Subject: CDC NCHSTP Daily News Update Date: Tue Jan 13 07:31:07 PST 1998 (258 lines) From: National AIDS Info Clearinghouse Copyright 1998, Information, Inc., Bethesda, MD CDC NCHSTP Daily News Update January 13, 1998 The CDC National Center for HIV, STD and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC NCHSTP Daily News Update should be cited as the source of the information. Copyright 1997, Information Inc., Bethesda, MD. HEADLINES --------- PEER-REVIEWED JOURNALS "Needle-Exchange Programmes in the USA: Time to Act Now" "SIV Vaccine For AIDS" GENERAL MEDIA "AIDS Group Urges New York To Start Reporting of H.I.V." "New Quinolones Active Against AIDS-Related MAC Infection" "Health--Thailand: Monks Enlist in Fight Against AIDS" "Phase I/IIa Ribozyme-Based HIV Therapy Trial Successful" "Doctor Should Be Pursuing FDA Approval, U.S. Says" "Court Clears Army To Oust HIV Soldier" "Hope at a Price" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Needle-Exchange Programmes in the USA: Time to Act Now" Lancet (01/10/98) Vol. 351, No. 9096, P. 75 According to an editorial in The Lancet, nearly one-third of the more than 570,000 AIDS cases reported in the United States have been caused either directly or indirectly by injection drug use. In fact, the editors note, almost half of all new HIV infections can be traced to such behavior, which not only affects the drug users but their sexual partners and, possibly, their children. Despite this problem, the United States has yet to provide easy access to sterile syringes. However, on March 31, 1998, when the Congressional ban on federal funding for needle-exchange programs is lifted, the Clinton Administration has an opportunity to address the spread of HIV through injection drug use. To date, Secretary of Health and Human Services Donna Shalala has not made an official determination whether the White House will support such programs, raising concerns among AIDS activists that Clinton may refuse to endorse the programs. Yet, the editors argue, study upon study offers convincing evidence--if not proof--that needle-exchange programs are effective in the fight against HIV and do not encourage drug use. In 1993, the Centers for Disease Control and Prevention recommended the expansion of needle-exchange programs in the United States. Then, in 1997, a National Institutes of Health panel argued that there is no doubt needle-exchange programs work. The President's Advisory Council on HIV/AIDS issued a report in December 1997 urging the President to move immediately to lift the ban on federal funding for needle exchanges. The Council noted that as many as 11,000 preventable HIV infections may occur in the United States by the turn of the century if current policies are not changed. "SIV Vaccine For AIDS" Science (01/02/98) Vol. 279, No.5347, P. 14; Farthing, Charles In a letter to the editor of Science, Charles F. Farthing responds to a Science news article that featured several researchers' data on monkeys developing immunodeficiency and/or AIDS after infection with HIV. Farthing, chair of the Live-Attenuated HIV Vaccine Subcommittee of the International Association of Physicians in AIDS Care, notes that Jon Cohen's article mentioned some researchers' criticisms of the publicity surrounding IAPAC's plan to have physicians test a live-attenuated HIV vaccine. However, Farthing points out that data from Australia and from Massachusetts about 19 humans who were accidentally infected with nef-deficient HIV 10 to 14 years ago was not included. None of the patients has experienced immunosuppression that is clearly the result of infection with attenuated HIV, Farthing notes, adding that "seven patients are still alive--all with normal immune function." According to Farthing: "this experience with a nef-deleted HIV in humans is surely more relevant in deciding whether a trial in humans is likely to be safe than consideration of SIV delta nef or SIV delta 3 infection in monkeys--a different virus in a different host." **************************************************************** GENERAL MEDIA **************************************************************** "AIDS Group Urges New York To Start Reporting of H.I.V." New York Times (01/13/98); Richardson, Lynda The Gay Men's Health Crisis, a New York-based AIDS service agency, is urging New York physicians to report all HIV infections to the state department of health. Currently, every state mandates the reporting of AIDS cases to public health officials, but many--including New York and California--do not require reporting of HIV infections. AIDS advocacy groups have traditionally opposed such measures for fear that HIV registration may deter early testing and treatment, due to a lack of confidentiality. In a policy statement to be released on Wednesday, the group explains that scientific advances and the need for the latest data require new approaches, and that a system that tracks only AIDS patients is no longer effective. "This is not a static epidemic and our position cannot be a static position," said Ronald S. Johnson, a managing director of the organization. The group's statement advocates a coded identification system that would allow the state to monitor the virus and provide current information while also ensuring individual privacy. A decision by New York--which has the highest rate of reported AIDS cases--to require HIV reporting would probably require a new state law, but no action will likely come until the New York State Advisory Council makes its recommendations on the issue, likely in March. "New Quinolones Active Against AIDS-Related MAC Infection" Reuters Health Information Services (01/12/98) Findings published in the December issue of the Journal of Antimicrobial Chemotherapy identify five new quinolones that demonstrate superior antimicrobial activity against Mycobacterium avium. Dr. Nandagopal Venkataprasad and colleagues from Ohio's Case Western Reserve University examined the efficacy of 16 new quinolones against the in vitro growth of mycobacteria in human monocytes and found that intracellular growth inhibition correlated with the MICs of the compounds. The researchers also discovered that PD 139586, PD119421, PD131575, PD143289, and PD135144 all demonstrated stronger activity against M. avium than ciprofloxacin and sparfloxacin. These findings may prove especially useful considering the rising incidence of M. avium complex infection in AIDS patients--many of whom have developed resistance to standard therapies. "Health--Thailand: Monks Enlist in Fight Against AIDS" IPS Wire (01/12/98) Six months ago, Thailand launched a project to encourage Buddhist monks--who are highly influential in the country--to counsel both people with HIV and members of HIV-negative populations. Funded by UNICEF, the project has already reached monasteries throughout the northern part of Thailand. Experts say the project is a prime example of how the nation is using its cultural resources in the fight against AIDS. Although some senior Buddhist clergy traditionally have considered discussing HIV/AIDS issues taboo, many young Thai monks have been enthusiastic about the UNICEF program. Already, several monasteries in northern Thailand are offering meditation centers, counseling, and income-generating activities for people with HIV. Other groups and communities in Thailand have also boosted their efforts in the fight against AIDS. For example, in the northern province of Chiang Mai--where nearly half of the people in Thailand with HIV live--more than 60 AIDS organizations have sprung up. Australia, meanwhile, has funded the AIDSNET Foundation, an off-shoot of the Northern AIDS Prevention and Care Program (NAPAC) that has supported community groups and NGOs in northern Thailand. Says AIDSNET Secretary Dr. Usa Duongsa: "In the early nineties, it was estimated that nearly 4 million people in Thailand will be HIV-positive by the year 2000 and nearly 150,000 would have died of AIDS. But that is not likely to be true primarily due to the efforts of organization fighting the pandemic." Still, greater efforts are needed in Thailand, especially efforts aimed at helping the hundreds of Thai children who have been orphaned by the HIV/AIDS pandemic. "Phase I/IIa Ribozyme-Based HIV Therapy Trial Successful" Reuters Health Information Services (01/12/98) Ribozyme Pharmaceuticals has reported the success of phase I/IIa trials of ribozyme-transduced stem cells for use as an HIV therapy. The treatment involves the introduction of multiple ribozymes targeting various HIV proteins into CD34 cells via a retroviral vector. According to Ribozyme, none of the five subjects experienced any adverse drug-related effects, and all tolerated the infusion of the treated cells. The first study participant has shown some evidence of transduced cells after six months, but company vice president Dr. Thomas Rossing noted that it is still too early to determine whether long-term engraftment will be attained. "Doctor Should Be Pursuing FDA Approval, U.S. Says" Tulsa World Online (01/10/97); Harper, David AIDS patient Robert Cowan has filed a case in the U.S. District Court in Tulsa, OK, seeking permission to take an unapproved AIDS treatment developed by a Tulsa doctor, Gary Davis. On Friday, Assistant U.S. Attorney Peter Bernhardt opposed the request, arguing that Davis should be investing his time in getting the treatment approved rather than in fighting legal battles. Davis submitted an Investigation New Drug Application to the Food and Drug Administration in March of last year to conduct a study of a goat-derived AIDS-neutralizing antibody, but the request was put on "clinical hold" until Davis submitted additional data and information. As yet, Davis has not provided the needed information, but Cowan believes he should be allowed to undergo the experimental treatment because his case is a medical emergency. "Court Clears Army To Oust HIV Soldier" Australian Associated Press (01/13/98); Klotz, Suzanne The Australian government has received clearance from the Full Court of the Federal Court to dismiss an HIV-infected soldier from the army, overturning a 1995 Human Rights and Equal Opportunities decision which found that the Australian Defense Forces (ADF) discriminated against the soldier when it discharged him. The unidentified soldier, who enlisted in the Australian Defense Force in 1993 after serving as a signaler in the Army Reserve, was discharged a month after his enlistment, following pathology test reports revealing that he was HIV-positive. The three ruling judges, who said the case was based on blood and "bleeding safety," found that the dismissal was in the context of the ADF's mandate that soldiers "go anywhere to perform any lawful duties required including combat, combat-related and peacekeeping duties as, when and where required." "Hope at a Price" Discover (01/98) Vol. 18, No. 1, P. 90; Richardson, Sarah Although there is still no cure for AIDS, HIV-positive patients have seen a glimmer of hope in the past year with the number of newly diagnosed AIDS patients in the United States dropping 6 percent from 1995 to 1996--the first decrease ever. In addition, the number of Americans who died of AIDS in the same period fell an amazing 23 percent. These statistics may represent the initial results of the use of a new class of antiretroviral drugs called protease inhibitors. A study by microbiologist Ashley Haase and colleagues at the University of Minnesota Medical School, reported in the May issue of Science, showed that a three-drug therapy including the drug ritonavir decreased virus levels by almost 99.9 percent in the bloodstream and the lymph nodes. Still, Haase notes that the drug did not kill the virus, and 10 million infectious viral particles remained in the patients' lymph systems. Haase emphasized that antiretroviral drugs do not kill HIV but rather, stop the spread of the virus by preventing the production of new virus. Because of the positive results, researchers are using antiretrovirals as a springboard to try to develop other combination therapies and vaccines. Some patients cannot use the new "drug cocktails" because of drastic side effects or because their HIV strain is resistant to the therapy. However, the greatest obstacle to treatment is the $8,000 to $12,000 annual price-tag. ***************************************************************** The AIDSNews Mailing List is maintained by the CDC National Center for HIV, STD and TB Prevention. Regular postings include the CDC NCHSTP Daily News Update, conference announcements, clinical trials information, current funding opportunities, and selected MMWR articles. To SUBSCRIBE, send the command "subscribe aidsnews firstname lastname" to the address listproc@aspensys.com. 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