Subject: CDC NCHSTP Daily News Update Date: Thu Feb 12 07:31:03 PST 1998 (255 lines) From: National AIDS Info Clearinghouse Copyright 1998, Information, Inc., Bethesda, MD CDC NCHSTP Daily News Update February 12, 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 "Natural History of Cervicovaginal Papillomavirus Infection in Young Women" GENERAL MEDIA "Nationline: Man Infected 18 Women With HIV, Report Says" "Transfusion No Longer Main Reason for HIV Infection in Older Adults" "West Africa Implements Regional AIDS Project" "Science & Health Bulletin: WHO Denies Claims of Approved AIDS Drug" "Russian Government Approves Federal Anti-Tuberculosis Program" "Cutting Back" "Mandatory HIV Surveillance System Could Be Implemented in the Next Year" INFORMATION FROM OTHER GOVERNMENT AGENCIES "Short-Course TB Prophylaxis Effective in HIV-Infected Individuals" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Natural History of Cervicovaginal Papillomavirus Infection in Young Women" New England Journal of Medicine (02/12/98) Vol. 338, No. 7, P. 423; Ho, Gloria Y.F.; Bierman, Robert; Beardsley, Leah; et al. New research suggests that the incidence of human papillomavirus infection in sexually active college women is high, although the median duration of the sexually transmitted disease is relatively short. Researchers from the Albert Einstein College of Medicine in New York tested 608 female students at Rutgers University for HPV every six months for three years. Twenty-six percent of the women were HPV-positive at baseline, and about 60 percent were infected with HPV at some point during the study. The 36-month rate of HPV infection was 43 percent in women who had tested negative for the STD at baseline. Factors associated with increased risk of incident HPV infection included younger age, Hispanic or African American ethnicity, a higher number of vaginal-sex partners, high rates of vaginal sex and alcohol consumption, and anal sex. The average length of the new infections was about eight months, with 70 percent going away after one year. Duration greater than six months was associated with older age, types of HPV related to cervical cancer, and infection with multiple types of HPV. The researchers note that the short length of most of the women's HPV infections indicates that the related cervical dysplasia should be managed conservatively. **************************************************************** GENERAL MEDIA **************************************************************** "Nationline: Man Infected 18 Women With HIV, Report Says" USA Today (02/12/98) P. 3A; Bacon, John An HIV-positive man infected 18 Missouri women with the virus before being killed last year, according to a report released on Wednesday. Darnell McGee of East St. Louis, IL, reportedly had more than 100 sex partners, ranging in age from 15 to 29. Due to confidentiality laws, Illinois health officials will not say whether they have tested women who had sex with McGee; however, Missouri officials said last spring that McGee had infected about 30 people based on Illinois statistics. According to public health officials, this is the largest-known documented case of an HIV-positive individual infecting others with the virus that causes AIDS. "Transfusion No Longer Main Reason for HIV Infection in Older Adults" Reuters Health Information Services (02/11/98) A report in the February issue of the Journal of the American Geriatric Society concludes that sexual transmission and drug abuse are increasing in prevalence as causes of HIV infection among older adults. The researchers--who studied 321 cases of AIDS in patients aged 60 or above--found that HIV infection resulted from blood transfusion 32 percent of the time, but that sexual transmission and drug abuse were increasingly implicated in infection. The study also found that 12 percent of the older adults had no reported risk factors for HIV, as compared with 4 percent of the younger adults. Commenting on the study, Dr. Margaret Terpenning of the University of Michigan in Ann Arbor noted that the efficacy of AIDS education programs aimed at older people should be evaluated and that issues such as patient resistance to HIV testing and improved physician-patient communication need to be addressed. "West Africa Implements Regional AIDS Project" PANA Wire Service (02/11/98); Masebu, Peter In an effort to address the AIDS problem in West Africa, regional health planners and scientists launched the 1996-2001 West African AIDS Project covering Benin, Burkina Faso, Ivory Coast, Ghana, Mali, Niger, and Senegal. While HIV prevalence in West Africa is not as high as it is in East, Central or Southern Africa, the area could see a rise in virus incidence due to migration, trade, and prostitution. The project replaces a previous measure enacted between 1985 and 1995; both are financed by the Canadian International Development Agency. The new project focuses on educating high-risk populations, such as commercial sex workers and migratory workers, on ways to avoid contracting HIV and other sexually transmitted diseases. The project will use basic screening methods and generic drugs to provide STD control and to reduce the spread of HIV. Health officials plan to have the project become self-financing through the sale of essential drugs to the regional communities involved. "Science & Health Bulletin: WHO Denies Claims of Approved AIDS Drug" PANA Wire Service (02/11/98); Kwateng, Francis The World Health Organization is claiming ignorance of Zambian Professor Mulenga Lukwesa's assertion that WHO had approved his drug, herbiron tisanferon, as a cure for HIV infection. The WHO information officer in Lusaka, Regina Shakakata, said that the regional office has received no word from its Geneva headquarters concerning the drug's approval. Lukwesa claims that his drug can cure AIDS and may also be used as a preventative measure. "Russian Government Approves Federal Anti-Tuberculosis Program" Itar Wire Service (02/12/98) The Russian government has approved a 17.5 billion ruble tuberculosis control program for 1998-2004 in an attempt to reduce the TB-related morbidity and mortality rate. The government estimates that TB caused 12 billion rubles in damage over the past year. According to the World Health Organization, Russia is in the midst of a TB epidemic, with incidence highest in Daghestan, Chechnya, Ingushetia, and Tuva. There were 25,000 TB deaths and 98,000 new cases reported in Russia during 1996, a 57.3 percent increase over 1993 statistics. "Cutting Back" Advocate (02/03/98) No. 752, P. 37; Gallagher, John AIDS advocacy groups are facing substantial cuts in funding, causing some groups to fold. Others have laid off staff, trimmed budgets excessively, or merged with other AIDS groups to remain solvent. For example, the Names Project Foundation--which sponsors the AIDS Memorial Quilt--has eliminated half of its two dozen staff positions and reduced its $5 million budget by 30 percent last year. Advocacy groups refer to the drop in donations as "donor fatigue." However, according to James Loyce Jr., head of AIDS Project Los Angeles, donors are reducing their donations rather than halting them, giving hope that the agencies may be able to woo contributors back to previous levels. AIDS advocacy groups are also worried about the high-profile, national debate concerning the perceived specialized treatment of AIDS research by governmental organizations. Some people feel that government agencies are singling out AIDS research for grants and ignoring other diseases in the process. While advocacy groups contend that this debate has not affected congressional spending on AIDS research, some fear a future drop in funding. "Mandatory HIV Surveillance System Could Be Implemented in the Next Year" AIDS Alert (02/98) Vol. 13, No. 2, P. 13 Officials from the Centers for Disease Control and Prevention say that mandatory reporting systems for HIV-positive individuals could be implemented as early as this summer. However, a key issue that could delay implementation is whether health departments should use unique identifiers such as codes or names. The CDC's Dr. Kevin DeCock said late last year that he expects a national HIV surveillance system to be in place possibly by this summer and no later than the beginning of 1999. With the decline in the AIDS death rate and the remarkable success of new HIV treatment, AIDS surveillance is no longer as reliable a source of information on the spread of the virus. This forces the need for a change in the current policies which require the registration of AIDS patients only. Accordingly, the CDC has been very active and vocal about the need to reform policies in the 20 states that have resisted HIV reporting measures, holding seminars and meetings aimed at educating public health and community leaders. However, some critics assert that name reporting could lead to discriminatory actions. Norma Lopez, of the National Council of La Raza in Washington, D.C, states that "there is no question in [her] mind that name-based surveillance will be used against immigrants in this country." Others claim that unique identifiers--codes replacing names in HIV reporting--offer a viable alternative that provides the necessary information while also affording personal protection. Sensitive to fears about confidentiality violations, the CDC is working to improve the security of computerized HIV and AIDS data collection systems and may establish standards for how the programs should be run. **************************************************************** INFORMATION FROM OTHER GOVERNMENT AGENCIES **************************************************************** "Short-Course TB Prophylaxis Effective in HIV-Infected Individuals" NIAID News (02/11/98); Carroll, Diana Results of an international study sponsored by the National Institute of Allergy and Infectious Diseases, the Centers for Disease Control and Prevention, and the Pan American Health Organization indicate that a two-month, short-course of therapy provides an effective alternative to the current year-long treatment for patients co-infected with HIV and tuberculosis. Preliminary results of the five-year study, led by Dr. Fred Gordon of the Veterans Medical Center in Washington, D.C., were recently presented at the Fifth Conference on Retroviruses and Opportunistic Infections. The researchers compared a two-month regimen of daily rifampin (RIF) and pyrazinamide (PZA) with a 12-month daily isoniazid (INH) regimen in nearly 1,600 HIV-positive patients, over 70 percent of whom were from the United States. After a mean 36 months of follow-up, the number of TB cases were the same in each treatment group. Moreover, 80 percent of patients in the RIF/PZA group completed treatment, compared to less than 50 percent of those in the 12-month regimen. Gordon noted that compliance rates for INH therapy are typically lower than those seen in the study. The new therapy could increase compliance and decrease costs. Dr. Helene Gayle, head of the CDC's National Center for HIV, STD, and TB Prevention, noted that "the greatest impact of these findings will be in the United States and other countries where preventive therapy is widely recommended for individuals infected with TB and at risk for developing active disease." ***************************************************************** 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. *****************************************************************