Subject: CDC AIDS Daily Summary Date: Tue Feb 16 07:31:02 PST 1999 (206 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Tuesday, February 16, 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 "Patient Appraisal of Mandarin Orange Didanosine: Implications for Adherence and Well-Being" GENERAL MEDIA "Study Finds H.I.V. Infection Is High for Young Gay Men" "Ignorance Feeds Deadly S. African AIDS Epidemic" "Hepatitis C Test Gets Approval" "Treatment: At What Cost?" "Insurance Firms Face State Rules to Report Diseases" "Egypt Closes Five Blood Banks in AIDS Cases" "Nashville Syphilis Rate High, Officials Explore Why" "HIV Vaccine Experiment Ignites Press Interest: But Scientists Ask, 'Will It Work in Humans?'" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Patient Appraisal of Mandarin Orange Didanosine: Implications for Adherence and Well-Being" Journal of the Association of Nurses in AIDS Care (01/99-02/99) Vol. 10, No. 1, P. 35; Reynolds, Nancy R.; Neidig, Judith L.; Brashers, Dale E. Researchers from Ohio State University conducted a survey of 15 patients taking a new mandarin orange-flavored didanosine. There were various complaints about the flavor and other problems with the older formulation of didanosine, so the flavored formula was devised in an attempt to increase adherence. The participants generally found the new preparation more tolerable, but they still had some problems with the drug. Some of the participants found the mandarin orange didanosine less agreeable to prepare and consume compared to other antiretroviral agents. The drug, for example, must be taken on an empty stomach, but some participants had other drugs that needed to be taken on an empty stomach but not with didanosine. Adherence decay due to undesirable responses to the medication was also reported. **************************************************************** GENERAL MEDIA **************************************************************** "Study Finds H.I.V. Infection Is High for Young Gay Men" New York Times (02/16/99) P. C16; Richardson, Lynda A large-scale study conducted in New York City found that HIV infection rates among young gay men are high. The Young Men's Survey found that 12 percent of the 15- to 22-year-old men who have sex with men that they surveyed are infected with HIV. Young gay African-American men had an 18 percent infection rate, while young Hispanic men had a 9 percent rate and young white men had a 3 percent rate. Young gay men of mixed race had a 16 percent infection rate. The study, reported at the Sixth Conference on Retroviruses and Opportunistic Infections in Chicago, was conducted by the New York City Health Department and the New York City Blood Center and financed by the Centers for Disease Control and Prevention. Men who had previously acquired a sexually transmitted disease had a 23 percent HIV infection rate, compared to 10 percent of men who had never had an STD. Forty-six percent of those surveyed said that they had participated in unprotected anal sex in the previous six months, although researchers do not know if high-risk behavior is rising in the city. They added that the racial and ethnic disparities were indicative of differences found nationwide. The survey also found that about one-third of 15- to 18-year-olds had a partner who was 30 years or older in the previous six months, while approximately 45 percent of 19- to 22-year-olds had a partner older than 30. Dr. Mary Ann Chiasson, of the New York City Health Department, noted that "it's more likely that older men are HIV infected than younger men so they may be at a higher risk of transmitting HIV. You see this pattern in sexually transmitted diseases, particularly in young women who are more likely to have older partners." "Ignorance Feeds Deadly S. African AIDS Epidemic" Washington Post (02/16/99) P. A1; Duke, Lynne The HIV infection rate in South Africa is soaring due to common misconceptions and social taboos. More than 16 percent of the 40 million person population of the country carry HIV, with prevalence estimated to reach 25 percent by 2010. Already, nearly 20 percent of 20- to 30-year-olds in South Africa carry the virus. Despite the high rate of infection, South Africa has been slow to institute prevention programs; however, the government has recently prioritized the epidemic. Some officials and experts note that there is widespread ignorance about the virus, with many people in the country harboring a wide variety of mistaken beliefs. The epidemic is expected to have a profound effect on South Africa's culture and economy, with many sectors facing a significant loss of manpower. An increase in the number of orphans is also expected. The spread of the disease has been attributed to a number of other factors besides a lack of HIV education; migrant workers and their partners with numerous sexual contacts, lack of condom use, and male promiscuity are also considered to be factors in the high incidence of HIV. "Hepatitis C Test Gets Approval" Boston Globe (02/13/99) P. A5 Chiron Corp.'s RIBA HCV 3.0 test for hepatitis C virus was approved for use by the Food and Drug Administration on Friday. The test is reportedly more accurate than the existing test and could help blood banks track hepatitis C virus contamination more effectively. Approximately 3.9 million people in the United States carry the virus. "Treatment: At What Cost?" Washington Post--Health (02/16/99) P. 6; Trafford, Abigail HIV treatment can have adverse effects, and many patients are weighing whether the side effects are worth the health benefit. One study of health care workers who were exposed to HIV in the workplace and subsequently took post exposure prophylaxis found that 50 percent to 70 percent of participants complained of adverse effects. Still, John G. Bartlett, chief of infectious diseases at Johns Hopkins University School of Medicine, notes that "it's pretty unusual to have people abandon treatment because of side effects." Some patients feel that there has not been enough research on side effects in women, who may react differently to drug regimens compared to men. "Insurance Firms Face State Rules to Report Diseases" Las Vegas Sun Online (02/15/99); Nadler, Art The Nevada state Health Division decided Friday that insurance companies will be required to report the names of potential policy holders who test positive for communicable diseases--including HIV, the hepatitis B and C viruses, syphilis, and tuberculosis. Currently, life insurers conduct blood tests on all prospective policy holders, with the state requiring the reporting of communicable diseases. However, the tests are conducted by Kansas laboratories, which do not report names, so the Nevada officials are informed only that communicable disease cases exist. Health authorities are now placing the burden of name reporting for seven listed diseases on the insurance companies, effective in about 30 days. Counsel for the American Council of Life Insurance, Joann Waiters, said that physicians should be responsible for name reporting. "Egypt Closes Five Blood Banks in AIDS Cases" CNN Interactive Online (02/15/99) Five blood banks have been closed in Egypt amid concerns of HIV infection. The blood banks were shut down after a woman was found to have contracted HIV through tainted blood that was sold by an HIV-infected man, according to Basma Shalabi, the health minister in charge of blood bank supervision. The man supposedly sold blood 144 times in 1998, according to one source. Four blood banks in Cairo and one in a Delta town, all privately owned, were closed. "Nashville Syphilis Rate High, Officials Explore Why" MSNBC Online (02/15/99) In Tennessee, the Nashville Metro Health Department has initiated a campaign to help stop the spread of syphilis in the region following reports indicating the city has the third highest rate of infection in the United States. Officials are also trying to determine how the disease reached such high levels there. Some believe that syphilis went unnoticed in the area because education was centered on other high-profile diseases, such as HIV. "HIV Vaccine Experiment Ignites Press Interest: But Scientists Ask, 'Will It Work in Humans?'" Scientist (02/01/99) Vol. 13, No. 3, P. 1; Watanabe, Myrna E. A recent study published in the journal Science by Jack Nunberg of the University of Montana in Missoula, ignited interest in the media over the possibility of an effective HIV vaccine. The scientists assessed immune response in mice who were inoculated with fused protein-receptor conglomerates combining recombinant simian fibroblast cells that express primary HIV-1 isolate envelope protein with recombinant human neuroblastoma cells expressing human CD4 receptor and CCR5 coreceptor for HIV-1. They found that the antibodies neutralized primary isolates containing HIV-1 in clades A through E. While the results are encouraging, the study needs to be conducted in other animal models. Additionally, the antibodies may have been directed against the altered receptors and coreceptors, and not to the virus envelope proteins. Some researchers are skeptical about the potential for a vaccine using the process; however, the researchers involved have received a National Institutes of Health grant to further investigate the process. They will study the molecular structure of the fusion intermediates on binding and plan on developing a Vaccinia virus-based vaccine involving the recombinant immunogens.