Subject: CDC AIDS Daily Summary Date: Fri Feb 19 07:31:01 PST 1999 (179 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Friday, February 19, 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 "Transfusion Medicine" "French AIDS Research Pioneers to Testify in Trial of Ministers" GENERAL MEDIA "Russia Seeks Aid to Fight Epidemic of Tuberculosis" "Plant Extracts May Inhibit HIV" "Missouri Capital News Briefs: [House Approves Allowing Greater Disclosure of HIV Test Results]" "New Epidemic of Recombinant HIV-1 Strain in Russia Reported" "Close Monitoring of Patients Cited as New TB Cases Fall to Record Low" "Female Trouble" "Cat Virus Yields Clues on Hard-to-Treat HIV" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Transfusion Medicine" New England Journal of Medicine (02/18/99) Vol. 340, No. 7, P. 525; Goodnough, Lawrence T.; Brecher, Mark E.; Kanter, Michael H.; et al. In the second of a two-part review article, researchers analyze current risks and developments associated with blood transfusion. Preoperative autologous donation has been increasingly used, in part to reduce the risk of HIV transmission through transfusion. Fifteen years ago the process was used in less than 5 percent of patients scheduled for elective surgery; as of 1992, one in every 12 blood units collected in the United States was from autologous donation. Much of this blood goes unused, and the process can be considered wasteful because the use of autologous units in patients other than the donor is discouraged. Adverse reactions, including eurythropoiesis, are considered a problem in autologous donation. Acute normovolemic hemodilation--the process of removing whole blood from a patient immediately before surgery and replacing the blood with an acellular fluid to maintain normvolemia--can result in the preservation of one-half to one unit of red cells. It has several advantages over autologous donation: it does not require testing, the blood is not removed from the operating room thereby eliminating ABO-incompatible blood transfusion due to administrative error, and it reduces the risk of bacterial contamination. Interoperative and postoperative recovery of blood also may be of value, although there is still some debate. In addition, the use of pooled plasma that has been washed with solvent-detergent to inactivate viruses with lipid envelopes raises some concerns over the possibility of transmission of nonenveloped viruses. The pooling of plasma could also result in the transmission of viruses that could be present in undetectably low frequencies. Researchers are also investigating the possibility of red blood cell substitutes for transfusion. "French AIDS Research Pioneers to Testify in Trial of Ministers" Science (02/12/99) Vol. 283, No. 5404, P. 910; Balter, Michael Noted AIDS researcher Luc Montagnier will testify in the trial of former French Prime Minister Laurent Fabius and two former ministers. The officials are accused of involuntary homicide in regard to their reported decisions concerning delayed actions to protect the French blood supply from HIV contamination. In addition to Montagnier, Nobel laureate Jean Dausset, geneticist Axel Kahn, former INSERM head Philippe Lazar, and other scientists will testify before the specially appointed Justice Court of the Republic. Jean Claude Gluckman, a member of the original team that isolated HIV, explained, "We have been called to put things in context of the knowledge of the time." **************************************************************** GENERAL MEDIA **************************************************************** "Russia Seeks Aid to Fight Epidemic of Tuberculosis" Baltimore Sun (02/19/99) P. 13A The tuberculosis infection rate in Russia rose 7 percent in 1998, according to Russian Health Minister Vladimir Starodubov. There were about 100,000 new cases in the last 10 months of the year, with almost 83 of 100,000 Russians infected with the disease. Starodubov said that the country would seek a loan from the World Bank to help fight the spread of the epidemic. Experts are worried about the spread of drug-resistant TB in Russia. "Plant Extracts May Inhibit HIV" Fox News Online (02/18/99) Researchers from the University of California, Irvine, report that a synthetic derivative from a plant extract used by Bolivian shamans to treat a number of illnesses may prevent HIV infection. Dr. W. Edward Robinson, Jr., and others designed seven synthetic drugs based on plant extracts that appear to inhibit HIV by blocking the enzyme integrase. Robinson, who reported his findings in the February 11 issue of the Journal of Medicinal Chemistry, noted that he is still fine-tuning the chemicals, but that human trials could begin in a few years. The drugs do not appear to be toxic to cells and, therefore, may be better tolerated. "Missouri Capital News Briefs: [House Approves Allowing Greater Disclosure of HIV Test Results]" PostNet Online (02/18/99) The Missouri House approved on Thursday a bill that would allow physicians treating law enforcement officers or health care workers access to any HIV test results reported to the state. The bill would also make it a misdemeanor for misuse of the information, punishable by up to a year in jail and a $1,000 fine. Physicians are already allowed access to this information when treating first-responders in emergency care situations. The bill now goes to the state Senate for consideration. "New Epidemic of Recombinant HIV-1 Strain in Russia Reported" Reuters Health Information Services (02/18/99) According to a study conducted by Russian and Finnish researchers, there has been a dramatic increase in the number of new HIV-1 A/B recombinant subtype cases in the Russian region of Kaliningrad, which borders Poland and Lithuania. Since June 1996, there have been about 100 new cases of HIV-1 infection reported a month in the region, with 1,709 cases reported as of December 1997. The strain is derived from Ukrainian A and B viruses; the report indicates that there may have been a single source for infections among intravenous drug users. At the Sixth Conference on Retroviruses and Opportunistic Infections, the researchers said they believe that the virus could be introduced into Europe through the open borders of Poland and Lithuania, and asserted that prevention strategies are needed. "Close Monitoring of Patients Cited as New TB Cases Fall to Record Low" Chicago Tribune Online (02/18/99) The number of new tuberculosis cases in Chicago fell to an all-time low last year, dropping 21 percent from 1997. The decrease in the incidence has been attributed to the initiation of Directly Observed Therapy, which was adopted by the Chicago Department of Public Health's TB control program in 1993. Officials also credit anti-HIV drugs with the decline, noting that the drugs have cut the number of people progressing to AIDS in the city by three-fifths. There were 470 new cases of TB in Chicago in 1998, with only three reported case of multidrug-resistant tuberculosis. "Female Trouble" POZ (02/99) No. 44, P. 75; Lands, Lark Researchers from Johns Hopkins University found that women who most likely contracted HIV through injection drugs progressed to AIDS with a smaller amount of HIV than men with similar risks. The women were found to have 1.6-times higher risk of progressing to AIDS when at viral loads that equaled the men's. The scientists will next investigate if the same phenomenon occurs in non-drug using HIV-infected populations. "Cat Virus Yields Clues on Hard-to-Treat HIV" New Scientist (02/13/99) Vol. 161, No. 2173, P. 27 Chi-Huey Wong and others at Scripps Research Institute in La Jolla, Calif., have developed a potential new drug for HIV based on feline protease. The chemical is active against feline immunodeficiency virus and works against HIV in vitro. The researchers will report their findings in the Journal of the American Chemical Society.