Subject: CDC AIDS Daily Summary Date: Mon Feb 8 07:31:02 PST 1999 (233 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Monday, February 8, 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 "Neutralizing Antibody Directed Against the HIV-1 Envelope Glycoprotein Can Completely Block HIV-1/SIV Chimeric Virus Infections of Macaque Monkeys" GENERAL MEDIA "French Officials on Trial on AIDS Deaths" "Twins Are Pioneers vs. HIV" "Budget Cuts Jeopardize AIDS Programs, Activists Say" "U.S. Can't Ignore Implications of TB Plaguing Russia" "AIDS Vaccine Trials Begin" "Making a Plan to Save a Continent" "Free HIV Drugs in April" "How Compliant Are Patients on HAART?" "Magic Molecules" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Neutralizing Antibody Directed Against the HIV-1 Envelope Glycoprotein Can Completely Block HIV-1/SIV Chimeric Virus Infections of Macaque Monkeys" Nature Medicine (02/99) Vol. 5, No. 2, P. 204; Shibata, Riri; Igarashi, Tatsuhiko; Haigwood, Nancy; et al. In an effort to determine if high-titer antibodies directed against the HIV-1 envelope confer resistance against infection, researchers from the National Institute of Allergy and Infectious Diseases attempted to immunize pig-tailed macaques with purified immunoglobin (IgG) from chimpanzees infected with various HIV-1 isolates. The researchers, led by Riri Shibata, challenged the monkeys with the HIV/SIV chimeric virus, SHIV, which bears an envelope glycoprotein derived form HIV-1(DH12). The authors found that anti-SHIV neutralizing activity is an absolute requirement for protection via antibodies. They add that "the measurement of end-point neutralizing titers of human vaccinees against such a 'physiological' challenge dose may not be technically feasible." The authors note that an effective vaccine may have to elicit multiple immune responses. **************************************************************** GENERAL MEDIA **************************************************************** "French Officials on Trial on AIDS Deaths" Baltimore Sun (02/08/99) P. 11A Laurent Fabius, the former prime minister of France, will go on trial this week for involuntary manslaughter due to decisions he may have made over the screening of blood products. The Fabius-run government blocked the sale of HIV detection kits by Abbott Laboratories in May 1985, reportedly so that a French competitor would not be excluded from the market. The French diagnostic kit was not available until some four months later, at which point the testing of donated blood for HIV became mandatory. By that time, however, hundreds of hemophiliacs and others receiving blood transfusions had contracted HIV through tainted blood products. Over one-quarter of France's 1,300 hemophiliacs who contracted HIV through blood products are estimated to have been infected in 1985. In 1992, four senior public health officials in France were convicted and sentenced for allowing the administration of tainted blood to hemophiliacs. A special court designed to judge cabinet members for their actions in office will begin the investigation into how much responsibility Fabius had in the decision. The court will also investigate the roles of two other cabinet members in the action, Georgina Dufoix and Edmond Herve, the former social affairs minister and former secretary of state for health, respectively. "Twins Are Pioneers vs. HIV" Boston Globe Online (02/08/99); Knox, Richard A. Three-year-old twins in Massachusetts are participating in the development of an HIV vaccine. Scientists at Therion Biologics are currently devising an HIV vaccine based on strains taken from the boy and the girl, who contracted the virus from their mother, in an attempt to vaccinate the children against the disease. In order to asses the efficacy of the vaccine, the twins will cease their triple-drug regimen. Recent research shows that anti-HIV drugs are often not effective in the reduction of viral loads to undetectable levels in many patients and that treatment eventually fails for a substantial amount of patients who first respond to the drugs. Furthermore, there has been the emergence of drug-resistant strains of HIV and the drugs often have adverse effects. However, other research indicates that the immune system can fight the virus under certain circumstances. The researchers in the twins' study believe that anti-HIV medication may have been too potent for the little girl--they believe that her immune system may not have had enough exposure to the virus to build antibodies to HIV. The boy has low levels of antibodies and a weak cellular response to HIV due to a brief HIV breakthrough 17 months ago. One of the researchers involved said that the vaccine will be used in an effort to induce long-term non-progression in the twins. "Budget Cuts Jeopardize AIDS Programs, Activists Say" Times Union Online (02/08/99); Johnson, Doug Some 130 AIDS advocates from New York state have endorsed a letter to Gov. George Pataki criticizing proposed cuts to AIDS programs. The cuts would come as part of the proposed 1999-2000 budget, which would reduce AIDS program funding by $2.4 million, eliminating some programs completely. AIDS treatment programs, housing assistance for people with AIDS, and assistance for AIDS orphans would all lose some funding. The advocates state in the letter that "at a time when our state has a budget surplus of more than 2 billion dollars, it's just plain wrong to slash services." "U.S. Can't Ignore Implications of TB Plaguing Russia" USA Today (02/08/99) P. 16A; Lee, Christopher Christopher Lee, project manager of the Princeton Project 55 Tuberculosis Initiative, asserts in a letter to the USA Today that the United States cannot ignore the spread of tuberculosis in Russia when assessing the economy of the region and broader public health concerns. He states that the prison system is the source of the current outbreak, with 10 percent of the 1 million prisoners in Russia infected with TB. Up to 30 percent of all prisoners are released each year, resulting in 1 million latent infections spreading throughout the community every three years. Currently, there are 150,000 active TB cases in Russia in the civilian population, and experts believe the levels will compound 50 times by 2000. Mortality will increase seventyfold, with death among children increasing ninetyfold. In addition, multidrug-resistant TB (MDR-TB) is at the highest level ever reported. Lee insists that "the U.S. government must take immediate action to address the MDR-TB epidemic and consider it a major foreign policy issue, not only to aid the Russian family but also to protect American families." "AIDS Vaccine Trials Begin" Africa News Service (02/07/99); Wendo, Charles Public health officials in Uganda plan to launch Monday the first trial in Africa of an HIV vaccine manufactured by French vaccine developer Pasteur Merieux Connaught. Officials said the trial, which is sponsored by the U.S. National Institute of Allergy and Infectious Diseases, would be conducted at the Mengo-based Joint Clinical Research Centre and the Uganda Virus Research Institute in Entebbe and would involve 40 healthy volunteers between the ages of 18 and 40 years. Researchers emphasized that volunteers will not be exposed to HIV, but that the efficacy of the vaccine will be evaluated by exposing blood from those vaccinated to HIV in the laboratory. The first phase of the study, which will use a weakened canarypox virus carrying three genes of HIV, is expected to take about two years. "Making a Plan to Save a Continent" Washington Post (02/07/99) P. C1; Milloy, Courtland Former Rep. Ronald V. Dellums, who served for 27 years for the 9th District of California, has devised what he calls an AIDS Marshall Plan for Africa. Under the plan, pharmaceutical companies, scientists, doctors, and government officials would all work together to address the problem of HIV in Africa. Dellums, the president of Healthcare International Management in Atlanta, explains that there would be "a partnership between pharmaceutical companies making a commitment of a substantial amount of money that Congress and the Administration would match." He contends that the problem urgently needs to be addressed because an estimated 21 million people will die in sub-Saharan Africa due to the virus in the next decade. Dellums is set to discuss the initiative with government officials in South Africa next week. "Free HIV Drugs in April" Africa News Service (02/06/99) Public health officials in Uganda have announced plans to offer free drug treatment to pregnant HIV-infected women beginning in April to help prevent transmission of the disease to their children. On Thursday, the officials said they are searching for hospitals that can help launch the program, which will eventually require user fees. Glaxo Wellcome has agreed to supply AZT for free. Studies have indicated that using AZT and lamivudine (3TC) together a month before birth can reduce mother to child transmission of HIV by 50 percent. "How Compliant Are Patients on HAART?" AIDS Alert (01/99) Vol. 14, No. 1, P. 11 In a recent study of highly active antiretroviral therapy (HAART) in HIV-infected individuals, frequent use of stimulant nonrecreational drugs was most strongly associated with noncompliance. Led by Dr. J.C. Walsh of the Imperial College in London, researchers analyzed data from 179 patients on triple- or quadruple-drug therapy. Just over half the patients were taking the medication twice daily, with 49 percent taking medication three times per day. Patients took an average of 18.4 pills a day. While mean adherence rates were 95 percent according to self-reported data, 21 percent of patients took 80 percent of their medications or less. Fifty-two percent of patients reported full adherence in the prior month, and about one-third said they had never missed a dose. A total of 83 percent of respondents reported taking most of their medications on time. "Magic Molecules" New Scientist (01/30/99) Vol. 161, No. 2171, P. 39; Fletcher, Liz The discovery of the intein may lead to new treatments against leprosy and tuberculosis. The intein is a self-excising section of a protein that ties together the remaining pieces of the protein it separates from. Biochemists had previously believed that enzymes were necessary for protein section excision. Furthermore, the intein appears to be able to integrate its coding DNA into other sections of DNA. About 90 inteins have been discovered in simple organisms, including mycobacteria. Tuberculosis and leprosy both result from mycobacteria species; benign mycobacteria do not appear to have the splicing sections. While it has been shown that the pathogens are damaging even without the inteins, scientists may be able to potentially debilitate the pathogens by targeting intein excision. If they can prevent the excision of the sequence, they may be able to deactivate a protein that is necessary for TB DNA repair, thereby disabling the pathogen. Thus far, no inteins have been found in humans, but recent discoveries indicates that inteins may be split within the genome, which may mean that they are present in more species than previously thought.