Subject: CDC NCHSTP Daily News Update Date: Fri Jan 23 07:31:04 PST 1998 (251 lines) From: National AIDS Info Clearinghouse Copyright 1998, Information, Inc., Bethesda, MD CDC NCHSTP Daily News Update January 23, 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 1998, Information Inc., Bethesda, MD. HEADLINES --------- PEER-REVIEWED JOURNALS "Association of an HLA-DQ Allele With Clinical Tuberculosis" "Non-Invasive Diagnosis of Pneumocystis Carinii Pneumonia (Letter)" "Has French AIDS Research Stumbled?" "Challenges for Vaccine Institute" GENERAL MEDIA "AIDS and Older Adults" "County Halts HIV-Testing Program Amid Concern of Link to Future Vaccine Testing" "AIDS Center Plans Continue" "Man With HIV Must Get Written Consent for Sex" "More Than Half of Belgian AIDS Patients Dead" "Science Feature: Blood Safety" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Association of an HLA-DQ Allele With Clinical Tuberculosis" Journal of the American Medical Association (01/21/98) Vol. 279, No. 3, P. 226; Goldfeld, Anne; Delgado, Julio; Thim, Sok; et al. Researchers from the Dana-Farber Cancer Institute in Boston have found a correlation between the HLA-DQB1 0503 gene and tuberculosis patients in Cambodia. In a two-stage, case-control study conducted between 1995 and 1996, the researchers found a significant association between the gene presence and susceptibility to TB. In the first stage, allele gene frequencies were measured in 78 TB patients and 49 non-TB control individuals; the second stage examined 48 TB patients and 39 controls. Seven DQB1 0503 genes alleles were detected in TB patients in the first trial, while nine TB patients were found to carry the allele in the second stage. None of the control subjects in either the first or second stages had the allele. According to the researchers, this is the first evidence correlating an identified gene with clinical development of tuberculosis. "Non-Invasive Diagnosis of Pneumocystis Carinii Pneumonia (Letter)" Lancet (01/17/98) Vol. 351, No. 9097, P. 218; Evans, R.; Ho-Yen, D.O. Researchers from Raigmore Hospital in the United Kingdom report in the journal Lancet that they have developed a hemi-nested polymerase chain reaction test that is more sensitive than standard PCR protocol for the identification of Pneumocystis carinii pneumonia. The test can be completed in one working day and uses the same external primers and pAZ102-l2, a more sensitive internal primer. According to the researchers, tests of patients with HIV-1 or AIDS showed hemi-nested PCR to have no advantage over standard PCR protocol for identification of PCP; the technique was a useful adjunct to the diagnosis of PCP in patients with non-HIV-1/AIDS immunocompromise. In conclusion, the authors recommend a noninvasive PCP diagnosis method--such as oral washes--for patients with HIV-1 or AIDS and the use of hemi-nested PCR tests for the rapid detection of PCP in patients with other forms of immunocompromise. "Has French AIDS Research Stumbled?" Science (01/16/98) Vol. 279, No. 5349, P. 312; Blater. Michael French scientists were at the forefront of AIDS research in the 1980s, but some experts say the country has since fallen behind. Included among French researchers' successes are the isolation of HIV, the sequencing of the virus' genome, and helping to discover the primary receptor used by HIV to attach to T lymphocytes. However, immunologist David Klatzmann of the Pitie-Salpetriere Hospital in Paris asks: "What major AIDS discovery has France made in the last 10 years?" Science magazine interviewed French and international scientists, asking them to identify the possible reasons why France lags behind in AIDS research after its auspicious beginning. A number of scientists cited the comparative lack of funding available in France--the United States outspends France 30 to 1 on AIDS studies. Others faulted the highly centralized, French hierarchical system, noting that the administrative atmosphere stifles young creative scientists. Some researchers blame communication problems, arguing that French AIDS research labs do not know what is happening in other laboratories. According to Willy Rosenbaum, of Rothschild Hospital in Paris, the only hope for the renewal of competitive AIDS research in France would be a "complete reconstruction" of the research institutions. "Challenges for Vaccine Institute" Nature (01/15/98) Vol. 391, No. 664, P. 222; Arya, Subhash Subhash C. Arya of the Center for Logistical Research and Innovation in New Delhi suggests research strategies for the Seoul-based International Vaccine Institute (IVI) in a letter to the editor of Nature. The author notes that IVI plans to conduct "epidemiological studies of the burden of vaccine-preventable diseases, an assessment of vaccine requirements, and clinical trials and field studies." Data gathered in IVI's research could then be used by the World Health Organization and vaccine manufacturers, for example, to modify the existing criteria for the stability of vaccines--a move that Arya asserts would "ensure intact potency even in black-market sales of products past their use-by date." Arya recognizes that, in some cases, there have been problems regarding the theft and subsequent sale of expired and toxic vaccines, the use of improperly stored HIV blood-screening diagnostics, and temperature control for vaccines. In conclusion, Arya suggests that manufacturers could select vaccines and diagnostics which are stabilized against the adverse environments delineated by the IVI, thus reducing the risk of inoculation with toxic vaccines and lowering "the risk of an iatrogenic HIV spread during blood transfusion" via the supply of antibody testing kits. **************************************************************** GENERAL MEDIA **************************************************************** "AIDS and Older Adults" Washington Post (01/23/98) P. A2 The Centers for Disease Control and Prevention has reported that between 1991 and 1996, new AIDS cases in the United States rose twice as fast among people age 50 or older as they did among people between the ages of 13 and 49. In 1996, the AIDS rate among older people rose 22 percent, to 6,400 cases from 5,260 in 1991. At the same time, younger groups saw a 9 percent increase, to 50,300 cases from 46,000 during the same period. According to the CDC, the data suggest that older adults are not protecting themselves against HIV and that their physicians are not looking for the virus. The agency noted that the majority of older adults who contracted HIV in the early stages of the epidemic probably received the virus from tainted blood transfusions, whereas more recent cases are the result of unprotected sex and injecting drugs. The CDC's Kimberly Holding observed: "Physicians who are caring for older people should discuss HIV risk factors with them and look for these diseases. They need to be included in AIDS education." "County Halts HIV-Testing Program Amid Concern of Link to Future Vaccine Testing" Sacramento Bee Online (1/22/98) The Los Angeles County Board of Supervisors has stopped a county HIV-testing program due to ethical concerns about the intended use of the results. The tests were halted for fear that the testing might be targeting poor African Americans for federal vaccine studies. John Schunhoff, head of public health for the county, explained that concerns were raised because the head of the HIV-testing program, Dr. Peter Krendt, also received a grant from the National Institutes of Health to find people for studies that "could, in the future, include the possibility of community testing a vaccine." Residents of the Jordan Downs and Nickerson Gardens housing projects in Watts, along with other poor people considered to be at high risk for HIV infection, participated in the testing program. However, L.A. County Supervisor Yvonne Brathwaite Burke said she is worried that the subjects could become "human guinea pigs." The testing program, funded by a grant from the Centers for Disease Control and Prevention, aimed to determine the efficacy and reliability of rapid HIV antibody testing. The tests--which could provide results while people wait--might aid in screening the homeless, drug addicts, and others who are unlikely to return to a clinic once they have left. The CDC stated Wednesday that it currently is not seeking vaccine participants nor testing any vaccines. "AIDS Center Plans Continue" New York Times (01/23/98) P. A21 New York's Queens College has moved ahead with its plan to create an AIDS research center, announcing that AIDS expert Luc Montagnier will head the new facility. New York has promised nearly $20 million to the school for the creation of the $30 million center. Montagnier said he plans to develop an HIV vaccine as well as treatments for those already infected with the virus. "Man With HIV Must Get Written Consent for Sex" Washington Post (01/23/98) P. A28 An HIV-positive Florida man has been ordered to obtain written consent from potential partners before engaging in sex. In explaining her ruling, Orange County Judge Deb Blechman said: "I don't think it's too much to ask since this particular disease carries a death sentence." The man, Jerrime Day, also received one year's probation for having sex with an underage woman. "More Than Half of Belgian AIDS Patients Dead" Reuters (01/22/98) New data from Belgium's health ministry indicates that more than half of the Belgian patients diagnosed with AIDS since the initial outbreak of the disease in the mid-1980s have died. A total of 1,376 of 2,286 AIDS patients in Belgium had died by year-end 1996. Since the outbreak began, more than 10,600 HIV infections have been diagnosed in the country, with men being four times more likely than women to carry the virus. The new data also estimated that between 700 and 1,000 new infections were diagnosed in Belgium each year. The majority of HIV infections among men have been traced to homosexual or bisexual contacts, while the source of infection among women was heterosexual contact. Additionally, the study showed that 6 percent of all cases were among injection drugs users and that virtually no cases resulted from blood transfusion. "Science Feature: Blood Safety" PANA Wire Service (01/21/98); Masebu, Peter In an effort to improve the safety of blood transfusions, health authorities in Eastern Africa are sending trainees to Uganda for a regional training course on blood safety. According to Peter Kataaha of the Uganda Transfusion Services, each country will send two doctors and two laboratory technicians to participate in the course. Some estimates hold that about 25 percent of the 2.5 million blood units transfused in sub-Saharan Africa in 1995 were not screened for HIV. Furthermore, by year-end 1995, only 16 of the 46 sub-Saharan nations had transfusion policies; however, the World Health Organization's regional blood safety initiative has forecast that 80 percent of the countries in the region will have a national budget for blood programs in the next five years. By 2003, the plan hopes to have guaranteed that 80 percent of blood donors are voluntary and non-remunerated. The 13-page blood safety document produced by the WHO's Regional Office for Africa also notes that family blood donation "poses a higher risk of transfusion-associated infections than voluntary donation." ***************************************************************** 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. To UNSUBSCRIBE, send the command "unsubscribe aidsnews" to the address listproc@aspensys.com. If you need assistance, please contact aidsinfo@cdcnac.org. *****************************************************************