Subject: CDC AIDS Daily Summary Date: Fri Feb 12 06:31:03 PST 1999 (236 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Friday, February 12, 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 "Control of Viremia in Simian Immunodeficiency Virus Infection by CD8+ Lymphocytes" "Origin of HIV-1 in the Chimpanzee Pan Troglodytes Troglodytes" "From Pan to Pandemic" GENERAL MEDIA "Surprise Discovery of Possible Cancer Protector" "Efforts to Curb Sexual Disease Prevent HIV Spread" "HIV Testing Controversy" "U.S. Officials Defend Export to Canada of High-Risk Prison Blood" "Salivary Inhibition of HIV: Possible New Prevention Strategy" "What You Need to Know About AIDS in Minority Groups" "Soluble Markers of Immune System Activation" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Control of Viremia in Simian Immunodeficiency Virus Infection by CD8+ Lymphocytes" Science (02/05/99) Vol. 283, No. 5403, P. 857; Schmitz, Jorn E.; Kuroda, Marcelo J.; Santra, Sampa; et al. SIV-infected, CD8+ lymphocyte-depleted rhesus monkeys showed rapid and marked increases in viremia, according to a research team from Harvard Medical School and elsewhere. The researchers, led by Jorn E. Schmitz, found that viremia was suppressed with the reappearance of SIV-specific CD8+ T cells. The results suggest that "an effective HIV-1 vaccine should elicit strong cellular immune responses that might block a primary viral infection or modulate viral replication in the newly infected individual," the authors conclude. "Origin of HIV-1 in the Chimpanzee Pan Troglodytes Troglodytes" Nature (02/04/99) Vol. 397, No. 6718, P. 436; Gao, Feng; Bailes, Elizabeth; Robertson, David L.; et al. Scientists have traced the origin of HIV-1 to SIVcpz found in Pan troglodytes troglodytes. The researchers sequenced a strain of SIVcpz found in a chimpanzee with a natural infection and found that all HIV-1 strains known to infect man are closely related to this SIVcpz lineage. The scientists further discovered that HIV-1 group N is a mosaic of SIVcpzUS and HIV-1 related sequences, indicating an ancestral recombination event in a host chimpanzee. The authors state that "these results, together with the observation that P. t. troglodytes coincides uniquely with areas of HIV-1 group M, N, and O endemicity, indicates that P. t. troglodytes is the primary reservoir for HIV-1 and has been the source of at least three independent introductions of SIVcpz into the human population." The authors note the possibility that other chimpanzee subspecies are infected with the SIV strain and that they may have transmitted the viruses to humans. In conclusion, the researchers recommend the screening of free-range living chimpanzees and human populations from corresponding geographic locales in order to fully understand the extent of natural SIVcpz infection. "From Pan to Pandemic" Nature (02/04/99) Vol. 397, No. 6718, P. 385; Weiss, Robin A.; Wrangham, Richard W. Recent data has shown that HIV-1 originates from the SIVcpz strain found in the chimpanzee Pan troglodytes troglodytes. Other research has discovered that several HIV-2 strains came from SIVsm found in sooty mangabey monkeys, while human T-lymphotropic virus type 1 appears to have developed from related simian viruses. The cross-species transmission of these viruses raises some important issues, including concerns that xenotransplantation of tissue may not be safe. Additionally, many monkeys are hunted for their meat, and people may be getting infected as a result. Many of the monkeys are being hunted into endangerment or extinction, and conservationists are unsure if a campaign publicizing the disease-transmitting danger involved in the hunting of these animals will be beneficial or harmful. There are fears that such a campaign, designed to reduce hunting of the apes, could backfire. Furthermore, there are issues concerning the use of chimpanzees in animal research. The new findings may lead to an increase of interest in using the animals for study models. There may be a more acceptable method of research with the monkeys, however; the scientists who traced the origin of HIV-1 used data acquired through fieldwork with free-living apes. In addition to monitoring live apes, field workers may also use fresh corpses that they occasionally find and DNA analysis of feces in order to further conduct studies while minimizing their impact on the chimpanzee population. **************************************************************** GENERAL MEDIA **************************************************************** "Surprise Discovery of Possible Cancer Protector" Fox News Online (02/12/99); Neergaard, Lauran A common detergent has been found to inactivate human papillomavirus (HPV) after brief exposure. The chemical, sodium dodecyl sulfate (SDS), works at low doses and may represent an easy and inexpensive way to prevent the spread of HPV, which is believed to be a major cause of cervical cancer. Scientists may be able to create a topical microbicide based on the chemical--which is commonly found in shampoos and toothpastes--which women could apply before sex to protect against the virus. Mary Howett, a microbiologist at Penn State University, and others reported their findings in the February issue of Antimicrobial Agents and Chemotherapy. "Efforts to Curb Sexual Disease Prevent HIV Spread" Reuters (02/12/99) Penny Hitchcock, of the National Institute of Allergy and Infectious Disease, and Lieve Fransen, of the European Commission, comment in Friday's issue of the Lancet on the efficacy of sexually transmitted disease treatments in relation to HIV prevention. They note that two separate studies in Africa seemed to have contradictory results; a study in the Rakai district of Uganda indicated that STD treatment did not reduce HIV transmission rates, while a study conducted in Mwanza, Tanzania, found that STD treatment prevented about 40 percent of HIV infections. However, Hitchcock and Fransen assert that the AIDS epidemic was at two different stages in the areas, with a 16 percent HIV prevalence in Rakai, compared to 4 percent in Mwanza. Furthermore, they state that STD interventions are useful in the prevention of HIV in the early phase of an HIV epidemic. "HIV Testing Controversy" MSNBC Online (02/12/99); Smith, Curtis Disease surveillance systems have been tracking AIDS cases in Alaska for years, but results may not be giving an accurate depiction of the spread of HIV in the state. New anti-HIV drugs have decreased the number of AIDS cases, but the number of people with HIV is not clear. Also, since federal funding for HIV/AIDS programs is dependent on the number of cases, accurate tracking becomes important in prevention efforts. Alaska just passed a law requiring name-based reporting of all HIV cases. And while some people worry that the measure will lead to a breach of confidentiality and suggest that a code-based identification system be used instead, health officials note that the new law does not have to do with finding the names of infected people, but with determining infection patterns and levels. "U.S. Officials Defend Export to Canada of High-Risk Prison Blood" CNews Online (02/11/99); Bueckert, Dennis A spokeswoman from the U.S. Food and Drug Administration, who asked not to be named, said that prisoners were allowed to donate blood, which was later used for export, in part, because it was felt that the donation would aid in their rehabilitation. The use of blood from prisoners, who are considered at high-risk for infectious disease, was discontinued in the United States in 1982; however, blood products from prisoners were apparently shipped to Canada for sale. Some Canadians may have become infected due to the products. Furthermore, there have been reports about irregularities concerning some of the collection centers at a few of the prisons involved. One doctor who worked in the Arkansas prison system in the 1980s claims that prisoners were permitted to donate blood even when they were visibly ill with AIDS and hepatitis C symptoms. Business considerations may have also been involved in blood manufacturers' decision to use the high-risk products. "Salivary Inhibition of HIV: Possible New Prevention Strategy" Reuters Health Information Services (02/11/99) Dr. Samuel Baron and colleagues at the University of Texas Medical Branch in Galveston determined that saliva appears to kill HIV-infected mononuclear leukocytes through hypotonic disruption. The researchers, who report their findings in the Feb. 8 issue of the Archives of Internal Medicine, found that 90 percent or more of the mononuclear leukocytes were rapidly disrupted by saliva. Saliva is devoid of many salts that are normally found in body fluids, making it hypotonic, which results in the inactivation of HIV-infected white blood cells. The scientists are investigating the use of bile salts for the use in a microbicide against HIV. "What You Need to Know About AIDS in Minority Groups" AIDS Alert--AIDS Guide for Health Care Workers Supplement (01/99) Vol. 14, No. 1, P. 1 President Clinton recently unveiled a $156 million initiative focusing on HIV/AIDS among minorities. The campaign, intended to develop HIV-prevention programs and increase access to drug treatment programs, among other things, was established because AIDS is "hitting hardest in areas where knowledge about the disease is scarce and poverty is high," Clinton said. The Centers for Disease Control and Prevention currently provides $253 million in funding to state and local health departments for HIV prevention programs. The agency, which also directly funds various organizations that have HIV prevention programs geared to high-risk individuals in specific minority groups, has been allotted an extra $4 million this year for community-based HIV-prevention organizations focusing on African-Americans and Hispanics. While minorities only made up about one-quarter of the total U.S. population in 1997, over half of all AIDS cases were among racial and ethnic minorities that year. Nearly 50 percent of all new AIDS cases in the United States were among African-Americans in 1997, while Hispanics now account for almost one-quarter--22 percent--of new AIDS cases. The rise of HIV among young Hispanics is especially worrisome. The National Institute of Allergy and Infectious Diseases noted in a report that minorities "bear a disproportionate burden of sickness and disease," including tuberculosis. "Soluble Markers of Immune System Activation" IVD Technology (01/99-02/99) Vol. 5, No. 1, P. 51; George, David A. CD4 cell count and HIV-1 viral load have been used as predictors for HIV-associated disease progression. Other markers for prediction are being investigated, including beta-2-microglobulin, neopterin, and tumor necrosis factor receptor type II (TNFR-II). The three markers have all shown to have approximately equal clinical value. Clinical immunoassays are currently available for beta-2-microglobulin. While rising levels of the molecule is associated with disease progression, there are conflicting results pertaining to the predictive value of beta-2-microglobulin. Some studies have shown that TNFR-II is a significant predictor of AIDS progression among rapid progressors. Future research needs to determine the best manner that these markers can be used in monitoring disease progression. Notice: The CDC HIV/STD/TB Prevention News Update will not publish on Monday, February 15, 1999, in observance of President's Day. Publication will resume on February 16.