Subject: CDC NCHSTP Daily News Update Date: Thu Feb 26 07:31:04 PST 1998 (224 lines) From: National AIDS Info Clearinghouse Copyright 1998, Information, Inc., Bethesda, MD CDC NCHSTP Daily News Update February 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 "National HIV Case Reporting (Letter)" GENERAL MEDIA "Methamphetamine Use Increases Risk of HIV and Other STDs" "HIV-Related Deaths Down in Florida" "Doctors Warned on HIV Risk From 'Rare' Reuse of Suture" "Science & Health Bulletin: Africa--AIDS" "Province Orders Doctors to Report All HIV Cases" "Proposed HIV Testing of Newborns Has State Lawmakers Split" "HIV Virus Tearing Through Singapore" "New CMV Retinitis-Related Syndrome Linked to Potent AIDS Treatment" "Foreign AID" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "National HIV Case Reporting (Letter)" New England Journal of Medicine (02/26/98) Vol. 338, No. 9, P. 626; Gostin, Lawrence O.; Ward, John W.; Baker, A. Cornelius In a letter to the editor of the New England Journal of Medicine, AIDS experts Lawrence O. Gostin, John W. Ward, and A. Cornelius Baker respond to three letters regarding their proposal for national HIV reporting. The authors assert that the letters are indicative "of a growing consensus that a national system of HIV surveillance is essential for effective monitoring of and public health response to the HIV/AIDS epidemic." They agree that how to go about reporting HIV cases is a key element of the reporting debate. Considering the privacy implications, the authors write: "names should not be collected by the government unless it is necessary to achieve important public health purposes;" however, they point out that a recent analysis of Maryland's system of unique identifiers had several limitations, including duplicate reports and a lack of HIV-risk data. Moreover, using unique identifiers instead of names could actually create additional privacy threats by raising the number of surveillance registries. In conclusion, Gostin et al. call for the creation of "a national HIV-surveillance system that is scientifically sound and supported by the public it serves." **************************************************************** GENERAL MEDIA **************************************************************** "Methamphetamine Use Increases Risk of HIV and Other STDs" Reuters Health Information Services (02/25/98) In the February issue of the Western Journal of Medicine, California researchers report that the use of oral methamphetamine increases the risk for HIV infection and sexually transmitted diseases. The study evaluated more than 258,500 sexually active patients at public HIV testing sites in California, all of whom denied injection drug use. The researchers found that oral methamphetamine users had a greater number of sexual partners than nonusers, and that use of the drug was an independent risk factor for participating in prostitution, having sexual contact with injection drug users, and using condoms less frequently. The researchers called on health educators to address the problem of methamphetamine use when designing HIV prevention programs. "HIV-Related Deaths Down in Florida" Miami Herald (02/25/98) P. 1B; Rafinski, Karen The Florida Health Department reported Tuesday that HIV-related deaths in the state declined 42 percent in the first nine months of 1997 compared with the same period of 1996. Deaths peaked in 1995 at 4,336, then dropped in 1996 by 29 percent. The study measured HIV-related deaths, regardless of whether the patient had developed AIDS or not. Deaths among white men in the state fell 52 percent, and dropped 49 percent among white women. Health officials noted that the reduction in HIV-related deaths among African Americans was not as high, with a 37 percent decline among African American men and a 27 percent fall for African American women. Hispanic men measured a 51 percent decrease in mortality, while Hispanic women showed a 53 percent decline. Spencer Lieb, an epidemiologist with the State Health Department, was not sure why the African American community did not show as great a reduction, but he suggested that many African Americans are diagnosed later in the course of infection, when drug regimen treatments are less effective. While optimism is high, AIDS experts caution that protease inhibitor treatments have not been around long enough to gauge their effects fully. "Doctors Warned on HIV Risk From 'Rare' Reuse of Suture" Australian Associated Press (02/25/98) Dr. Graham Rouch, head of the Victorian Department of Human Services, Australia, notified the Royal Australian College of General Practitioners that the reuse of suture material may transmit HIV and hepatitis. Research indicates that soaking suture in ethanol before reusing it does not kill HIV. While the practice is considered very rare in Australia, it is more common in countries with a shortage of medical supplies. The research--reported in the Journal of Medical Virology--was prompted by concern over a number of practices that could possibly transmit HIV, including the use of multi-dose vials of anesthetic. "Science & Health Bulletin: Africa--AIDS" PANA Wire Service (02/25/98); Hule, Jerome The U.S.-based Population Reference Bureau estimates that 3.8 million HIV cases in children were screened in 1997, 3.4 million of which were located in sub-Saharan Africa. Overall, Botswana and Zimbabwe were said to be the most-affected regions; author Thomas Goliber estimated that one in five adults from the two nations would likely die from AIDS--excluding new infections. Goliber asserted that social, cultural, and health factors are responsible for the high incidence of HIV infection in Africa. In particular, he blamed the high rate of sexually transmitted diseases, the low rate of condom use, and circular migration for HIV's spread. "Province Orders Doctors to Report All HIV Cases" Edmonton Sun Online (02/26/98); Bray, David As of May 1, the Alberta provincial government will make HIV a reportable condition in order to monitor infection properly, gain a greater understanding of the virus' progression, and improve early access to therapies, Health Minister Halvar Jonson announced on Wednesday. Under the new directive, doctors will be required to report all HIV-positive patients to regional health authorities. HIV-positive individuals will also be asked to name their sexual partners, although there are no penalties for non-cooperation. "Proposed HIV Testing of Newborns Has State Lawmakers Split" Indianapolis Star News Online (02/25/98) Indiana lawmakers are divided over a proposal that would require HIV testing for all newborns in the state. As it now stands, Senate Bill 261 allows doctors to test newborn infants for HIV if it is deemed medically necessary, even if the mother refuses to allow the screening. The original draft had said that all newborns would be tested regardless of parental consent; the modified bill was passed by the Indiana House last week. Dr. Martin B. Kleiman, the Ryan White Professor of Pediatrics at Riley Hospital for Children, is calling on state legislators to adopt mandatory HIV testing to ensure proper and timely treatment and to reduce the chance of infection through breast milk. Currently, New York is the only state with universal HIV testing of newborns. "HIV Virus Tearing Through Singapore" Nando Times Online (02/25/98) According to the Singapore Ministry of Health, HIV infections in the country rose 24 percent in 1997, with a total of 731 infections recorded by the end of December. The ministry said that 173 new HIV infections were reported last year, 34 more than in 1996. The overwhelming majority of the infections were contracted through heterosexual sex--primarily casual sex and sex with prostitutes in Singapore and overseas, the ministry noted. "New CMV Retinitis-Related Syndrome Linked to Potent AIDS Treatment" Reuters Health Information Services (02/25/98) Researchers report a new syndrome marked by posterior segment intraocular inflammation that leads to visual impairment in AIDS patients with signs of immune recovery after antiretroviral treatment with protease inhibitors. The report, published in the February issue of the Archives of Ophthalmology, examined 130 subjects with cytomegalovirus retinitis and AIDS over a 15-month period. The researchers found evidence of symptomatic vitritis and papillitis with cystoid macular edema or epritinal membrane formation in five of the patients, who also had inactive CMV retinitis unrelated to the visual loss. The researchers noted that it is unclear what caused the inflammatory response, but note that the other patients did not experience immune recovery vitritis. "Foreign AID" Village Voice (02/17/98) Vol. 43, No. 7, P. 25; Trebay, Guy AID for AIDS is a nonprofit organization that sends unused anti-HIV medication to HIV-positive people in Latin and Central America. Due to lack of funds and availability of medication, patients in these nations often cannot receive the life-sustaining medications that are much more readily available in the United States. The extra medication comes from donors who may have stockpiled it, people who have switched treatments, or those who no longer need the drugs. The New York-based organization does not prescribe medication; however, it collects extra medication from donors, checks the expiration dates, and sends the drugs to specific patients. Still, pharmacist Ken Glickstein warns that "a prescription is written to you specifically. If you give it to someone else and they have an allergic reaction or go into shock, you have a problem." Program director Luis Roa notes that AID for AIDS only provides the drugs, although two volunteer physicians on staff act as long-distance treatment consultants. ***************************************************************** The AIDSNews Mailing List is maintained by the CDC National Center for HIV, STD and TB Prevention. 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