Subject: CDC NCHSTP Daily News Update Date: Mon Mar 16 07:31:05 PST 1998 (213 lines) From: National AIDS Info Clearinghouse Copyright 1998, Information, Inc., Bethesda, MD CDC NCHSTP Daily News Update March 16, 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 "A Chemokine Receptor CCR2 Allele Delays HIV-1 Disease Progression and Is Associated With a CCR5 Promoter Mutation" GENERAL MEDIA "AIDS 'Czar' Thurman Vows to Keep Backing Needle Exchange" "Communications Failure Blamed in Tuberculosis Case" "State HIV Reporting May Change" "Metronidazole Gel Ineffective as Single Agent for Trichomaniasis" "Prenatal HIV Screening Varies Widely Among Physicians" "Malaysia to Deport Infected Workers" "China Hopes to Embolden Squeamish Condom-Buyers" "HIV/STD Integration: New Data Help Forge Linkage" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "A Chemokine Receptor CCR2 Allele Delays HIV-1 Disease Progression and Is Associated With a CCR5 Promoter Mutation" Nature Medicine (03/98) Vol. 4, No. 3, P. 350; Kostrikis, Leondios G.; Huang, Yaoxing; Moore, John; et al. New research suggests that the CCR2-V64I allele is protective against HIV disease progression and is in complete linkage disequilibrium with a point mutation in the CCR5 regulatory region. The absence of CCR5 very strongly protects against HIV-transmission in homozygous populations and heterozygotes typically have a progression delay of two years. A recent study showed that a conservative substitution (V64I) within the CCR2 coding region also delays disease progression; however, subsequent tests could not duplicate the results. Researchers from the Aaron Diamond AIDS Research Center in New York and colleagues report that the initial findings concerning the CCR2 conservative substitution are in fact true. The team, which examined 953 samples from the Chicago Macs with the CCR2 genotype, found that the V64I allele delayed the rate of HIV progression in both heterozygotes and homozygotes by two to three years. Additionally, the CCR2 and CCR5 genes are closely linked on chromosome three and have an 82 percent sequence homology among the proteins, indicating that either of the genes may have arisen by duplication. **************************************************************** GENERAL MEDIA **************************************************************** "AIDS 'Czar' Thurman Vows to Keep Backing Needle Exchange" Baltimore Sun (03/16/98) P. 2A In an effort to reduce the number of new HIV infections, White House AIDS Czar Sandra Thurman vowed Sunday that she will continue to work on the issue of needle-exchange programs. Thurman noted that while the issue is complicated by the need to reduce drug abuse, she wants "to do what is in the best interest of people living with HIV and AIDS, and all Americans." Thurman relayed the news at the opening session of a four-day meeting of the White House Advisory Panel on AIDS. "Communications Failure Blamed in Tuberculosis Case" Postnet Online (03/16/98) Health officials in St. Louis report that a communications breakdown in the city health department may have allowed a patient with infectious, drug-resistant tuberculosis to go untreated. The patient, who was co-infected with AIDS, went untreated for about two months despite being seen at four separate medical centers. While city and state officials discussed the man's case, all involved failed to ensure that the man was receiving antibiotics to prevent the transmission of the disease to others. Officials say that it is only luck that kept the 50-year-old man, who was infected last year, from infecting others. St. Louis recorded more TB cases last year than at any time in the last decade. Several management problems have been reported in the city's TB control program, but city and state officials said changes have been made to substantially improve the program. "State HIV Reporting May Change" Houston Chronicle Online (03/15/98); Marquis, Julie California, New York, Illinois, Pennsylvania, Georgia, and Massachusetts are considering legislation requiring HIV reporting in an effort to accurately monitor the disease. However, a number of AIDS advocacy groups are concerned about the protection of HIV patients' privacy. Advocates of HIV reporting state that current surveillance methods--required name reporting for AIDS patients--cannot accurately monitor the changing epidemic. HIV-infected patients may have a 10- to 15-year delay between infection with the virus and the onset of AIDS. Experts assert that this is enough time for communities and subpopulations to quietly acquire the virus. The United States has reported 612,000 AIDS cases since 1981, but the Centers for Disease Control and Prevention estimates an HIV population of 650,000 to 900,000. A central issue to the HIV reporting debate is whether it should include patient names or should be anonymous. The CDC is set to release its recommendations for the reporting of HIV in the coming months; the recommendations could require compliance by tying the measures to federal funding. Bills are also pending in Congress that would require HIV surveillance. "Metronidazole Gel Ineffective as Single Agent for Trichomaniasis" Reuters Health Information Services (03/13/98) Scientists from the State University of New York Health Science Center, the University of Colorado, and the University of Chicago report that metronidazole vaginal gel has a considerably reduced cure rate for trichomoniasis compared to oral metronidazole. According to the team's report in the March issue of Sexually Transmitted Diseases, 100 percent of 15 women who were orally treated tested negative in wet preparation and culture for T. vaginalis, while only 44 percent of 16 women tested negative after vaginal treatment. The researchers note that the gel was effective for symptom relief but not as a single treatment agent. The authors suggest that the gel could possibly be used in combination therapy or as an alternative for women who cannot tolerate oral metronidazole. "Prenatal HIV Screening Varies Widely Among Physicians" Reuters Health Information Services (03/13/98) A report published in the March issue of Sexually Transmitted Diseases indicates that only 43 percent of physicians routinely advise universal HIV screening for prenatal patients, although approximately 90 percent agree with the practice. The survey, conducted by Dr. Edward A Belongia of the Marshfield Medical Research Foundation in Wisconsin and colleagues, of 83 obstetricians and 94 family doctors who were randomly selected from the Minnesota Medical Association also found that only about an average of 10 percent of prenatal patients were screened for HIV. The group observed that female physicians were more likely to test for the virus. The researchers note that despite public support for screening measures, public health agencies and health care providers still face considerable challenges in implementing HIV screening guidelines. "Malaysia to Deport Infected Workers" United Press International (03/16/98) Malaysia's health minister, Chua Jui Meng, has asked the Immigration Department to deport 1,030 legal foreign workers who were found after mandatory medical checkups to have serious or infectious diseases. Most of the workers are from Indonesia and Bangladesh; the rest are from Pakistan, Thailand, the Philippines, India, and Burma. Eight of the workers have HIV or AIDS, 668 are infected with hepatitis, 263 have venereal diseases, and 18 carry tuberculosis. "China Hopes to Embolden Squeamish Condom-Buyers" Nando Times Online (03/15/98) China Daily's Business Weekly reports that Chinese authorities are planning to launch contraceptive specialization stores in order to relieve the embarrassment associated with buying condoms felt by some individuals at local department stores. Currently, department stores are the primary retailer of condoms, contraceptive pills, and creams, but regional taboos over the public discussion of sex deters a number of potential customers. The stores--which would be launched this year in the provincial capitals--would be licensed by the State Family Planning Commission, training staff and providing suitable facilities for government-approved contraceptives. The central government plans to boost spending on contraceptives to more than $36 million in 1998. The program is designed to help control the population growth and fight against the transmission of HIV and other sexually transmitted diseases. "HIV/STD Integration: New Data Help Forge Linkage" AIDS Alert (03/98) Vol. 13, No. 3, P. 27 The Centers for Disease Control and Prevention is planning to publish guidelines this year detailing how to integrate testing and services for HIV and other sexually transmitted diseases, the first step to starting a nationwide effort to speed up services at treatment centers. Such service improvements would mean patients would no longer have to seek STD testing and treatment at a center separate from the place they receive HIV testing or treatment. The guidelines were prompted in part because of research on the impact of co-infection with HIV and other STDs, as well as the changing epidemiology for HIV. Recent studies have also shown that STD prevention is a key strategy for preventing HIV. ***************************************************************** 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. *****************************************************************