Subject: CDC AIDS Daily Summary Date: Thu Feb 4 07:31:01 PST 1999 (208 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Thursday, February 4, 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 "The Use of Legal Action in New York City to Ensure Treatment of Tuberculosis" "Syringe Exchange and Risk of Infection With Hepatitis B and C Viruses" "HIV/AIDS Information Overload" GENERAL MEDIA "New Drugs May Lessen HIV Rate of Infection" "AIDS Expected to Kill 200 People a Day in Zimbabwe This Year" "Study Links HIV and Cervical-Cancer Virus" "Ligand Drug Receives Approval" "Another Round in the AIDS Wars" "New Treatment Seems to Eliminate HIV Signs" "Government Considers Compensation for Bad Blood Victims" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "The Use of Legal Action in New York City to Ensure Treatment of Tuberculosis" New England Journal of Medicine (02/04/99) Vol. 340, No. 5, P. 359; Gasner, M. Rose; Maw, Khin Lay; Feldman, Gabriel E.; et al. New York City passed in 1993 regulations to increase adherence among patients receiving tuberculosis treatment following a rise in the number of TB cases. Under the regulations, the health commissioner can issue orders compelling a person to be examined for the disease and to receive treatment under direct observation if needed. Members of the Bureau of Tuberculosis Control for the New York City Department of Health and the Centers for Disease Control and Prevention evaluated the legal use of this action between April 1993 and April 1995, finding that most patients, even those with severe social problems, can complete treatment without regulatory intervention. The researchers analyzed over 8,000 cases of TB treatment, finding that only 150 patients were required to undergo directly observed treatment. Furthermore, 139 patients were ordered to be detained during therapy, 12 patients were ordered to be tested for TB, and three patients were required to complete treatment. The investigators found that action was usually taken due to treatment history of the patient, not due to social characteristics. They add that "the less restrictive measure of mandatory directly observed therapy was often effective." "Syringe Exchange and Risk of Infection With Hepatitis B and C Viruses" American Journal of Epidemiology Online (02/01/99) Vol. 149, No. 3, P. 203; Hagan, Holly; McGough, James P.; Thiede, Hanne; et al. Research conducted as part of the Risk Activity Variables, Epidemiology, and Network Study of intravenous drug users involved in a Seattle-King County, Wash., needle-exchange program indicates that the program was not effective in reducing hepatitis B virus (HBV) or hepatitis C virus (HCV) among the users. The authors of the study note that, while uncontrolled confounding or other bias may have obscured a beneficial impact, the study of 187 HCV-seronegative and 460 HBV-seronegative IDUs did not suggest such an effect. The participants were enrolled in the study between June 1994 and January 1996 and followed for seroconversion one year later. At follow up, there were 39 HCV infections and 46 HBV infections, the researchers report. "HIV/AIDS Information Overload" Lancet (01/30/99) Vol. 353 , No. 9150, P. 412; Green, Chris W. In a letter to the editor of the Lancet, Chris W. Green, of Indonesia, comments on the amount and distribution of information available on HIV/AIDS. Green states that, while there is an incredible amount of information on the virus, most of the information is in English and is not accessible to people in non-English speaking countries, particularly developing countries where the information is most needed. While others focus on implementing treatment options in developing countries, Green asserts that there has been a lack of emphasis placed on delivering timely information in native languages in developing nations. The author recommends that "information providers in developed countries should actively support the translation and dissemination of information in local languages." **************************************************************** GENERAL MEDIA **************************************************************** "New Drugs May Lessen HIV Rate of Infection" USA Today (02/04/99) P. 1D; Painter, Kim A number of researchers believe that anti-HIV drugs may reduce viral transmission by cutting viral levels in blood, semen, and vaginal secretions, thereby decreasing the number of new infections. However, the number of new infections has not yet significantly changed, with about 40,000 people in the United States contracting the virus annually. Speaking at the Sixth Conference on Retroviruses and Opportunistic Infections in Chicago on Wednesday, the Centers for Disease Control and Prevention's Jonathan Kaplan said that while the drugs likely reduce infectiousness, "we're probably not seeing a significant impact yet." He added that only about half of the HIV-infected people in the United States receive drug treatment and that they may have higher risk factors for the transmission of HIV, including needle sharing or risky sex. Additionally, some data indicate that treated individuals are increasingly undertaking high-risk behavior, such as ignoring safe sex measures and engaging in sex with many partners. These factors could offset any benefit in transmission reduction that would normally be seen from the drug therapy. Kaplan reminds that there is no guarantee that low viral levels guarantee reduced transmission risk. "AIDS Expected to Kill 200 People a Day in Zimbabwe This Year" Baltimore Sun (02/04/99) P. 12A Some 70,000 people in Zimbabwe are expected to die from AIDS this year, according to Dr. Evaristo Marowa, the head of the country's AIDS prevention program. Marowa said Wednesday that a failure to use protective measures during sex by young, sexually active adults is causing the massive death toll. Last year, around 100 people a day died due to AIDS--half of this year's expected rate. Approximately 1.6 million of Zimbabwe's 12 million people are infected with HIV. "Study Links HIV and Cervical-Cancer Virus" Philadelphia Daily News Online (02/04/99) A study by Dr. Joel Palefsky, of the University of California at San Francisco, published in the Journal of the National Cancer Institute, found that HIV-infected women have a high risk of human papillomavirus (HPV) infection. HPV is believed to be a major cause of cervical cancer. Over 1,175 HIV-positive women and 500 HIV-negative women who were engaged in high-risk behavior were analyzed in the study; those women with the most immune system damage due to HIV infection were found to have the highest risk for HPV infection. Additionally, younger women, African-American women, and women who smoke were determined to be over 50 percent more likely to be infected with HPV than women over the age of 40, white women, and women who do not smoke. "Ligand Drug Receives Approval" Wall Street Journal (02/04/99) P. B12 Ligand Pharmaceuticals said Thursday it received Food and Drug Administration approval to begin marketing its Panretin gel, a treatment for skin lesions in AIDS patients with Kaposi's sarcoma. The company expects annual sales of the drug, its first approved product, to top $35 million in the United States and $70 million in western Europe. "Another Round in the AIDS Wars" Washington Post--Montgomery Weekly (02/04/99) P. MD1; Johnston, Erica While anti-HIV drugs help infected patients live longer and have healthier lives, health care workers in Maryland report that they are busy caring for more HIV-positive people than ever. The face of the disease is changing in many Maryland counties, increasingly infecting women and African Americans. A survey conducted between June 1997 and June 1998 found that 80 percent of Maryland residents with AIDS were African-American and one-third were women. Homosexual sex is still the leading cause of transmission in the state, which has the sixth highest AIDS rate in the country, although injection-associated transmission is rising. One facet of the redoubled effort is a new oral HIV test that requires no needles or blood. Some health care workers note that, while information about the disease seems to be widespread, there has been little change in behavior. Activists assert that people must alter their behavior in order to stop the spread of the virus. "New Treatment Seems to Eliminate HIV Signs" Milwaukee Journal Sentinel Online (02/04/99); Marchione, Marilynn Researchers report that two patients who received the immune booster interleukin-2 in addition to standard AIDS treatment with protease inhibitors now show no signs of HIV in their blood or in lymph node samples. Tae-Wook Chun, of the National Institute of Allergy and Infectious Diseases, said that it is too early to conclude that HIV was eradicated in the patients. The two patients were removed from HIV treatment three weeks ago to determine if their infection was eradicated; neither has shown signs of the virus in the blood. The study was presented at the Sixth Conference on Retroviruses and Opportunistic Infections in Chicago. "Government Considers Compensation for Bad Blood Victims" New Zealand XTRA Online (02/03/99) New Zealand's government is considering compensating 250 people who were infected with hepatitis C virus as the result of blood transfusions with tainted products. According to a spokesperson for Health Minister Wyatt Creech, crown lawyers are considering the proposal and will report back to the minister on the matter. **************************************************************** The PreventioNews Mailing List is maintained by the CDC National Center for HIV, STD, and TB Prevention. Regular postings