Subject: CDC AIDS Daily Summary Date: Tue Feb 2 07:31:02 PST 1999 (208 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Tuesday, February 2, 1999 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 HIV/STD/TB Prevention News Update should be cited as the source of the information. HEADLINES GENERAL MEDIA "Short Treatment Reduces Possibility of Mother-Child HIV Transmission" "HIV Study Finds Virus Use in Vaccine May Cause AIDS" "Study Pinpoints 'Extremely Low Levels' of HIV" "New Jersey's Hard Line on Needle Exchanges" "Here's What the President Would Do: Medical Research" "The Source of AIDS" "'Triple Cocktail' Hope in AIDS Fight" "In Senegal, Common Sense Spells Success" "Screening Very Important Part of Caring for Internationally Adopted Child" "Opposition Diminishes to HIV Tracking System" **************************************************************** GENERAL MEDIA **************************************************************** "Short Treatment Reduces Possibility of Mother-Child HIV Transmission" Washington Post(02/02/99) P. A6; Brown,David A report presented at the Sixth Conference on Retroviruses and Opportunistic Infections in Chicago reveals that a one-week AZT and 3TC regimen for HIV-infected pregnant women can reduce the risk of mother-to-child HIV transmission by more than one-third. A five-week course reduced transmission rates by around 50 percent. The researchers also found that the administration of the drugs after delivery conferred a major benefit, while women who only received the medications during labor and delivery did not benefit. The PETRA (for perinatal transmission) study was conducted by the Joint UN Program on HIV/AIDS at two locations in Uganda, two in South Africa, and one in Tanzania. The experiments, which began recruiting in 1996, were strongly criticized for their use of placebos, despite the fact that an earlier study in the United States showed that AZT cut vertical transmission rates. "HIV Study Finds Virus Use in Vaccine May Cause AIDS" Wall Street Journal (02/02/99) P. C19 A study reported in the February issue of Nature Medicine indicates that using a weakened HIV vaccine may cause disease. The study, conducted by Dr. Ruth Reprecht of the Dana-Farber Cancer Institute and others, involved 16 macaques that were inoculated with a genetically crippled version of SIV as adults and eight that were inoculated as infants. During the study, one of the adult macaques and six of the macaques vaccinated when young developed AIDS, while some of the others developed immune-system abnormalities. Although some weakened HIV vaccine studies have been encouraging, the new finding casts doubts on the viability of the use of such a system in humans. "Study Pinpoints 'Extremely Low Levels' of HIV" USA Today (02/02/99) P. 6D; Painter, Kim A study presented at the Sixth Conference on Retroviruses and Opportunistic Infections in Chicago showed that some people who were repeatedly exposed to HIV but do not appear to contract the virus are actually infected. The infected individuals--who had repeated, unprotected sex with infected partners, but continually tested negative for the virus--had "extremely low levels" of HIV, the researchers said. Tuofu Zhu, of the University of Washington at Seattle, said that the people may harbor defective HIV strains that do not cause disease but serve to protect them, similar to a natural vaccine, against more pathogenic strains. "New Jersey's Hard Line on Needle Exchanges" New York Times (02/02/99) P. A20; Kocieniewski, David Last year, the New Jersey-based Chai Project needle exchange was forced to cease distribution of syringes following the arrest of volunteer Diana McCague for breaking the state's ban on possession or distribution of syringes. The group continues to distribute condoms, bleach kits for sterilization, and prevention pamphlets, but it no longer hands out clean needles. New Jersey Gov. Christine Whitman has a strict stance on the needle exchanges, asserting that they set a bad example for children. Meanwhile, New Jersey has the third-highest rate of HIV infection in the country due to intravenous drug use and the highest HIV rate among women and children. The Centers for Disease Control and Prevention, the National Institutes of Health, and the Surgeon General have all released reports indicating that needle-exchanges significantly decrease the incidence of HIV among intravenous drug users without encouraging drug use. There are currently 113 exchange programs in 30 states, exchanging 17.5 million needles annually. "Here's What the President Would Do: Medical Research" Washington Times (02/02/99) P. A10 Under President Clinton's budget proposal, the National Institutes of Health would receive an additional $320 million, a 2 percent increase. NIH currently receives $15.6 billion. The new budget plan would include $35 million for AIDS research, for a total of $1.8 billion in funding, and the Food and Drug Administration would get an additional $190 million in funds, an increase of 17 percent. "The Source of AIDS" New York Times (02/02/99) P. A24 Research recently revealed that HIV originated in the chimpanzee subspecies Pan troglodytes troglodytes in central Africa. They can carry the genetically similar strain of SIVcpz, which is believed to have been transferred to humans as a result of hunting and handling of chimpanzee meat. According to an editorial in the New York Times, the subspecies is still being hunted and is fast nearing extinction. The continued hunting threatens to wipe out the viral genetic reservoir before research on the virus can develop, which could possibly hinder the future development of treatments for HIV infection. The authors note that the dilemma shows the clear need to preserve biodiversity. "'Triple Cocktail' Hope in AIDS Fight" Financial Times (02/02/99) P. 10; Pilling, David New data suggest that triple-drug therapy without protease inhibitors is as effective in the suppression of HIV viral load as triple-drug therapies that contain them, according to the Atlantic study, which was conducted by European and U.S. universities. Protease inhibitors may have severe adverse effects, such as unusual fat deposits, in patients who take the drugs for long-periods of time. The results of the study were presented at an annual conference on retroviruses in Chicago. "In Senegal, Common Sense Spells Success" Washington Post (01/31/99) P. B2; Schoofs, Mark Senegal has instituted a state program that requires governmentally licensed prostitutes to be screened for sexually transmitted diseases every month and HIV every six months. The requirement has heightened awareness about STDs and HIV among the women. Even if a woman tests HIV positive, her license will not be pulled; instead, she will be counseled about how safer sex will help her. Officials assert that preventing the women from practicing would only force them into illicit prostitution, and they note that incidence of STDs, including HIV, among prostitutes in Senegal has dropped in recent years. The prevalence of STDs among adult sex workers in Senegal has declined from over 45 percent in 1991 to under 20 percent by 1996. While much research focuses on the elimination of HIV through medical intervention, Senegal's program is an example of how a simple intervention can help decrease the problem. One of the keys to Senegal's success has been the promotion of condoms. Whereas about 800,000 condoms were distributed in 1988, a total of 7 million condoms were passed out in 1996, reflecting the changing behavior in Senegal. "Screening Very Important Part of Caring for Internationally Adopted Child" Infectious Diseases in Children (01/99) Vol. 12, No. 1, P. 28; Rosenthal, Marie Over 10,000 children in the United States are adopted from abroad annually. According to a prospective study of 294 internationally adopted children, about 57 percent had at least one unsuspected medical diagnosis, indicating that screening for infectious diseases in the children remains important. HIV-1 and -2 testing is recommended for all children, regardless of country of origin, although positive ELISA tests in children younger than 18 months may reflect the HIV status of the mother, not the child. Hepatitis B virus (HBV) screening is also recommended for most children; up to 10 percent of women are positive for hepatitis B surface antigen in Eastern Europe, China, Southeast Asia, and India. Children from Korea do not need to be tested for HBV because the government has required vaccination of newborns for the past decade. Not all children who test positive for surface antigens are necessarily carriers. Children should also be tested for tuberculosis, with 1 percent to 2 percent of internationally adopted children carrying the pathogen. Other diseases to be on the alert for include syphilis, which is commonly diagnosed--and misdiagnosed--in Russian mothers, and hepatitis C virus, which is problematic in China. "Opposition Diminishes to HIV Tracking System" Washington Blade (01/22/99) Vol. 30, No. 4, P. 1; Wright, Kai The District of Columbia appears to be leaning toward a name-based HIV surveillance system. The D.C. Department of Health's community advisory board has voted to recommend a name reporting system, and the director of the Department of Health is expected to make a final decision and begin implementation within six months. Ron Lewis, chief of the D.C. Agency for HIV/AIDS, said the city needs more accurate data on the virus. He added that a federal push for name-based reporting is also affecting the decision, noting that there were concerns that funding would be reduced if an HIV surveillance system is not introduced. The board further recommended that all city-funded HIV testing sites provide the option of anonymous testing, although Lewis said the it is unclear whether the option will be available at every site. A motion to recommend the use of unique identifiers for HIV surveillance in consultation with Maryland did not pass the board. Officials believe that a unique identifier system could increase the financial burden and load by 40 percent to 60 percent annually.