Subject: CDC NCHSTP Daily News Update Date: Thu Mar 5 07:31:05 PST 1998 (231 lines) From: National AIDS Info Clearinghouse Copyright 1998, Information, Inc., Bethesda, MD CDC NCHSTP Daily News Update March 5, 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 "An Outbreak Involving Extensive Transmission of a Virulent Strain of Mycobacterium Tuberculosis" "Variations in the NRAMP1 Gene and Susceptibility to Tuberculosis in West Africans" GENERAL MEDIA "AZT Price Cut for Third World Mothers-to-Be" "U.S. Sets a Plan to Combat Hepatitis C, Hoping to Track Down Those Infected" "HCV Accelerates HIV Infection" "Across the USA: Kansas" "Doctor, Hospital Sued for Alleged Breach of AIDS Confidentiality" "Dermatologic Presentations in HIV Differ by Gender" "PNG Combats AIDS--and Black Magic" "No AIDS Test No Permit DOH to CSWs" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "An Outbreak Involving Extensive Transmission of a Virulent Strain of Mycobacterium Tuberculosis" New England Journal of Medicine (03/05/98) Vol. 338, No. 10, P. 633; Valway, Sarah E.; Sanchez, Maria Pia C.; Shinnick, Thomas; et al. Researchers from the Centers for Disease Control and Prevention report on an outbreak from 1994 to 1996 of a particularly virulent strain of tuberculosis in rural communities in two counties in Tennessee and Kentucky. Twenty-one patients were identified with TB, while 72 percent of 429 contacts had positive skin tests--including 86 with documented skin-test conversions. The TB strain also had a ten-times greater reproductive rate in infected mice. The researchers note that infection with the TB strain was not associated with an increase of active TB. However, they suggest this may be due to the quick response by surveillance teams and the early introduction of isoniazid treatment. They also noted that the strain has been selected for genome-sequencing in the Mycobacterium tuberculosis project, which may provide information leading to the development of a subunit vaccine or tests for high-risk individuals. The scientists note that a large reservoir of M. tuberculosis likely remains in the affected communities and continued surveillance is necessary due to the unusual transmission characteristics of the strain. "Variations in the NRAMP1 Gene and Susceptibility to Tuberculosis in West Africans" New England Journal of Medicine (03/05/98) Vol. 338, No. 10, P. 641; Bellamy, Richard; Ruwende, Cyril; Corrah, Tumani; et al. Natural-resistance-associated macrophage protein 1 (NRAMP1) gene polymorphisms may affect susceptibility to tuberculosis, according to researchers from the Wellcome Trust Center for Human Genetics and Gambia's Medical Research Council Laboratories. The gene homologue in mice, NRAMP1, has been shown to be associated with resistance to infection with certain mycobacterium, including Mycobacterium avium, Leishmania donovani, and Salmonella typhimurium. The researchers typed polymorphisms in NRAMP1 in a case-controlled study of TB in the Gambia and found four polymorphisms that were each significantly associated with TB. They examined 410 tuberculosis patients and 417 non-infected blood donors, excluding those not indigenous to the region and all HIV-positive subjects. Heterozygotes for the INT4 and 3'UTR variants showed increased TB risk in the Gambia. The researchers note that the tuberculosis-susceptibility allele appears to be dominant, although whether linkage is involved in the interaction or not is still unclear. **************************************************************** GENERAL MEDIA **************************************************************** "AZT Price Cut for Third World Mothers-to-Be" Wall Street Journal (03/05/98) P. B1; Waldholz, Michael Glaxo Wellcome is expected to announce today a plan to immediately reduce the price of AZT by as much as 75 percent for pregnant HIV-positive women in developing countries. This marks the first time one of the world's largest drug manufacturers has agreed to cut the price of AIDS therapy to get it to regions particularly hard-hit by the epidemic. The price cut is designed to decrease vertical HIV-transmission between mothers and newborn children, but not to provide long-term treatment to the mothers. The move, expected to help an estimated 3 million HIV-infected pregnant women, comes on the heels of new research from the Centers for Disease Control and Prevention and the United Nations Joint Program on HIV/AIDS that found that administering AZT to pregnant women in Thailand for just three weeks decreased transmission rates by 50 percent. A year's worth of AZT in the United States costs about $4,000, down from $12,000 when the drug was first introduced a decade ago. "U.S. Sets a Plan to Combat Hepatitis C, Hoping to Track Down Those Infected" Wall Street Journal (03/05/98) P. B12; McGinley, Laurie Surgeon General David Satcher will unveil today a program designed to attack the spread of hepatitis C, which can cause chronic liver inflammation, cirrhosis, and possibly cancer. The proposal will include direct notification of people who may have been infected with the hepatitis C virus through blood transfusion before screening devices for the virus were instituted in 1992. Approximately 300,000 people may have become infected through blood transfusions. Satcher is expected to inform a House subcommittee that hospitals and blood banks will be required to identify individuals with a high-risk of having contracted the disease through tainted blood and to advise them to seek medical testing for the virus. The program will also include a public education project run by the American Liver Foundation. "HCV Accelerates HIV Infection" Reuters Health Information Services (03/04/98) According to a study published in the March 5th issue of AIDS, HIV-positive patients who are coinfected with hepatitis C virus have a faster progression to AIDS. Dr. Pascal Chavanet of the Hopital du Bocage in Dijon, France, and colleagues report that clinical infection progressed faster over a three year period in 119 co-infected subjects than in the 119 control subjects who were infected with HIV only. The researchers also noted that HCV infection posed a significant risk for increased clinical and immunological progression in patients in the early stages of HIV infection. The scientists concluded that the findings warrant the use of interferon-based treatment for co-infected patients. "Across the USA: Kansas" USA Today (03/05/98) P. 7A A bill before the Kansas Legislature could allow the public identification of people testing positive for HIV. Critics contend that the bill, which would require health officials to report HIV-infected patients to the state health department, constitutes a violation of privacy. "Doctor, Hospital Sued for Alleged Breach of AIDS Confidentiality" Chicago Tribune Online (03/04/98) The AIDS Legal Council of Chicago has filed suit against a physician and La Grange Medical Hospital on behalf of two plaintiffs, known as John and Jane Doe, who claim that the physician informed relatives of a married woman she was treating that the woman had contracted HIV. The plaintiffs allege that this disclosure violated the AIDS Confidentiality Act. They also contend that the doctor and a nurse at the hospital told the plaintiffs' family members that the woman's husband was aware of his HIV status when he married her and he "gave Jane Doe AIDS." "Dermatologic Presentations in HIV Differ by Gender" Reuters Health Information Services (03/04/98) Researchers reported at the 56th annual meeting of the American Academy of Dermatology that HIV-infected women appear to present viral skin diseases less frequently than HIV-infected men. Dr. Paradi Mirmirani of the University of California, San Francisco, found a 1.5 percent incidence of skin diseases among a cohort of 322 HIV-positive women, as compared to previous studies which found a 21 percent incidence among men. The study, part of the Women's Interagency HIV Study, also indicates that women have a lower incidence of Kaposi's sarcoma and herpes simplex than men. Dr. Miguel Munoz of the Virgen Macarena Hospital School of Medicine in Seville, Spain, also reported at the meeting that nearly 70 percent of HIV-infected patients in a study of 1,161 subjects had some kind of cutaneous diagnosis, such as seborrheic dermatitis, xerosis, and drug eruptions. Meanwhile, Harvard's Dr. Joel M. Gelfand announced findings that ultraviolet B (UVB) phototherapy does not raise viral levels in HIV-positive patients, despite research showing that HIV is activated by UVB in cell culture. "PNG Combats AIDS--and Black Magic" Reuters (03/04/98); Friel, Terry As a number of Papua New Guinea inhabitants blame black magic for the spread of HIV and other sexually transmitted diseases, health care workers in the nation are attempting to treat the disease without upsetting local culture. Treating villagers with modern medicine, the government--along with donors like Australia, the World Health Organization, and the European Union--will spend more than $7 million to combat AIDS. With many schools closed due to lack of funding, large distances between villages, and a lack of television coverage, the government will focus on radio broadcasts and roving theater and singing groups to educate the population on the disease. Only 914 cases of HIV/AIDS have been reported in the country, but health workers estimate that there could be as many as 10,000 cases, with the number possibly skyrocketing to 20,000 by 2001. "No AIDS Test No Permit DOH to CSWs" Sun Star Daily Online (03/05/98) The Davao City Health Office in the Philippines announced that nightclub entertainers and commercial sex workers must be tested for HIV before they can receive a work permit. The screening comes as part of an effort by Mayor Rodrigo R. Duterte to improve public awareness of the disease and to control the problem. Sanitary inspectors will work in the field to identify sex workers who operate without clearance. ***************************************************************** The AIDSNews Mailing List is maintained by the CDC National Center for HIV, STD and TB Prevention. 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