Subject: CDC NCHSTP Daily News Update Date: Wed Mar 11 07:31:04 PST 1998 (207 lines) From: National AIDS Info Clearinghouse Copyright 1998, Information, Inc., Bethesda, MD CDC NCHSTP Daily News Update March 11, 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 "Predictive Value of Quantitative Plasma HIV RNA and CD4 Lymphocyte Count in HIV-Infected Infants and Children" "CD4-Cell Count in HIV-1 Infected Individuals Remaining Highly Viraemic With Highly Active Antiretroviral Treatment (HAART)" GENERAL MEDIA "Tempers Flare Over Needle-Exchange Bill" "Canadian Hemophiliacs File Suit Over Tainted Blood" "GWU Hospital Settles AIDS Suit" "Drug Abusers Praise Needle Exchanges" "Paclitaxel Highly Active Against HIV-Related Kaposi's Sarcoma" "HIV Soldier Sentenced for Having Unprotected Sex" "Blood Business" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Predictive Value of Quantitative Plasma HIV RNA and CD4 Lymphocyte Count in HIV-Infected Infants and Children" Journal of the American Medical Association (03/11/98) Vol. 279, No. 10, P. 756; Palumbo, Paul E.; Raskino, Claire; Fiscus, Susan; et al. Researchers, led by Paul E. Palumbo of the University of Medicine and Dentistry of New Jersey, report on the use of HIV RNA plasma levels and CD4 lymphocyte counts as predictive measures in HIV-positive children age 3 months to 18 years. According to the team, results of a double-blind, randomized, placebo-controlled study of 566 infants and children suggest that plasma HIV RNA levels are high for children under the age of 6 years and that there is an age-dependent downward trend in plasma RNA levels, reaching a plateau of 50,000 to 100,000 copies/milliliter at approximately 6 years of age. They also report that baseline RNA values are a highly significant predictor of disease progression, with log10 HIV-1 RNA levels directly proportional to Kaplan-Meier failure percentage. Age was not a significant predictor in this model. In the CD4 cell count model, 2-year progression free survival was correlated with both CD4 cell counts and age. Combination of plasma RNA levels and CD4 lymphocyte data is "a more powerful approach than using either variable alone," the researchers said. "CD4-Cell Count in HIV-1 Infected Individuals Remaining Highly Viraemic With Highly Active Antiretroviral Treatment (HAART)" Lancet (03/07/98) Vol. 351, No. 9104, P. 723; Kaufmann, Daniel; Pantaleo, Gioseppe; Sudre, Philippe; et al. Daniel Kaufmann and colleagues at the Swiss HIV Cohort Study Data Center report that highly active antiretroviral treatment (HAART) may still provide prevention of CD4 reduction benefits to patients that remain viremic. They examined 101 HIV-positive patients who had been receiving HAART treatment for at least 3 months. CD4 cell count increase was seen in 93 percent of 98 patients assessed, and interruption of HAART was associated with decreased CD4 cell count independent of prior viremia level. Plasma viral RNA analysis of 15 patients who remained on antiretroviral therapy but were still viremic showed an accumulation of drug-resistant mutations in the viral reverse transcriptase and protease domains. The researchers suggest that a cumulative benefit of small viral load reductions could account for the increase of CD4 cells in these patients. Due to the possible effect that these findings could have on treatment strategies, they strongly recommend further studies in larger cohorts to determine the possible benefit of HAART in viremic patients. **************************************************************** GENERAL MEDIA **************************************************************** "Tempers Flare Over Needle-Exchange Bill" Washington Times (03/11/98) P. C4; Redmon, Jeremy On Thursday, the Maryland Senate is expected to take a final vote on a measure that would permit needle-exchange programs in Harford, Montgomery, Prince George's, and Baltimore counties. Current laws forbid the possession of drug paraphernalia. The bill, which would allow those counties to offer drug addicts sterile needles and syringes in exception to state laws--survived a key vote on Tuesday amid much debate. Critics assert that the programs will increase crime and send the wrong message to children concerning drug use; however, advocates claim that needle-exchange programs save lives and taxpayer funds devoted to AIDS patient care. "Canadian Hemophiliacs File Suit Over Tainted Blood" Reuters (03/10/98); Le Gras, Gilbert Canadian hemophiliacs who were infected with the hepatitis C virus through tainted blood transfusions filed suit against the Canadian Red Cross on Tuesday, seeking $2.7 billion in damages. The class action suit, which includes approximately 22,000 hemophiliacs, contends that methods to screen for hepatitis C were available but were not implemented. Toronto attorney David Harvey, who represents the patients, claims the CRC should not have exposed his clients to pooled plasma batches containing blood from more than 20,000 separate donors. The Canadian government is expected to offer compensation for individuals infected between 1986 and 1990; the recent suit covers periods before 1986 and after 1990. "GWU Hospital Settles AIDS Suit" Washington Post (03/11/98) P. B7 George Washington University Hospital in Washington, D.C., has agreed to pay a $125,000 settlement to Ron Flowers after the man was denied treatment due to his HIV-positive status in March 1996. The hospital paid Flowers--who had filed a complaint under the Americans with Disabilities Act--for compensatory damages and attorney's fees, although it rejects the man's allegations and any liability. Under the terms of the agreement, GWU Hospital will institute steps to make sure that its staff does not discriminate against HIV-positive individuals. "Drug Abusers Praise Needle Exchanges" Boulder News Online (03/09/98); Mears, Jennifer Colorado is considering a law to legalize needle-exchange programs. According to the Centers for Disease Control and Prevention, nearly 50 percent of the needle-exchange programs in the country in 1995-1996 were illegal; some 23 percent were permitted by local legislation, but not by state law. Boulder County, CO, for example, runs an $80,000 needle-exchange program despite current state laws. Critics argue that the programs condone drug use, while proponents say that the programs help fight the spread of HIV and hepatitis. One client of the Boulder exchange program noted: "What they are doing is giving syringes out to stop AIDS. It's not to make people quit. It's about educating. Clean needles stop AIDS." According to statistics, one-third of adults with AIDS contracted HIV via infected needles or through sex with an injected drug user. "Paclitaxel Highly Active Against HIV-Related Kaposi's Sarcoma" Reuters Health Information Services (03/10/98) New research published in the March Issue of the Journal of Clinical Oncology indicates that paclitaxel is active against HIV-related Kaposi's sarcoma. The scientists found that the drug--which is effective in treatment of ovarian, breast, and lung carcinomas--had a substantial effect upon 20 of 28 subjects in the study, with two complete responses. The researchers, led by Robert Yarchoan of the National Cancer Institute, suggest further studies investigating the effect of paclitaxel in combination with other cytotoxic and antiangiogenic medications. The Food and Drug Administration approved the drug for the treatment of Kaposi's sarcoma last year based on the results of the trial. "HIV Soldier Sentenced for Having Unprotected Sex" Washington Times (03/11/98) P. A6 Specialist Raymond Humphries, a HIV-positive Army soldier, was sentenced by a military judge to 15 years in prison on Tuesday for having unprotected sex with eight women. The man also received a dishonorable discharge, a reduction to the military's lowest enlisted rank, and forfeiture of all pay. Four of the women were impregnated, and two have tested positive for HIV. "Blood Business" Economist (02/14/98) Vol. 346, No. 8055, P. 44 For-profit blood donations have been outlawed in India in an attempt to eliminate donations by drug addicts, alcoholics, or anemic "professional" donors who may transmit HIV or hepatitis to patients. However well-intentioned the move, the decision has attracted criticism from many segments of India's health care community. Doctors fear the development of an unregulated "black market" and blood-bank owners question the forced closure of banks with sophisticated screening facilities while government and volunteer agencies lacking such safeguards remain open. Others point out that contamination testing is an expensive proposal for cash-strapped state governments; HIV tests alone cost 300 rupees or around $7.76 per unit. Many fear the new measures will worsen the blood shortage and force desperate patients to risk infection due to an even greater need. ***************************************************************** 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. *****************************************************************