Subject: CDC NCHSTP Daily News Update Date: Fri Feb 6 07:31:06 PST 1998 (256 lines) From: National AIDS Info Clearinghouse Copyright 1998, Information, Inc., Bethesda, MD CDC NCHSTP Daily News Update February 6, 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 "Reduction in SIV Replication in Rhesus Macaques Infused With Autologous Lymphocytes Engineered With Antiviral Genes" "Perturbation of CD4 and CD8 T-Cell Repertoires During Progression to AIDS and Regulation of the CD4 Repertoire During Antiviral Therapy" GENERAL MEDIA "An Inexpensive AIDS Drug?" "Research on Anti-HIV Drugs Is a Combination of Progress and Setback" "AIDS Toll in State Down 43 Percent in 1997" "Proposed HIV Reporting Change Gets Some Support" "Studies Show It's Dangerous to Cut Back On HIV Drugs" "Four Drug Regimen Strong Against HIV" "HIV Drugs Credited for Saving Lives in New York" "Man With HIV Suing Store" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Reduction in SIV Replication in Rhesus Macaques Infused With Autologous Lymphocytes Engineered With Antiviral Genes" Nature Medicine (02/98) Vol. 4, No. 2, P. 181; Donahue, Robert E.; Bunnell, Bruce A.; Zink, M. Christine; et al. Researchers, led by Robert E. Donahue of the National Heart, Lung, and Blood Institute, report on trials in which three rhesus macaques were subjected to retroviralally mediated gene transfer with the antisense gene vector containing tat/rav to test the efficacy of gene therapy against SIV. The monkeys were subsequently infected with SIV, and blood and lymph nodes form the macaques were sampled over the course of a year to measure the progress of the infection. While all three of the animals became infected with SIV, the animals that received the gene therapy demonstrated a significant reduction in viral load in the blood and lymph nodes. They also had sustained numbers of CD4 cells and showed little disruption of lymph node architecture. While current anti-HIV regimens have been effective in drastically reducing viral load, anti-HIV techniques have not been able to eradicate the virus from HIV-infected cells. The combination of current drug therapy and gene therapy could be used to fight opportunistic HIV infection. The researchers conclude that although there are clearly differences between SIV in macaques and HIV in humans, the findings are "encouraging and lend support to initiation of clinical trials to test these concepts in humans infected with HIV." "Perturbation of CD4 and CD8 T-Cell Repertoires During Progression to AIDS and Regulation of the CD4 Repertoire During Antiviral Therapy" Nature Medicine (02/98) Vol. 4, No. 2, P. 215; Gorochov, Guy; Neumann, Avidan U.; Kereveur, Anne; et al. French researchers investigated T-cell antigen receptor (TCR) reservoirs based on the varying lengths of the beta chain CDR3 hypervariable region in HIV-1 infection and after combination antiretroviral treatment. The researchers observed substantial restrictions in CD8 T-cell repertoire usage at all stages of natural progression, a phenomenon that continued into the first six months of therapy. Meanwhile, significant CD4 T-cell repertoire perturbations were not found in the early stages of infection, but correlated with disease progression. Normalization of the CD4 repertoire was seen in eight of 10 patients; in two cases, therapy was unsuccessful. According to the researchers, the findings suggest that "an efficient control of HIV replication may allow qualitative modifications of CD4 repertoire balance." **************************************************************** GENERAL MEDIA **************************************************************** "An Inexpensive AIDS Drug?" Washington Post (02/06/98) P. A2 At the Fifth Conference on Retroviruses and Opportunistic Infections, Jeffrey E. Galpin of the Sherman Oaks Hospital Research Institute in Los Angeles reported that a combination of an older leukemia treatment drug, hydroxyurea, with the drugs ddI and d4T, reduced the level of HIV in the blood of 42 patients below detectable levels. The new drug is inexpensive--it costs $30 a month--compared to the $1,300 monthly price tag of combination therapies that use protease inhibitors and reverse transcriptase inhibitors. Researchers also reported that three HIV-positive patients who received hydroxyurea treatment over a year ago may have permanent remission of the virus. The drug targets host cells in the patient, rather than the virus itself, preventing HIV from developing a resistance to the drug. The drug also appears to reduce the chances of HIV resistance to other AIDS treatments. While some researchers are skeptical about the remission claims, many have begun incorporating hydroxyurea into existing combination treatments. "Research on Anti-HIV Drugs Is a Combination of Progress and Setback" New York Times (02/06/98) P. A12; Altman, Lawrence At the Fifth Conference on Retroviruses and Opportunistic Infections, scientists announced that efforts to ease rigorous combination therapy regimens and reduce resistance to the drugs have met with mixed results. Researchers have tried to reduce the daily number of pills--which can number over a dozen several times daily--after several months. Another effort includes simplifying the scheduling of dosages by minimizing the number of times some of the pills are taken. Researchers have also devised laboratory tests to guide initial drug treatments in order to reduce the incidence of resistance. However, these tests will not be available until the scientists have determined the outcomes of the treatment. Moreover, researchers have developed new combinations of the 11 approved anti-HIV medications, hoping that the new combinations will be more powerful, have fewer side-effects, and help those who have failed previous combination therapy. Also at the conference, two drug companies reported on several studies finding that the use of two protease inhibitors--nelfinavir and indinavir--were as effective in suppressing HIV when they were taken two times a day rather than three times a day in combination therapy. "AIDS Toll in State Down 43 Percent in 1997" Baltimore Sun (02/06/98) P. 1A; Bor, Jonathan Health officials report that the number of AIDS-related deaths in Maryland last year dropped 43 percent, more than two times the percentage drop seen in 1996. Statistics show that 611 Maryland residents died from AIDS in 1997, versus 1,182 in 1996. Although delays in reporting deaths from the last few months of the year could alter the figures, Dr. Liza Solomon--head of the Maryland AIDS Administration--noted that a 43 percent drop in deaths were seen in studies of both the first six months of the year and of the first nine months, when compared to the same periods of 1996. She expects the figures to hold even after the year's statistics become final. The drop appears to reflect the increasing impact of new AIDS drug combinations that include protease inhibitors. "Most people attribute the decline both to the new drugs like protease inhibitors and other treatments that prevent some of the more severe complications," said Solomon. "The protease inhibitors are probably responsible for the lion's share of this." The decline in AIDS-related deaths was seen across gender and ethnic lines, but the reductions were larger among white patients than African Americans. AIDS-related deaths fell 70 percent among white males and 65 percent among white women, but only 35 percent among African-American men and 37 percent among African American women. Solomon said the discrepancy appeared to be because fewer African Americans were receiving care early and receiving care consistently. "Proposed HIV Reporting Change Gets Some Support" Fort Worth Star-Telegram Online (02/05/98); Prince, Jeff A plan to use patient names in confidential reports of HIV infection in Texas has been cautiously backed by AIDS activists and social service providers. At a town hall meeting in Arlington, VA, on Wednesday, many providers backed the switch to name-based reporting of HIV infections, although some stressed the need to ensure both confidentiality and the availability of funds to link patients with services. Texas is currently one of only three states to use a unique identifier (UI) to report HIV infections. However, state officials claim the UI system does not work. According to Texas health official Ann Robbins, the state has "come to the conclusion after three years of study that what this UI system does is inappropriate," because reporting data is "incomplete, unreliable, and unrepresentative of the epidemic." "Studies Show It's Dangerous to Cut Back On HIV Drugs" Reuters (02/05/98) Researchers for the AIDS Clinical Trial Group reported on Thursday that reducing the amount of medication in current triple-drug therapy can lessen the treatment's efficacy. The study, sponsored by the National Institute of Allergies and Infectious Diseases, divided 309 HIV-positive subjects into three groups: one receiving only Crixivan, another receiving only AZT and 3TC, and a third that received all three medications. The patients on Crixivan alone had a 16 percent failure rate, while the AZT/3TC group and triple-drug therapy patients had failure rates of 18 and 3 percent, respectively. A team of French researchers reported similar findings for 379 patients, and said they stopped the trial once the drugs' effects became apparent. "Four-Drug Regimen Strong Against HIV" Reuters (02/05/98) A study of 57 HIV-positive volunteers found that a new four-drug combination of nevirapine, indinavir, AZT, 3TC, or, in some cases, d4T, was effective in reducing the HIV levels of all the volunteers, including those who had received similar treatments in the past. Of the 18 volunteers who had never received HIV drugs, 16 experienced a decrease of HIV to undetectable levels after 24 weeks of treatment. Researchers also said that 86 percent of the patients who had used HIV drugs before had also experienced a drop in HIV to undetectable levels. Richard Beach, a participant in the research at Stratogen Health in Miami Beach, said that the new four-drug therapy was probably the most effective treatment available today. The researchers also tested the four-drug therapy on infants, but said it was not as effective in children younger that three months. "HIV Drugs Credited for Saving Lives in New York" Reuters (02/05/98) At the Fifth Conference on Retroviruses and Opportunistic Infections Mary Anne Chiasson of the New York City Department of Health reported that AIDS deaths in the city fell by 30 percent between 1995 and 1996. The decline was attributed to the increased availability of protease inhibitors. A research team led by Chiasson followed 150 AIDS patients who died during 1996 and 150 who did not die, and found that 10 percent of those who died had taken protease inhibitors, versus 32 percent of those who lived. "Man With HIV Suing Store" Bakersfield Californian Online (02/05/98) An HIV-positive man in Bakersfield, CA, is suing the Longs Drugs chain, asserting that a pharmacist released information to the man's ex-wife and two children concerning his HIV status. The man said he had visited the pharmacy to fill a prescription, but had to wait several days to pick up the entirety of it. When his ex-wife went to the store two days later, the pharmacist reportedly asked her if she would like to pick up the man's prescription, whereupon she learned that her ex-husband was receiving treatment for HIV. Despite statements by the man's lawyer, the woman said she is not using the information against her ex-husband, although it has been mentioned in court. ***************************************************************** 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. 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