Subject: CDC AIDS Daily Summary Date: Wed Feb 3 07:31:02 PST 1999 (193 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Wednesday, February 3, 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 PEER-REVIEWED JOURNALS "Human Immunodeficiency Virus Type 1 Neutralizing Antibodies Accelerate Clearance of Cell-Free Virions From Blood Plasma" "Indian Welfare Minister Orders Compulsory HIV Testing for Children in Care" GENERAL MEDIA "Babies' Deaths Raise Fear Over AIDS Therapy" "AIDS Forum Is Told of Sex Disparity" "New HIV Cases Point the Way to Prevention" "Deaths From AIDS Fall" "Genes Prove Patients Infected in Surgery" "Pharmacia & Upjohn Says HIV Drug Shows Promise in Study" "Statistically Insignificant" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Human Immunodeficiency Virus Type 1 Neutralizing Antibodies Accelerate Clearance of Cell-Free Virions From Blood Plasma" Nature Medicine (02/99) Vol. 5, No. 2, P. 211; Igarashi, Tatsuhiko; Brown, Charles; Azadegan, Ali; et al. Tatsuhiko Igarashi of the National Institute of Allergy and Infectious Diseases and colleagues measured the rate of HIV clearance in the general circulation of rhesus macaques. The monkeys received a continuous infusion of cell-free particles in the presence and absence of virus-specific antibodies. The researchers observed that the clearance of physical and infectious particles of an HIV-1 isolate was very rapid in naive animals. They also found that the half-life of virion RNA was greatly reduced in monkeys with high-titer HIV-1 isolate-specific neutralizing antibodies; these monkeys showed undetectable viral levels. Further tests suggested that viral infectivity loss in the blood was due to the combined effects of extravascular clearance and intravascular inactivation of HIV-1 infectivity due to antibody binding. "Indian Welfare Minister Orders Compulsory HIV Testing for Children in Care" Lancet (01/30/99) Vol. 353, No. 9150, P. 390; Sharma, Dinesh C. The social welfare minister of Delhi, India, Krishna Tirath, recently ordered compulsory HIV testing for all children in government care homes. Tirath further recommended voluntary testing of women who live in the homes. The official noted that many of the women and children in the government care homes come from red-light districts and other similar areas. The mandate violates a national policy prohibiting compulsory testing. Tirath said that compulsory testing would be for the benefit of public health, noting that children who test positive would be able to receive care. The National AIDS Control Organization and the Joint Action Council of Non-Government Organizations claimed Tirath does not have the right to mandate testing for the children in light of national policies. **************************************************************** GENERAL MEDIA **************************************************************** "Babies' Deaths Raise Fear Over AIDS Therapy" New York Times (02/03/99) P. A16; Altman, Lawrence K. French researchers at the Sixth Conference on Retroviruses and Opportunistic Infections in Chicago reported the deaths from a rare neurological disease of two babies involved in a trial of AZT and 3TC among pregnant HIV-positive women. U.S and United Nations officials said they would immediately begin investigations to determine if the drug treatment is linked to the deaths. In the study, HIV-positive pregnant women were given AZT from the 24th week of pregnancy and received it intravenously during labor; they were also given 3TC during the last eight weeks of pregnancy, and their infants remained on the drug during the first five weeks of life. A total of 2.6 percent of the infants born to the 194 infected mothers were born with HIV. The two babies who died were not infected with HIV. Dr. Stephane Blanche of the Neckar Hospital in Paris said that the infants died from mitochondrial dysfunction, which affects about one in 10,000 babies. Dr. Kevin De Cock, of the Centers for Disease Control and Prevention, noted an "urgent" need for further research in the matter. "AIDS Forum Is Told of Sex Disparity" Boston Globe Online (02/03/99) P. A12; Knox, Richard A. Dr. Katherine Anastos of Catholic Medical Centers in New York City reported at the Sixth Conference on Retroviruses and Opportunistic Infections in Chicago that HIV-positive women in the United States are not receiving treatment early enough. Treatment initiation is usually determined by viral levels in the blood, but women have viral levels that measure 20 percent lower than viral levels in men for any given stage of HIV infection, Anastos announced. She said that treatment guideline levels should be reduced by 20 percent, which would only increase the number of women needing treatment by 2 percent to 5 percent. The study involved over 1,200 HIV positive women and 1,600 men, making it the largest study on gender differences in HIV infection thus far. "New HIV Cases Point the Way to Prevention" USA Today (02/03/99) P. D1; Painter, Kim New research indicates that the majority of new HIV infections in the United States among first-time blood donors were in the Southeast. Furthermore, most of the infected individuals had little education and were Hispanic or African-American. The Centers for Disease Control and Prevention's Harold Jaffe noted that the study "confirms where the problem is." On average, one in 10,000 donors were found to be infected with HIV, confirming that few donors carry the virus. The data show where the new infections are occurring, providing information on areas that need to be targeted for HIV prevention. The study was reported at the Sixth Conference on Retroviruses and Opportunistic Infections in Chicago. "Deaths From AIDS Fall" New York Times (02/03/99) P. A17 Preliminary data for 1998 indicate that 1,947 people in New York City died from AIDS during the year, a 26 percent decline from 1997 and the fourth consecutive year of decline in the city. The drop also marks the first time since 1985 AIDS-associated deaths have dropped below 2,000. City officials said that improved drug therapy and access to care were responsible for the decline. The decrease in deaths was seen among both sexes and all age and racial groups, although female African-Americans saw the smallest decline. "Genes Prove Patients Infected in Surgery" United Press International (02/02/99); Susman, Ed Four Australians were apparently infected with HIV through their dermatologist, according to Nitin Saksena, of the Retrovirus Genetics Laboratory in New South Wales. Genetic analysis showed that all four patients were infected with the same strain of HIV. Saksena, speaking at the Sixth Conference on Retroviruses and Opportunistic Infections in Chicago, said, "We are confident now that these people were all infected on Nov. 13, 1989, while undergoing surgery at a private clinic in Sydney." While the case first made headlines in 1992, proof was lacking until recently. The four people apparently received their infection due to a breakdown in infection control at the clinic; a man with HIV who had been operated on the same day is believed to be the source of the infection. There is no indication that the virus was passed from a health care worker to the patients, according to the Centers for Disease Control and Prevention. "Pharmacia & Upjohn Says HIV Drug Shows Promise in Study" Dow Jones News (02/02/99) Pharmacia & Upjohn released Tuesday findings from a clinical study that indicate two newer AIDS drugs are somewhat effective against clinical isolates that had proven resistant to older drugs of the same type. The newer drugs investigated were Dupont Merck Pharmaceutical's Sustiva and Pharmacia's experimental non-nucleoside reverse transcriptase inhibitor, PNU142721. Pharmacia said it was unsure if the same level of efficacy would occur in actual treatment situations. "Statistically Insignificant" Washington Blade (01/22/99) Vol. 30, No. 4, P. 1; Wright, Kai AIDS advocacy groups have a hard time addressing the needs of men who have sex with men in developing nations. Often, these men refuse to acknowledge themselves as homosexual or bisexual, and many nations do not have privacy laws for health information, notes Richard Stern, who runs a network of Central American AIDS service groups that work with men who have sex with men. Furthermore, there is a lack of programs that reach out to these individuals, and the few groups that do often do not reach enough people to justify extensive funding. The U.S. Agency for International Development and other programs, such as India's NAZ Foundation, are trying to address this problem. USAID is currently initiating two projects: one that will target men who have sex with men in Latin America, and another program that will link U.S.-based AIDS organizations with similar programs in developing countries.