Subject: CDC AIDS Daily Summary Date: Wed Feb 10 07:31:02 PST 1999 (169 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Wednesday, February 10, 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 "France Begins Trial of Ex-Officials Over H.I.V.-Tainted Blood" "Population Found Dropping in U.S. and Other Nations" "Unethical Studies Let Infants Contract HIV" "AIDS Research Ethics" "State AIDS Cases Reach 8-Year Low" "Teens Open to Safe Sex, Abstinence on TV" "AIDS Falls Off State's List of Top 10 Causes of Death" "Roche's HIV Drug Invirase Gets Prix Galien 1998 Award" "The Price of Success" **************************************************************** GENERAL MEDIA **************************************************************** "France Begins Trial of Ex-Officials Over H.I.V.-Tainted Blood" New York Times (02/10/99) P. A11; Whitney, Craig R. The trial of former French prime minister Laurent Fabius and two cabinet members who served under him between 1984 and 1986 began Tuesday in France. The ex-officials are accused of manslaughter and criminal negligence due to an alleged decision to delay the use of HIV tests for the country's blood supply. The accused reportedly delayed the testing in order to allow a French company that designed a screen to compete with an American company that had released an HIV test months earlier. According to experts, at least 300 cases of transfusion-associated HIV transmission in France during this period were avoidable. Georgina Dufoix, the former Minister of Social Affairs, and Edmond Herve, who acted as the Secretary of State for Health, are also on trial. Fabius faces up to three years in jail, if convicted, while Herve and Dufoix could receive sentences of up to five years and fines reaching $90,000. "Population Found Dropping in U.S. and Other Nations" Washington Times (02/10/99) P. A2; Wetzstein, Cheryl Experts have found that the fertility rate is falling in many countries, particularly modern nations. According to researchers, fertility rates tend to drop when families move to urban settings, when personal wealth increases, when contraception and abortion are easily accessed, when marriage is delayed, and when there are high rates of sexually transmitted diseases, including HIV. However, two-thirds of the world still has "replacement-level"--an average of 2.1 children over a woman's lifetime--or greater fertility rates. The world's population is forecast to hit 6 billion this year and 8.9 by the year 2050. "Unethical Studies Let Infants Contract HIV" Wall Street Journal (02/10/99) P. A23; Lurie, Peter; Wolfe, Sidney M. Drs. Peter Lurie, a medical researcher, and Sidney M. Wolfe, the director of the Public Citizen's Health Research Group, note that a recent study confirming the efficacy of short-course drug treatment for the reduction of vertical HIV transmission among infected pregnant women would have reached the same conclusions even if a placebo arm had not been used. In a letter to the editor of the Wall Street Journal, the authors state that researchers involved in the study ignored subanalysis of a previous study showing reduced vertical HIV transmission due to short-course treatment. Lurie and Wolfe contend that the recent study was unethical and resulted in the unnecessary transmission of HIV to hundreds of infants. "AIDS Research Ethics" New York Times (02/10/99) P. A30; Halpern, Scott D. Scott D. Halpern, a medical student at the University of Pennsylvania, asserts that placebo-based controls are the most efficacious way to conduct many trials. In a letter to the New York Times, Halpern states that it should not be surprising that recent research showed less costly and simpler drug regimens are effective in the reduction of vertically-transmitted HIV. Furthermore, other research showing that a small number of infants involved in this research acquired fatal complications should also not be surprising. Halpern argues that charges of unethical use of placebo control are not justified because "other ways to arrive at such answers would have required exposing more subjects to the potential dangers." "State AIDS Cases Reach 8-Year Low" United Press International (02/10/99) The number of new AIDS cases decreased in Illinois last year, according to data released by the state Department of Public Health. The AIDS incidence decreased by one-third across Illinois in 1998, continuing a decline that began four years ago. There were 1,256 new AIDS cases last year in the state, compared to 1,863 in 1997, marking the least number of new cases since 1980. Officials credit new drug therapies and prevention efforts for the decline. Illinois has the sixth highest number of cumulative AIDS cases in the country. "Teens Open to Safe Sex, Abstinence on TV" Boston Globe Online (02/10/99) P. A16; Hart, Jordana The Kaiser Family Foundation reports that over half of 1,300 randomly selected television shows in a one-week period had sexual content--two-thirds of them during prime time viewing hours. Only 10 percent of these shows made any reference to contraception or the possibility of delaying sex. Informal interviews of teens conducted by the Boston Globe indicate that younger viewers would not lose interest in their favorite shows if dialogue concerning safe sex and abstinence were included. One interviewee, Bianca DuJour, a 15-year-old sophomore at Boston Latin Academy and member of the Teen Empowerment youth group, noted, "Teens learn a lot about sex from TV. The message is that sex is an everyday thing and everybody does it, because they are so casual about it [on television]." "AIDS Falls Off State's List of Top 10 Causes of Death" Dallas Morning News Online (02/10/99); Beil, Laura According to the Bureau of Vital Statistics, AIDS is no longer one of the top 10 causes of deaths in Texas. Anti-HIV medication has been credited for the decrease in the AIDS-mortality rate. HIV-associated deaths declined for the second straight year; AIDS had been on the list of top 10 killers in the state since 1990. "Roche's HIV Drug Invirase Gets Prix Galien 1998 Award" Dow Jones News (02/10/99); Greil, Anita The International Prix Galien 1998 Award, which is awarded every two years to an innovative pharmaceutical product that has made an important contribution to modern therapy, has been jointly awarded to three HIV drugs: Roche's Invirase, Merck's Indinavir, and Abbott Laboratories' Ritonavir. Roche characterized the award as the Nobel prize for medicines and said this year's decision reflects the important role protease inhibitors play in the battle against HIV and AIDS. "The Price of Success" New Scientist (01/30/99) Vol. 161, No. 2171, P. 12; Knight, Jonathan Researchers from the University of California at San Francisco have developed a mathematical model showing that drug resistance in some HIV-infected individuals to highly active antiretroviral therapy (HAART) could lead to large increases in HIV incidence in the future. Sally Blower and others found that if the incidence in San Francisco of drug resistance in HIV among homosexual men is equal to levels seen in clinical trials, then the HIV incidence in the city will decrease by 20 percent in the next 10 years. Additionally, if risky sexual activity among homosexual men in the city falls by half, then the HIV incidence will decrease by 50 percent. However, if 90 percent of homosexual men in San Francisco take HAART and adherence is worse than seen in clinical trials, the HIV rate will increase 15 percent over the next 10 years, according to Blower's model. Blower notes that one way to avoid this scenario is to expand the strict policy of monitoring patients used in clinical trials to all HIV-positive patients. Drug companies are also trying to increase adherence by simplifying regimens.