Subject: CDC AIDS Daily Summary Date: Fri Feb 28 07:31:11 PST 1997 (191 lines) From: National AIDS Info Clearinghouse Copyright 1997, Information, Inc., Bethesda, MD AIDS Daily Summary February 28, 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 ****************************************************** "U.S. Deaths From AIDS Fall Sharply" "Needle-Swap Program Survives a Challenge" "Isis Cites Promising Results in Drug for Crohn's Disease" "Parents Quit Suit Against Red Cross" "Australian Study Doubts Genetic AIDS Protection" "Developing World Continues to Bear HIV Burden" "Tuberculosis Testing Mandated at School" "Outpatient Access to Care and Hospitalization Rates" "A Naturally Unbalanced Combat" "Her Name Is Mary" ****************************************************** "U.S. Deaths From AIDS Fall Sharply" Washington Post (02/28/97) P. A1; Brown, David AIDS-related deaths in the United States declined dramatically for the first time in 1996, officials at the Centers for Disease Control and Prevention reported Thursday. The decrease crossed geographical, racial, and ethnic lines, but was not observed among women or people who contracted HIV through heterosexual exposure. CDC officials attribute the decline to a reduction in the number of people who progress to AIDS, as well as advances in life-prolonging treatment for patients who develop the disease. The number of AIDS-related deaths in the first six months of 1996 was estimated at 22,000, a 13 percent decrease from the 24,900 deaths recorded during a similar period in 1995. Experts say the decline can only partly be attributed to the introduction of protease inhibitors, new drugs which became available last spring. "AIDS deaths began to plateau in 1995, and that really suggests that something began to happen before protease inhibitors were licensed by the FDA," said CDC's chief epidemiologist John W. Ward. Two relevant factors that preceded the new drugs were the use of two-drug antiviral therapies, which extended survival, and increased use of an anti-infective pill that helps prevent Pneumocystis carinii pneumonia. "Needle-Swap Program Survives a Challenge" Philadelphia Inquirer (02/28/97) P. B1; Marder, Dianna Philadelphia's needle exchange program, known as Prevention Point, was saved from possible extinction Thursday as 12 angry City Council members rejected a proposal to suspend the program. The program, which aims to curb the spread of HIV among the city's drug users, exchanged 700,000 sterile needles for used ones turned in by intravenous-drug users last year. Councilman Frank Rizzo, who, upon learning how many needles were distributed, expressed concern that syringes might be sold on the black market, sponsored a proposal to suspend the program at once pending an investigation. The proposal was debated and then tabled. Joan Krajewski, a supporter of Rizzo's plan, said she wants Health Department officials to answer questions about the program by March 27, when the Council is expected to give final approval to the proposed city budget. "Isis Cites Promising Results in Drug for Crohn's Disease" New York Times (02/28/97) P. B3; Fisher, Lawrence M. An antisense drug for the inflammatory bowel condition known as Chron's disease has yielded promising results in a clinical trial, Isis Pharmaceuticals announced Thursday. The company had previously reported positive results using antisense technology-- which works by blocking selected genes from producing disease-causing proteins--to treat the AIDS-related eye infection CMV retinitis. The use of the drug against Chron's disease demonstrates the first application in which it is not directly injected into the diseased organ as it is in the Isis treatment for CMV retinitis. Isis' share gained 25 cents on the Nasdaq stock exchange to close at 18.875. "Parents Quit Suit Against Red Cross" Toronto Globe and Mail (02/27/97) P. A1; McIlroy, Anne Legal tactics by the Canadian Red Cross have forced the parents of an 8-year-old boy who contracted hepatitis C through a tainted blood transfusion to drop a lawsuit against the agency in order to avoid losing their doctor. Jarad Gibbenhuck became one of 12,000 Canadians believed to have contracted the potentially fatal liver disease after he received tainted blood during open-heart surgery shortly after his birth. His parents had joined a lawsuit to receive compensation from the Canadian Red Cross Society and federal and provincial governments. Dr. Jacobus Kooy, who had treated Jarad since March 1995, was named as a third party by the Red Cross in the lawsuit. The Red Cross charged that he had failed to diagnose Jarad's condition in a "timely way" and "failed to minimize any impact" of the hepatitis C infection. The doctor told the Gibbenhucks that he could not continue to treat a patient involved in a lawsuit he has been named in, thus prompting the family to drop the suit. "Australian Study Doubts Genetic AIDS Protection" Reuters (02/28/97); Tait, Paul New findings from Australian researchers have cast doubt on previous studies which suggested that a genetic mutation could provide some protection from HIV infection. The researchers report today in the journal of Nature Medicine that they found a man who became infected with HIV despite the presence of the genetic mutation. U.S. researchers had reported last August that a genetic mutation of the CCR5 receptor made it more difficult for HIV to infect cells. The new finding means that the mutation is not effective HIV protection for everyone. "Developing World Continues to Bear HIV Burden" Reuters (02/27/97) An estimated 90 percent of the 3.1 million new HIV infections worldwide in 1996 occurred in developing countries, according to an article in the Feb. 19 issue of "The Blue Sheet." UNAIDS' Saladin Osmanov told participants at the recent meeting of the American Association for the Advancement of Science that an estimated 33 million people are now infected with HIV worldwide and that a total of 7.6 million people have died of AIDS, including 2.6 million children. Osmanov also predicted that childhood mortality may triple in sub-Saharan Africa by the year 2000 as a result of the disease. "Tuberculosis Testing Mandated at School" United Press International (02/27/97) Following a student's diagnosis with contagious tuberculosis last month, officials at a Southern California high school have ordered mandatory testing for some 2,800 students and teachers. The mass testing was called for after two of the student's classmates at Fountain Valley High School were suspected of having active tuberculosis. Further tests found that the two additional students were not infected. "Outpatient Access to Care and Hospitalization Rates" AIDS Clinical Care (02/97) Vol. 9, No. 2, P. 16 Costs of hospitalization account for about 75 percent of the direct medical costs spent on AIDS care in the United States. A study of hospitalization and access to care, reported in a recent issue of the Journal AIDS, was conducted at seven hospitals in southern California, representing different hospital types and patients populations. A total of 217 HIV patients at the hospitals were interviewed from May 1992 to April 1993. Forty-eight percent of those surveyed said that ambulatory care was somewhat or very easy to access, while 20 percent said obtaining services was somewhat or very difficult. Greater difficulty was associated with lower income, less education, and nonprivate insurance. Better access to care was significantly associated with a lower likelihood of hospitalization, the researchers concluded. "A Naturally Unbalanced Combat" Nature Medicine (02/97) Vol. 3, No. 2, P. 156; Zagury, D. Research has shown that host effector cytotoxic T lymphocytes (CTLs) are important in controlling HIV-1 infection, but their exact role has not been confirmed. Two studies published in the February issue of Nature Medicine reveal that the CTL response is initially able to restrict the virus' growth, but that HIV-1 variants ultimately grow unchecked and progress to AIDS. In the first study, Borrow et al. evaluate the CTL response in an HIV-infected rapid progressor who initially showed high CTL levels. In the second study, meanwhile, Goulder and colleagues report the results of six HIV-positive patients with a phenotype linked to AIDS nonprogression. Both studies showed that HIV-1 infection prompted the differentiation of effective CTLs which restricted viral growth until CTL mutants emerged. In the rapid progressor, this happened within six months, compared to 8 to 10 years in the slow progressors. Patients in both studies rapidly developed AIDS after the uncontrolled growth of mutant viral strains began. "Her Name Is Mary" POZ (02/97) P. 110; Decker, Shawn; Loving, Jesse Heiwa In an interview with POZ magazine, Mary Hanerfield, an HIV-positive recovering alcoholic, says "acceptance of not being able to do things I used to can be hard." She notes, for example, that she loves to swim but can no longer go in pools because of the risk of disease. Hanerfield, now an advocate for other HIV patients in recovery who has started Alcoholics Anonymous groups for people with HIV, says she tested HIV-positive in 1990 after being in recovery for a year. She started drinking heavily again, but ultimately entered a detox center and founded an AA group for people with HIV. She also began using various alternative treatments, which led to her involvement in Direct AIDS Alternative Information Resources, a nonprofit buyers club and information clearinghouse for alternative therapies of which she is now a board member. "Today," Hanerfield says, "I'm learning to give myself peace and happiness and not feel guilty about it." Moreover, she adds, "I have learned that I am not my disease; I am not limited."