Subject: CDC NCHSTP Daily News Update Date: Mon Jan 26 07:31:03 PST 1998 (247 lines) From: National AIDS Info Clearinghouse Copyright 1998, Information, Inc., Bethesda, MD CDC NCHSTP Daily News Update January 26, 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 "Bloodborne Pathogen Hotline" "Bioelectrical Impedance Analysis (BIA) in HIV Infection: Principles and Clinical Applications" GENERAL MEDIA "Racial Health Gap Continues, Studies Say" "Experiment Combines Drug With HIV Vaccine" "Green Cross Scraps Gene Therapy Plan for HIV Patients" "UK Researchers Call for Routine Antenatal HIV Testing" "Intermittent Clarithromycin Effective for MAC Pulmonary Infection" "Honduras Uses Soccer in War Against AIDS" "Deja Vu" INFORMATION FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION "Symposium on Condom Use" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Bloodborne Pathogen Hotline" Journal of the American Medical Association (01/21/98) Vol. 279, No. 3, P. 188; Stephenson, Joan The National Clinicians' Post-Exposure Prophylaxis Hotline (a 24-hour toll-free hotline) has been initiated to help health care workers exposed to bloodborne diseases on the job. Staffed by trained physicians, the hotline will provide counseling and treatment recommendations for workers with occupational exposure to bloodborne diseases such as HIV and hepatitis. The hotline, which can be reached by calling (888) 448-4911, combines and expands two programs at San Francisco General Hospital, and is a project of the Health Resources and Services Administration and the Centers for Disease Control and Prevention. The hotline is run in collaboration with the San Francisco Department of Public Health and the University of California at San Francisco. The CDC estimates that there are at least 5,000 needlestick exposures to HIV annually. "Bioelectrical Impedance Analysis (BIA) in HIV Infection: Principles and Clinical Applications" Journal of the Association of Nurses in AIDS Care (01/98-02/98) Vol. 9, No. 1, P. 49; Swanson, Barbara; Keithley, Joyce Sensitive and accurate assessments of body composition can be used to promote the early detection and management of HIV-associated nutritional changes. Bioelectrical impedance analysis--a safe, noninvasive, and convenient method of measuring body composition--is increasingly being used with HIV and AIDS patients, note Barbara Swanson of the Women's Interagency HIV Study at the University of Illinois and Joyce K. Keithley of Rush University College of Nursing. The technique uses low voltage, alternating current to estimate indirectly body fat, body cell mass, extracellular mass, and extracellular fluid--the four components of body composition. However, BIA has a few faults: it may not be as accurate as other body mass measures and may be affected by a number of external factors. According to Swanson and Keithley: "recent validation studies indicate that BIA correlates moderately well with more direct methods of body composition measurement and is sufficiently sensitive to detect the body composition changes that occur with HIV disease progression." Still, the researchers note that further research is needed to determine the appropriate uses and limitations of BIA with regard to HIV infection. **************************************************************** GENERAL MEDIA **************************************************************** "Racial Health Gap Continues, Studies Say" New York Times (01/26/98) P. A16; Kilborn, Peter Research shows a widening health gap between African Americans and white Americans, according to an article published in Monday's New York Times. For example, Centers for Disease Control and Prevention statistics show that the number of diabetes cases rose 33 percent among African Americans from 1980 to 1994, triple the increase among white Americans. Although African Americans have made significant advances in areas such as jobs, education, and housing, federal health officials and analysts say there is growing evidence that race, discrimination, and social and cultural factors affect health care. The White House is expected to offer new ways to address the problem in President Clinton's budget proposal next month. "Experiment Combines Drug With HIV Vaccine" Reuters (01/24/98) University of Pennsylvania researchers plan to combine an HIV vaccine with proven triple-drug therapy, hoping that the vaccine will work better in patients who have the virus under control. Under the trial, the vaccine--Apollon Inc.'s Malvern--will be administered to 21 patients receiving triple-drug treatments. Malvern, which uses four pieces of HIV's DNA, has shown promise in trials but has not yet been proven to slow infection. Dr. Rob McGregor, director of clinical AIDS research at the University of Pennsylvania, believes that an enhanced response may be achieved in patients whose immune systems have stabilized. "Green Cross Scraps Gene Therapy Plan for HIV Patients" Kyodo News Service (01/26/98) Green Cross Corp., a Japanese pharmaceutical company, has said it will drop its plans to test a gene therapy treatment on people with HIV. However, research will still continue on the treatment. The company decided to abandon the plan due to the lack of available reports on the effectiveness of similar trials on 200 HIV-positive patients in the United States. Green Cross initially planned to test the gene treatment on four HIV-positive individuals at the Kumamoto University Hospital in southwestern Japan, using a specially created vector to introduce a gene designed to activate patients' HIV-fighting T-cells to prevent the development of AIDS. The four prospective patients had consented to the test, and the Japanese government had approved the trials in May 1997. "UK Researchers Call for Routine Antenatal HIV Testing" Reuters Health Information Services (01/23/98) Researchers in the United Kingdom have called for the implementation of routine antenatal HIV testing in response to reports that detection rates of HIV infection in pregnant women have not improved since the initiation of a national policy initiative in 1992. According to a collection of reports in the January 24th issue of the British Medical Journal, while HIV infection rates among pregnant women in the United Kingdom are low, infection rates for pregnant women in London increased six-fold between 1988 and 1996. The researchers believe that HIV testing options should be both available and recommended to all women in areas with a high prevalence of HIV. One study, conducted by Dr. Wendy J. Simpson of the University of Edinburgh and colleagues, found that a universal offer of HIV testing to women significantly increased the chances that the woman would allow testing; Simpson suggests that all women attending antenatal clinics be offered testing and that midwives be ordered to keep a record of the offer. "Intermittent Clarithromycin Effective for MAC Pulmonary Infection" Reuters Health Information Services (01/23/98) At the Fourth International Conference on Macrolides, Azalides, Streptogramins, and Ketolides, researchers from the University of Texas Health Center in Tyler announced that intermittent clarithromycin may be effective in the prophylaxis or treatment of disseminated Mycobacterium avium complex lung disease in HIV-negative individuals. The six-month study tested 55 MAC-positive patients with a triple-drug regimen of clarithromycin, ethambutol, and rifabutin or rifampin thrice weekly. The study showed negative sputum cultures at the end of the trials for 77 percent of the 39 patients completing the therapy; none of the patients developed clarithromycin resistance. "Honduras Uses Soccer in War Against AIDS" Reuters (01/24/98); Thomas, Dan Honduras--with the help of UNICEF, the U.S. Agency for International Development, and the European Community--plans to implement soccer-related AIDS information and education initiatives in an attempt to reach a wider audience. The non-governmental organization COMVIDA will launch the effort by staging a pre-game show at soccer matches, hoping that the correlation between soccer and AIDS will increase awareness of how HIV can spread, how it may be prevented, and its effects. The show pits the "Death United" team--featuring Death in goal, Infected Syringe and Drugs in defense, Infidelity and Promiscuity at midfield, and HIV and AIDS as forwards--against a San Pedro team consisting of Head of the Family in goal, Womankind and Knowledge at midfield, and Abstinence and Fidelity in attack; Condom will be a substitute. The highly orchestrated, theatrical piece will be accompanied by commentary and is intended to show fans how HIV passes from one person to another and how people can protect themselves against the virus. "Deja Vu" POZ (02/98) P. 25; Hess, Scott The U.S. Department of Health and Human Services and the U.S. branch of the International AIDS Society (IAS) have published HIV treatment guides that recommend a protease-based three-drug therapy and advise symptom-free HIV-infected individuals to hold off on treatment. The two guides differ on when HIV patients should begin drug regimens. While the HHS guide suggests initiation of treatment when a patient's viral load exceeds 10,000 to 20,000 copier/mL or when the CD4 count falls below 500, the IAS says that treatment should begin when an individual's viral load is between 5,000 and 10,000 copies/mL, regardless of CD4 count. The HHS and IAS guides also differ in their panel membership: the HHS guide was created by doctors, researchers, and industry representatives, while the IAS board is composed of only physicians. HHS panel member Martin Delaney, of Project Inform, observed: "The guidelines disagree in an area where nobody has the absolute answer, so it comes down to expert opinion." **************************************************************** INFORMATION FROM THE CENTERS FOR DISEASE CONTROL AND PREVENTION **************************************************************** "Symposium on Condom Use" Centers for Disease Control and Prevention (CDC) (01/26/98) The 2nd Annual National Symposium on Overcoming Barriers to Condom Use will take place in Los Angeles on February 19-20, 1998. The conference will provide an opportunity for health care providers, researchers, and outreach workers to share experiences and information on condom efficacy and technical developments, and will serve as a forum for a multi-disciplinary discussion of condom-related issues. Key issues will include trends in attitudes and usage; advertising, media, and social marketing; new technologies; ethics; the safer sex message; international usage and trends; and managed care and condoms. For information contact PPSI, 101 Lucas Valley Rd., Suite 210-E, San Rafael, CA 94903, or E-mail PPSI@aol.com ***************************************************************** 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. *****************************************************************