Subject: CDC AIDS Daily Summary for Date: Fri Mar 3 06:31:01 PST 2000 (215 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Thursday, March 2, 2000 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. Contact the sources of the articles abstracted below for full texts of the articles. HEADLINES PEER-REVIEWED JOURNALS "Science and More for TB" GENERAL MEDIA "Merck & Co. Will Pledge $100 Million of Vaccines to World's Poorest Children" "Patients File Competing Suits Against GU" "New Tacoma Controversy Over TB Listings" "UK Health Ministry Issues St. John's Wort Warning" "[Utah] Senate OKs Abstinence Sex Ed Bill" "Ignorance Could Worsen South Africa AIDS Threat" "Heroin Chic, Ecstasy Myth Noted in US Report" "Community-Based Centers to Care for Kenya's HIV Patients" CORRECTION "Correction to 2/24/00 Prevention News Update: Are Booster Immunisations Needed for Lifelong Hepatitis B Immunity?" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Science and More for TB" Nature (www.nature.com) (02/17/00) Vol. 403, No. 6771, P. 687 An estimated 2 billion people are infected with Mycobacterium tuberculosis, and there are 16 million cases of active tuberculosis (TB). The Global Alliance for TB Drug Development is working to coordinate research and develop affordable drugs; however, the editors of Nature note that effective control programs are also necessary, so further drug resistance is not created. The alliance's goal is to have a new TB drug by 2007. New technologies will be essential in the success of a new treatment, so the typical $300 million to $500 million cost of developing a new drug can be reduced to $100 million. The editors suggest that instead of having big drug companies subsidize the project, the alliance might do better in choosing smaller pharmaceutical and biotechnology firms, which can offer innovation and flexibility, among other things. They also point out that while drug firms must make their products more affordable to developing nations, "developing countries need reminding that the cost of business as usual will be much more than that of investing in the development of drugs and vaccines." **************************************************************** GENERAL MEDIA **************************************************************** "Merck & Co. Will Pledge $100 Million of Vaccines to World's Poorest Children" Wall Street Journal (www.wsj.com) (03/02/00) P. B2; Harris, Gardiner; Waldholz, Michael The chairman of Merck, Raymond Gilmartin, is to announce today at a meeting with President Clinton and leaders of three other top pharmaceutical companies that Merck will donate $100 million worth of vaccines to be used by children in the poorest nations of the world. While Merck's donation, which will be used to vaccinate against hepatitis B in sub-Saharan Africa, will probably be the largest, American Home Products, SmithKline Beecham, and Aventis Pharma will also donate vaccines for the prevention of meningitis, malaria, elephantiasis, and polio. Other efforts on part of the four companies to treat disease with vaccines include pledges to conduct additional vaccine research, especially work in the area of AIDS, and the joining of a group of government, healthcare, and nonprofit institutions interested in increased research for vaccines. American Home is expected to donate 10 million doses of a meningitis and pneumonia vaccine valued at $40 million retail, Aventis is expected to contribute 50 million doses of a polio vaccine, and SmithKline is expected to announce increased child trials for its malaria vaccine. "Patients File Competing Suits Against GU" Washington Post (www.washingtonpost.com) (03/02/00) P. B3; Goldstein, Avram Two competing lawsuits filed against Georgetown University Medical Center on Wednesday claim the center failed to protect patients by not upholding American Hospital Association guidelines that call for universal drug screening before hiring new employees. Around 600 patients must be tested for HIV, hepatitis, and other viruses after X-ray technician Jeffrey L. Royal was discovered siphoning off painkillers from infusion pumps and intravenous lines and replacing the drugs with saline solution. The fear is that Royal may have used contaminated needles to inject the salt water into the equipment. Lawyers for the cases assert that pre-employment drug testing could have identified Royal's problem before he was hired last fall. So far, 466 patients have been notified of the need for testing, and officials say another 100 to 150 will probably notified in the near future. "New Tacoma Controversy Over TB Listings" Seattle Post-Intelligencer Online (www.seattle-pi.com) (03/02/00); Hopkins, Jack The Tacoma-Pierce County Health Department in Washington State has started keeping lists of individuals who test positive for tuberculosis (TB). The new policy requires doctors to report the names of those who test positive, in the hopes of keeping the disease from overcoming a community. The policy, approved with little public attention in January, requires doctors to report all individuals with active TB as well as anyone who tests positive but is not infectious. The list of TB patients' names will be kept confidential like the state list of AIDS patients' names, but the health department will not contact people who test positive for TB. There were 43 cases of active TB in Pierce County last year, which is low. Opponents feel the policy may target immigrants and AIDS patients unfairly, since they are at greater risk for infection. "UK Health Ministry Issues St. John's Wort Warning" Reuters (03/01/00) The British government has warned against using St. John's wort, an herbal remedy for depression, because it can prevent some prescriptions from working properly. The Ministry of Health warned that some drugs for the treatment of HIV, heart conditions, and asthma, and the oral contraceptive pill could be affected by the herb. Around 2 million people in Britain use the St. John's wort. "[Utah] Senate OKs Abstinence Sex Ed Bill" Salt Lake Tribune Online (www.sltrib.com) (03/02/00); Fahys, Judy A measure that stipulates that abstinence is the only topic for sex education was passed by the Utah Senate on Wednesday. The issue is controversial, as opponents say that teenagers need correct information regarding pregnancy and sexual health. Under House Bill 411, teachers can warn students "with respect to criminal conduct, pregnancy, AIDS, and other sexually transmitted diseases, and the failure of contraceptives as a protective strategy." The measure now goes to Gov. Mike Leavitt for approval. While most senators said that abstinence is already being taught, some expressed concern about the explicitness of sex education materials from certain organizations and the idea that sex outside of marriage is acceptable. "Ignorance Could Worsen South Africa AIDS Threat" Reuters (03/01/00) A survey by MarkData found that, in a sample of 2,200 South Africans, between 55 percent and 65 percent of the population was exposed to significant degree of risk for HIV infection because of ignorance regarding the disease. An estimated 1,700 South Africans are infected with HIV each day, and, according to the report, 20 percent of the population studied was considered at extreme risk for contracting the virus. Lack of safe sex and other fallacies regarding HIV are fueling the crisis. Some of the individuals surveyed thought AIDS was not necessarily fatal, while others said they thought a cure was available. "Heroin Chic, Ecstasy Myth Noted in US Report" Reuters (03/01/00); Monaghan, Elaine The belief that the drug ecstasy is safe, along with rising cocaine use in Europe, were two trends listed in a State Department report on drugs for 1999. According to the study, the heroin user is now viewed as "chic," unlike the previous image of a heroin addict dying in an alley with a needle stuck in his or her arm. In addition, needles are not always necessary, since high-grade Colombian heroin can be sniffed. The report cited a survey from August 1999 that estimated the overall number of American heroin users at about 1.2 million. "Community-Based Centers to Care for Kenya's HIV Patients" PANA Wire service (03/01/00) As part of an effort to reduce expenses, HIV and AIDS patients in Nairobi, Kenya, will now be treated in community-based centers instead of hospitals. Two pilot projects for community-based healthcare have been established in Kibera and Embakasi. The AIDS epidemic has had a significant impact on Kenya, with about 40,000 HIV infections recorded in Nairobi alone. In part because of the high cost of care for HIV and AIDS patients, hospital treatment is no longer sustainable, explained Provincial Commissioner Cyrus Maina, who also said "there is a greater need to understand the impact of the epidemic and the effect of results-oriented interventions." *************************************************************** CORRECTION *************************************************************** "Correction to 2/24/00 Prevention News Update: Are Booster Immunisations Needed for Lifelong Hepatitis B Immunity?" Lancet (www.thelancet.com) (02/12/00) Vol. 355, No. 9203, P. 561 According to the European Consensus Group on Hepatitis B Immunity, lifetime protection from hepatitis B virus (HBV) infection depends on immunological memory, which lasts at least 15 years in healthy individuals. The first three-dose course of immunization is usually enough to start anti-HB production during childhood. The need for booster doses of HB vaccine depends on the risk factors involved, and is recommended for immunocompromised individuals when the titre falls below 10mIU/mL. People who do not respond to a primary course of shots should remain under observation as well. The researchers note, "To date there are no data to support the need for booster doses of HB vaccine in immunocompetent individuals who have responded to a primary course." Those who are at greater risk for infection--including healthcare workers, intravenous drug users, those engaging in risky sex, and immunocompromised patients--should receive effective primary vaccination, the researchers said.