Subject: CDC AIDS Daily Summary Date: Thu Feb 25 06:31:02 PST 1999 (206 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Thursday, February 25, 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 "Virulent HIV Strains, Chimpanzees, and Trial Vaccines" "Use of Antiviral Therapy by Intravenous Drug Users With HIV" GENERAL MEDIA "Canadians Seek Justice Probe in Sale of Prison Blood" "'Blood' Trial of Former French PM Collapses" "HIV-Tracking Bill Receives Preliminary OK" "Doctors Suspected in HIV Transplant" "Science Feature: Senegal [to Provide Free] Antiretrovirals" "Not Yet on the Books, HIV Reporting Law Being Studied" "Incidence of HIV Positive on the Rise in Pondy" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Virulent HIV Strains, Chimpanzees, and Trial Vaccines" Science (02/19/99) Vol. 283, No. 5405, P. 1117; Prince, Alfred M.; Allan, Jonathan; Andrus, Linda; et al. In a letter to Science, a group of scientists "urge those who carry out vaccine research in the chimpanzee model to seriously question the use of virulent HIV challenge inocula from both a scientific and ethical standpoint." The researchers include Alfred M. Prince and Linda Andrus from the New York Blood Center; Jorg Eichberg, editor-in-chief of the Journal of Medical Primatology; Jane Goodall of the Jane Goodall Institute for Wildlife Research Education; and seven others. Specifically, the authors object to the use of a recently isolated strain of HIV that causes AIDS-like syndrome in chimpanzees. They assert that the strain is unusually virulent and, therefore, is not appropriate for use in a challenge. The scientists contend that the use of the strain could "seriously jeopardize" the HIV vaccine effort because candidate vaccines may effectively protect against less virulent wild-type HIV strains. Prince et al. believe that suitable strains for challenge should have similar virulence characteristics to wild-type strains and should be primary isolates grown on peripheral blood lymphocytes. They suggest a recently developed Han-2 strain that meets these characteristics and does not cause AIDS rapidly, if at all. The authors note that the euthanasia of chimpanzees is universally condemned and that the use of highly virulent HIV strains that cause AIDS in the animals would necessitate euthanasia. According to the authors, use of the strain should be opposed on that ground alone. "Use of Antiviral Therapy by Intravenous Drug Users With HIV" Journal of the American Medical Association (02/24/99) Vol. 281, No. 8, P. 699; Mannheimer, Sharon B.; Curtis, James L.; El-Sadr, Wafaa M.; et al. Sharon B. Mannheimer and others from the Columbia University College of Physicians and Surgeons in New York City report in a letter to the editor findings that differ from a recent study by David D. Celentano and colleagues. Celentano, of the Johns Hopkins School of Hygiene and Public Health, and associates reported antiretroviral therapy (ART) use among 51 percent of HIV-infected intravenous drug users in their survey. In a separate survey, Mannheimer et al. found that 78 percent of HIV-infected IDUs were receiving ART. Possible discrepancies between the surveys could have arisen from the fact that their subjects were participating in a drug rehabilitation program including on-site HIV primary care. In another letter Dr. Stephanie H. Michaels and colleagues from the Louisiana State University School of Medicine found results similar to Celentano et al: HIV patients with a history of substance abuse, incarceration, and who are AIDS-free are unlikely to receive ART. Meanwhile, Dr. Rita Murri and others from Catholic University of Rome also note that ART use may be underestimated when compiled by self-reporting. In response, Celentano and Dr. David Vlahov state that Mannheimer's findings demonstrate the major recommendation of the original study--that combination therapy can be effectively promoted in conjunction with other services. **************************************************************** GENERAL MEDIA **************************************************************** "Canadians Seek Justice Probe in Sale of Prison Blood" Washington Times (02/25/99) P. A6; Seper, Jerry A group of Canadians is calling for the U.S. Department of Justice to investigate the sale of blood donated from Arkansas prisoners to Canada in the 1980s. The group brought a $1.1 billion suit against Canadian officials, claiming they allowed the purchase of blood products tainted with HIV and hepatitis C virus. David Harvey, the lawyer for the group, said that he expects to bring a similar suit against U.S. authorities and plans to subpoena President Clinton, who was the governor of Arkansas at the time of the sale. The Food and Drug Administration ruled that the blood was unfit for use in the United States in 1983. The Royal Canadian Mounted Police has launched a criminal investigation of the issue and has received cooperation from the FBI. "'Blood' Trial of Former French PM Collapses" Financial Times (02/25/99) P. 2; Graham, Robert Former French Prime Minister Laurent Fabius and two former ministers were exonerated by the chief prosecutor of any wrongdoing in a trial investigating their fault in the failure to sufficiently protect the French blood supply from HIV in the 1980s. Chief prosecutor Jean-Francois Burgelin said that there was insufficient evidence to prosecute Fabius, Edmond Herve, and Georgina Dufoix; however, he did criticize the former officials for their passive role in dealing with the situation. The judges of the special court of justice of the republic are expected to pass a formal decision on the case within the next week. It is unlikely that they will decide against the prosecution's recommendations. In the course of the trial, biologist Francis Gros, the scientific advisor to Fabius in 1985, took full responsibility for the decision to delay the introduction of a blood test for HIV. Top medical officials also noted during the trial that they were afraid to introduce a blood screening process at the time for fear that the system would be considered discriminatory against homosexuals and others at high risk. "HIV-Tracking Bill Receives Preliminary OK" Topeka Capital Journal Online (02/25/99); McLean, Jim A bill requiring the reporting of names and addresses of HIV-infected patients received preliminary approval by the Kansas House on Wednesday. Under the legislation, the Kansas Department of Health and Environment would receive the confidential information, although anonymous testing will also still be available. A similar bill failed in the Kansas legislature last year due to privacy concerns, but the new bill addresses those issues, adopting strict rules and regulations for the protection of names and stiffening penalties for violations of confidentiality. A final House vote on the issue is expected today. "Doctors Suspected in HIV Transplant" Newsday Online (02/24/99) The El Norte newspaper reported on Wednesday that 10 physicians under suspicion for transplanting HIV-infected kidneys to two patients have been suspended by Mexican officials. The doctors had apparently failed to wait for the blood test results from the organ donors before transplanting the kidneys. According to Jesus Zacarias Villarreal, health secretary of the northern state of Nuevo Leon, the physicians could lose their licenses. Federal authorities could act on the case because transplants are regulated by federal law, but the affected patients would first have to present a criminal complaint before legal action could be taken. "Science Feature: Senegal [to Provide Free] Antiretrovirals" PANA Wire Service (02/24/99); Masebu, Peter Despite the low rate of HIV infection in Senegal--between 1 percent and 1.5 percent of a population near 8 million--the government recently reaffirmed its commitment to fighting the virus and said it would provide antiretroviral drugs at a discount to 55 HIV-infected people. In an effort to add meaning to the pledge, the government said it has already set aside 250 million CFA francs to purchase the medicines. Leading researchers have been unable to explain why the country has such a low rate of HIV compared to other African nations, but they note that the political commitment at the highest levels of government has played a major role in controlling the spread of the disease. Senegal began planning its own antiretrovirals project following the launch of similar pilot programs in nearby Cote d'Ivoire and Uganda. "Not Yet on the Books, HIV Reporting Law Being Studied" Pittsburgh Tribune-Review (02/25/99); Stricker, Diana The Pennsylvania Department of Health is investigating whether to require the reporting of HIV cases in the state--one of 12 states and territories that does not currently require reporting. Of the 44 states and territories that require HIV reporting, 32 use name-based reporting and 12 use coded identification. Pennsylvania officials are undecided on which type of system to institute. All reporting types would keep infected individuals' privacy; however, some opponents participants at a hearing Wednesday voiced concerns about confidentiality. Proponents assert that the system is needed to obtain accurate data on HIV infection rates. "Incidence of HIV Positive on the Rise in Pondy" Hindu Online (02/25/99) The incidence of HIV is increasing in Pondicherry, India, with 36.3 cases per 1,000 people, according to health officials. However, Dr. D. Balasubramanian, project director of the AIDS Control Program, said that the high numbers were in part due to the use of testing facilities in the region by people from other states. Pondicherry is undertaking projects to increase HIV awareness to help prevent the spread of HIV.