Subject: CDC NCHSTP Daily News Update Date: Fri Feb 27 07:31:08 PST 1998 (203 lines) From: National AIDS Info Clearinghouse Copyright 1998, Information, Inc., Bethesda, MD CDC NCHSTP Daily News Update February 27, 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 "Screening for Tuberculosis in Jail and Clinic Follow-Up After Release" "Identifying Condom Users at Risk for Breakage and Slippage: Findings From Three International Sites." "Cytotoxic-T-Cell Responses in Early HIV-1 Infection" GENERAL MEDIA "UNAIDS Issues Guidelines on HIV/AIDS and Human Rights" "Rape Survivors Predisposed to HIV/STD Risk Factors" "Westchester TB Cases Up 60 Percent" "Clinical Measures Predict Likelihood of HIV Dementia" "Chinese Scientists Study Equine AIDS Link" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Screening for Tuberculosis in Jail and Clinic Follow-Up After Release" American Journal of Public Health (02/98) Vol. 88, No. 2, P. 223; Tulsky, Jacqueline Peterson; White, Mary Castle; Dawson, Carol; et al. Researchers have reported on tuberculosis screening and treatment for jail inmates as well as clinic follow-up for inmates released before treatment was completed. The scientists, led by Dr. Jacqueline P. Tulsky of the University of California at San Francisco, screened 3,352 inmates in the San Francisco County Jail for TB. Nearly 17 percent of the subjects reported prior positive skin tests, while 330 of the 1,229 who received tests were positive for TB. Of those testing positive, 151 were started on an isoniazid regimen, with an average treatment time of 68.5 days. Ninety-three patients were eligible for follow-up treatment; however, only three had appeared at the San Francisco Department of Public Health within a month of release. One additional subject returned to the clinic 69 days after release. The researchers concluded that jail is an important screening site for TB due to the high demographic overlap between inmates and high-risk TB populations. In addition, they called for strategies to enhance isoniazid treatment in jail populations. San Francisco is currently implementing a system in which tuberculosis-infected inmates will receive a month's supply of isoniazid upon release. "Identifying Condom Users at Risk for Breakage and Slippage: Findings From Three International Sites." American Journal of Public Health (02/98) Vol. 88, No. 2, P. 239; Spruyt, Alan; Steiner, Markus J.; Joanis, Carol; et al. Researchers from Family Health International and elsewhere report that men with a history of condom breakage or slippage pose a higher risk for future condom failure. The team evaluated 130 male condom users at three international sites, categorizing the subjects as either high-risk--men with a history of one or more condoms that broke or slipped off--or low risk. The subjects were given 5 condoms to use over a 3-week period. The researchers found that condom failure occurred twice as often among members of the high-risk group as compared to the low-risk subjects. Opening condom packages with sharp objects and unrolling the condom before putting it on resulted in elevated rates of condom failure. There was also a correlation between condom failure and lower education. The authors suggest that family planning providers help clients learn to maximize condom effectiveness in order to reduce the spread of sexually transmitted diseases and unwanted pregnancies. "Cytotoxic-T-Cell Responses in Early HIV-1 Infection" New England Journal of Medicine (02/26/98) Vol. 338, No. 9, P. 622; McElrath, M. Juliana; Hughes, James; Musey, Luwy In a letter to the editor of the New England Journal of Medicine, Dr. M. Juliana McElrath of the Fred Hutchinson Cancer Research Center and colleagues reassert that Env-specific responses may contribute to a delay in the progression of HIV disease, despite challenges to their conclusion due to differences in univariate analysis and multivariate analysis. The researchers note that CD4 lymphocyte cell counts do not indicate helper function. They also report that T-helper-cell dysfunction occurs in HIV-positive patients with normal CD4 cell counts early in disease progression. However, in response to comments by Dr. Andrew N. Phillips of the Royal Free Hospital School of Medicine in London, the team compared univariate and multivariate analysis, adjusting for CD4 lymphocyte cell counts. Their results were unchanged, indicating an inverse correlation between HIV-1 Env-specific cytotoxic T-lymphocytes and plasma HIV-1 RNA. **************************************************************** GENERAL MEDIA **************************************************************** "UNAIDS Issues Guidelines on HIV/AIDS and Human Rights" Reuters Health Information Services (02/26/98) In an attempt to offer measures to protect human rights and promote health for HIV populations, the joint United Nations Program on HIV/AIDS (UNAIDS) and the Office of the High Commissioner for Human Rights last week released the International Guidelines on HIV/AIDS and Human Rights. The document is designed to alleviate discrimination against HIV-positive people, thereby assisting in prevention and treatment as well. The guidelines focus on governmental responsibility, law and policy reform, and structural reform in government. Additionally, UNAIDS commissioned the International Council of AIDS Services Organizations to compile guidelines for use in non-governmental agencies, and is working on a guide for use by government policy makers. "Rape Survivors Predisposed to HIV/STD Risk Factors" Reuters Health Information Services (02/26/98) Dr. Ralph J. DiClemente and co-investigators at the University of Alabama Birmingham report in the February issue of the Journal of Women's Health that African American women who have been raped are three times more likely to have risk factors related to risk of infection by HIV and other sexually transmitted diseases. The study--which examined 165 African American women of low socioeconomic status in San Francisco, CA--found a 14 percent prevalence of rape after the age of 14. These women were significantly more likely to report HIV-related sexual, psychologic, and social experiences, and they were three times as likely to report not using condoms during the past three months and 3.3 times less likely to report consistent condom use over a 3-month period. The team noted that HIV prevention programs should take social risks into account. "Westchester TB Cases Up 60 Percent" MSNBC Online (02/26/98) New statistics from Westchester County, NY, show a 60 percent increase in tuberculosis cases between 1996 and 1997. The 116 cases reported in 1997 was about average; the increase in reported tuberculosis infections is due to a large drop in 1996 cases. Health officials are still concerned about the increase in incidence, especially in high-risk areas such as cramped spaces, migrant worker areas, and poverty-stricken communities. To slow the spread of the disease, officials are aggressively testing and vaccinating people against the disease. In addition, the Westchester Health Department made 12,000 visits last year to ensure antibiotic usage by TB-exposed individuals. "Clinical Measures Predict Likelihood of HIV Dementia" Reuters Health Information Services (02/26/98) Researchers from Emory University and the Centers for Disease Control and Prevention report in the February issue of Neurology that HIV-positive patients with lower than 100 CD4 T cells/ml and anemia--or an AIDS-defining condition--are at high risk for developing HIV-related dementia within a 2-year period. The study examined the medical records of more than 19,000 HIV-positive subjects, investigating factors associated with the development of dementia. Additionally, the researchers found the lowest 2-year probability for developing dementia among patients with CD4 T-cell counts greater than 200 cells/ml and no additional risk factors. The researchers noted that while no proven prophylactic treatment for HIV-related dementia currently exists, it may be possible to identify those individuals who may benefit from existing and candidate therapies. "Chinese Scientists Study Equine AIDS Link" Australian Associated Press (02/27/98) Scientists at China's leading AIDS research center are investigating Equine Infectious Animal (EIA) disease, a fatal horse illness that is similar to AIDS, in the hopes that it will lead to a vaccine against HIV. Researchers at the Academy of Preventive Medicine are working in collaboration with the Harbin Veterinary Institute of the Chinese Academy of Agricultural Sciences to determine whether the model for an EIA vaccine can be applied to HIV. Scientists report that at least half of the EIA gene structure is identical to that of HIV, and they expect that the EIA vaccine will provide a valid research model. ***************************************************************** 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. *****************************************************************