Subject: CDC NCHSTP Daily News Update Date: Fri Feb 26 14:01:04 PST 1998 (200 lines) From: National AIDS Info Clearinghouse Copyright 1999, Information, Inc., Bethesda, MD [Apologies for the duplicate of Thurs. Feb. 25 that went out this morning. Here is the issue of today's date. --BG] CDC HIV/STD/TB Prevention News Update Friday, February 26, 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 "Database Study of Antibiotic Resistant Tuberculosis in the United Kingdom, 1994-6" "Ethics and HIV Trials" GENERAL MEDIA "United Nations: AIDS and the Young" "Sex While Intoxicated Boosts STD Risk" "Inside the Beltway: Lecture and Test" "Greater Cancer Fight Sought" "Syphilis Outbreak Striking SAC Area" "Interferon Helps Hepatitis C Patients" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Database Study of Antibiotic Resistant Tuberculosis in the United Kingdom, 1994-6" British Medical Journal Online (02/20/99) Vol. 318, No. 7182, P. 497; Irish, Charles; Herbert, Josephine; Bennett, Diane; et al. Using data collected through the U.K. Mycobacterial Resistance Network, researchers examined Mycobacterium tuberculosis resistance levels of newly diagnosed cases in the United Kingdom between 1994 and 1996. They calculated resistance to each first line antibiotic and multidrug resistance, finding that just under 6 percent of over 10,000 isolates were found to be resistant to isoniazid, while 1.7 percent of isolates were resistant to rifampicin, 1.2 percent to pyrazinamide, and 0.7 percent were resistant to ethambutol. Multidrug resistance was observed in 1.5 percent of isolates. Multidrug and isoniazid resistance rates were found to be higher in people aged 15 to 44 years, people with a known history of tuberculosis, males, and patients co-infected with HIV. Patients from England--particularly London--were also found to have higher rates of isoniazid and multidrug resistance, compared to patients from elsewhere in the United Kingdom. The scientists note that, although overall resistance is low in the United Kingdom, it is important to maintain surveillance of the disease. "Ethics and HIV Trials" American Journal of Public Health (02/99) Vol. 89, No. 2, P. 255; Simonds, R.J.; Dondero, Timothy J.; DeCock, Kevin M.; et al. In a letter to the editor of the American Journal of Public Health, experts from the Centers for Disease Control and Prevention comment on a recent trial conducted in Thailand that measured mother-to-child transmission of HIV when zidovudine was used. Some have called the trial unethical because it used a placebo arm; however, the authors believe that the trial would not have been able to reach the conclusions that it did without the placebo arm. Following the discovery that zidovudine use resulted in reduced vertical transmission, the CDC, along with other scientific agencies, urged that other HIV trials currently being sponsored by those agencies drop the use of placebo or replace it with the CDC short-course zidovudine regimen. A trial in Cote d'Ivoire sponsored by the CDC subsequently dropped its placebo arm. The authors note, "These and other trials were conducted because the longer '076' regimen shown to be effective in the United States and Europe is too complex and too costly to be implemented in most developing countries." Additionally, they say that the "Bangkok regimen" may not be appropriate in some regions and it still may be possible to use a placebo arm as a proxy for a current local standard of care for intervention evaluation. **************************************************************** GENERAL MEDIA **************************************************************** "United Nations: AIDS and the Young" New York Times (02/26/99) P. A6 The United Nations has initiated a new campaign designed to fight the spread of HIV in young people. According to the agency, almost 600,000 children under the age of 15 and 2.5 million people aged 15 to 24 contracted the virus last year. This averages to six new HIV infections among young people every minute. "Sex While Intoxicated Boosts STD Risk" Reuters Health Information Services (02/25/99) A multicenter team of researchers found that people who have sex while intoxicated are at a higher risk for sexually transmitted diseases. The researchers, who report their findings in the February issue of Sexually Transmitted Diseases, interviewed 366 adults enrolled in a court-ordered driver intervention program following driving-under-the-influence convictions. Over half of the respondents admitted having sex while drunk or high in their last 10 sexual encounters; 63 percent of these men failed to use a condom while chemically impaired. About 10 percent of the subjects had an STD at some point in their lives, while women had higher rates of STDs. "Inside the Beltway: Lecture and Test" Washington Times (02/26/99) P. A5; McCalin, John The Environmental Protection Agency has arranged to test government officials for HIV in conjunction with next Wednesday's lecture at the EPA by Sandy Thurman, director of the White House Office of National AIDS Policy. The tests will be confidential and run throughout the week. "Greater Cancer Fight Sought" Washington Times (02/26/99) P. A11; Larson, Ruth Oncologists are calling for increased funding for research into bone marrow and lymphatic cancers, which they assert are reaching epidemic proportions. Researchers believe that viral infections may damage immune cells, resulting in the cancers. People with HIV for more than six years are 100 times more likely to get lymphoma. Traditional treatments for the cancers include chemotherapy and radiation therapy, both of which have toxic side effects. "Syphilis Outbreak Striking SAC Area" San Antonio Express-News Online (02/23/99); Foy, Nichole Neighborhoods near the San Antonio College in Texas, have seen a cluster of new syphilis cases. Local health officials are investigating eight new syphilis cases that have been identified in the region in the past two months. Seven of the cases occurred among homosexual men. The authorities conducted a door-to-door campaign to warn residents in an effort to help curb the spread of the disease, urging those at risk to get tested. They also plan to meet with the owners of predominantly gay nightclubs and leaders in the gay community to discuss disease prevention and testing. The health authorities noted that the targeted effort was unusual but pointed out that syphilis can increase the risk of HIV transmission. "Interferon Helps Hepatitis C Patients" Reuters Health Information Services (02/25/99) A report published in the journal Digestive Diseases and Science showed the reversal of liver fibrosis in two hepatitis C virus-infected patients who received interferon treatment. Up to half of all patients with chronic hepatitis C develop cirrhosis, which scientists commonly believed was irreversible when due to the infection. The new report contradicts this belief, indicating that there are exceptions where cirrhosis can reverse. The two patients studied were given an 18-month regimen of interferon-A.