon Inaugural Gala, organized by AIDS lobbyist Tom Sheridan to raise money to help a freshman congresswoman from California combat efforts by former Rep. Robert K. Dornan to reclaim his seat. The event is being hosted by the American AIDS Political Committee to support Rep. Loretta Sanchez (D-Calif.). However, other AIDS groups, such as ACT UP, have criticized Sheridan for not adequately supporting AIDS candidates in 1995 and 1996. "It's inauguration week and he's trying to get a piece of the action and profit," said ACT UP's Steve Michael, who suggests that people just send their money directly to Sanchez. Sheridan says the money used by his political action campaign in previous years went toward a direct mail fund-raising plan, voter education, and organizational help for candidates. "This Doctor Wants to Help You Die" New York (01/13/97) Vol. 30, No. 1, P. 25; France, David Dr. Howard Grossman, a New York physician who joined a lawsuit two years ago to overturn the state's ban on physician-assisted suicide, says he never expected the case to reach the Supreme Court. Grossman, along with two other doctors, filed the suit on behalf of one of his AIDS patients who did not want to face a slow, painful death. The doctor later gave him a large dose of morphine, a practice which is legal under a technicality of state law. A recent survey of 69 AIDS doctors showed that one-third admitted to actively helping administer a lethal drug--either in the form of pills or injections. Grossman notes, "AIDS docs are a different breed, we have dealt with a lot more death in a lot more intense way." Doubts about physician-assisted suicide may be increasing in the AIDS community, however, as new therapies improve survival among such patients. "I very much support this right," said Sean Strub, the founder and editor of Poz magazine, who has seen his health improve dramatically with new drugs. "But if this was a common, everyday practice and socially acceptable, it is something I would have seriously considered a year ago, when I was failing very substantially." "Is Death Inevitable With Multiresistant TB Plus HIV Infection?" Lancet (01/11/97) Vol. 349, No. 9045, P. 71; Drobniewski, Francis Patients infected with both HIV and multidrug-resistant tuberculosis (MDRTB) are more likely to survive if TB is diagnosed quickly and drug resistance is detected early, says Francis Drobniewski of King's College School of Medicine in a commentary in the Lancet. MDRTB is on the rise, due to poor patient compliance and inadequately supervised treatment, which usually includes isoniazid and rifampicin. Rapid progression from Mycobacterium tuberculosis infection to TB disease is more likely in HIV-positive individuals, as is the development of extrapulmonary disease. As evidence, Drobniewski cites a retrospective study of TB patients at a New York hospital. The research found that, of 38 patients with MDRTB, all but four were HIV-positive. Half of the patients responded to treatment, with an average survival time of 315 days. A second study showed improved survival when MDRTB was detected early and therapy was used. Response and survival in both studies were more likely if at least two treatments to which the isolate was susceptible in in vitro testing were used. In conclusion, Drobniewski urges the use of rapid tests for all major anti-TB drugs, the identification of new drug targets, and the development of new treatment strategies. She also notes the importance of advanced planning, close surveillance for nosocomial TB, and a high suspicion for the disease. The AIDS Daily Summary will not publish on Monday, January 20, 1997, in observance of Martin Luther King, Jr. Day. Publication will resume on Tuesday, January 21.