Subject: CDC AIDS Daily Summary for Date: Fri Mar 10 06:31:01 PST 2000 (193 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Friday, March 10, 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 "Electric Razors as a Potential Vector for Viral Hepatitis" "HIV Incidence Among Injection Drug Users in New York City, 1992-1997: Evidence for a Declining Epidemic" GENERAL MEDIA "Mass Injections Against Parasite Spread Hepatitis Across Egypt" "Scientists Discover Antibody That Blocks HIV From Cells" "Digene Gets FDA OK for Disease Detection Test" "Austrian Firm Suspected of Exporting Bad Blood" "UN Forces Play Deadly Role in Spread of AIDS, Ambassador Says: Condoms to Be Given to All Peacekeepers" "Zambia: Incorporate AIDS Subject in Schools Curriculum" "AIDS: Still Searching" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Electric Razors as a Potential Vector for Viral Hepatitis" New England Journal of Medicine (www.nejm.org) (03/09/00) Vol. 342, No. 10, P. 744; Kelly, Colleen R. In a letter to the editor of The New England Journal of Medicine, Dr. Colleen R. Kelly of Boston Medical Center suggests that shared electric razors may be why so many patients in veterans hospitals shows signs of hepatitis exposure. Overall, the United States has a 1.5 percent rate of chronic hepatitis C infection and 5.5 percent for chronic hepatitis B. According to Kelly, however, "as many as 24 percent of nonalcoholic patients in Veterans Affairs facilities who do not have liver disease have antibodies to hepatitis B, and 3.0 percent have antibodies to hepatitis C." While working at the Veterans Affairs Hospital in Jamaica Plain, Massachusetts, Kelly observed communal use of electric razors. Although she knows of no cases in which hepatitis B or C viruses were isolated from the razors, Kelly points out that there "is a potential hazard" because of the risk of small cuts and abrasions. Kelly recommends replacing communal razors with disposable, single-use ones to stop this practice and to reduce the risk of hepatitis transmission. "HIV Incidence Among Injection Drug Users in New York City, 1992-1997: Evidence for a Declining Epidemic" American Journal of Public Health (www.apha.org/news/publications/journal/AJPH2.html) (03/00) Vol. 90, No. 3, P. 352; Des Jarlais, Don C.; Marmor, Michael; Friedmann, Patricia; et al. Researchers from Beth Israel Medical Center report that the low incidence of HIV infection and the declining prevalence of the virus among injection drug users (IDUs) in New York City suggest that the HIV epidemic among this group may be in a "declining phase." HIV first entered the IDU population of New York in the mid-1970s and spread rapidly through the early 1980s, with the average seroprevalence reaching about 50 percent. Using 10 studies of nearly 5,000 subjects between 1992 and 1997, the researchers found the observed incidence rates ranged from 0 per 100 person-years at risk to 2.96 per 100 person-years at risk. They note that the weighted average incidence rate of infection was 0.7 per 100 person-years at risk. Comparisons with other cities--including Bangkok, Amsterdam, and Baltimore--show that New York City appears to have one of the lowest incidence rates around for IDUs. "The recent decline in HIV prevalence, the continuing declines in HIV risk behavior, and the low incidence of HIV reported here all make a strong case for a declining phase in the very large HIV epidemic among injection drug users in New York City," the researchers conclude. They warn, however, that the HIV epidemic among IDUs in the city is not "over," citing as an example the resurgence of tuberculosis in New York after control efforts were reduced in the face of declining cases. **************************************************************** GENERAL MEDIA **************************************************************** "Mass Injections Against Parasite Spread Hepatitis Across Egypt" New York Times (www.nytimes.com) (03/10/00) P. A9 A decades-long mass campaign intended to eliminate a blood parasite in Egypt backfired, infecting thousands of people in the country with hepatitis C virus (HCV). According to a report in The Lancet (2000;355:887), HCV was transmitted through unsterilized needles and reused syringes employed in the fight against schistosomiasis from the 1950s to 1980s. During the effort, each patient received 12 to 16 injections of a tartar emetic; the injections were discontinued when an inexpensive oral drug became available. However, the researchers note that by that time, there had been "epidemic spread" of HCV in Egypt, with many people likely also contracting hepatitis B. Statistics show that 15 percent to 20 percent of the 63.3 million Egyptians have antibodies to hepatitis C. "Scientists Discover Antibody That Blocks HIV From Cells" Kyodo News Service (03/10/00) New research from Italian scientists discusses the discovery of an antibody that prevents HIV from entering cells. The-four-year study, published in the Journal of Immunology (2000;164:3426), involved 90 people who had HIV-infected partners. The researchers found that the subjects carried an antibody that their infected partners did not, one that can alter CCR5 and make it inaccessible to HIV. The findings could lead to new HIV treatments or the development of a vaccine, the authors said. "Digene Gets FDA OK for Disease Detection Test" Reuters (03/07/00) Digene Corp. has received marketing clearance from the U.S. Food and Drug Administration for its Hybrid Capture II test. The test is used to identify or confirm the presence of Chlamydia trachomatis DNA and Neisseria gonorrhea DNA in cervical specimens. "Austrian Firm Suspected of Exporting Bad Blood" Reuters (03/10/00) An Austrian firm is being investigated for possibly selling blood to India and China that was not screened for HIV and hepatitis. Austrian prosecutors refused to name the firm, which went bankrupt three years ago. State prosecutor Dietmar Gutmayer said, however, that the company is suspected of selling the blood, from U.S. and African donor centers, as a medical product without testing it for disease. The blood reportedly was processed by an Israeli company, prior to being returned to Austria for distribution through firms in Switzerland and France. "UN Forces Play Deadly Role in Spread of AIDS, Ambassador Says: Condoms to Be Given to All Peacekeepers" Ottawa Citizen (www.ottawacitizen.com) (03/10/00) P. A11; Bone, James The United Nations (UN) has begun handing out condoms to peacekeepers following American complaints that UN forces may be spreading HIV in countries they are trying to protect. New budget provisions provide for the supply of "one condom per man per day" to UN troops. Although the UN does not track HIV cases associated with peacekeeping missions, a number of Croatian women reportedly were infected after going out with UN soldiers. Also, some troops returning from Cambodia were diagnosed with an HIV strain found in Southeast Asia. At the urging of U.S. ambassador to the UN Richard Holbrooke, resolutions authorizing peacekeeping missions now include statements "encouraging efforts by the UN to sensitize UN personnel in the prevention and control of AIDS." "Zambia: Incorporate AIDS Subject in Schools Curriculum" Africa News Service (03/09/00) In Zambia, UNAIDS country representative Dr. Kenneth Ofosu Barku has suggested that students entering college in the country should first pass a class about AIDS. At a workshop in Lusaka, Barku said HIV should be a priority in the curriculum so Zambia can successfully fight the epidemic. He noted, "HIV/AIDS is the major problem which has led to all the development problems because people could not get the formal education in the first place regarding the disease." "AIDS: Still Searching" New York (www.newyorkmag.com) (02/07/00) Vol. 35, No. 5, P. 37; Kinetz, Erika The last major breakthrough in AIDS drug research, the development of the highly active antiretroviral therapy (HAART), does not always do what its creators had hoped at its inception five years ago. Dr. David Ho and Dr. Martin Markowitz have found that HAART, while extending the comfort periods and the lives of AIDS patients, cannot rid the body of the virus. Also, the drugs do not help everyone. Hope may be on the way, however. Markowitz will begin trials at the Aaron Diamond AIDS Research Center of three new drugs that appear to work better with fewer side effects than those currently on the market. Meanwhile, three other drugs in various stages of development are radically different in approach: two fusion inhibitors are being tested on humans, and one drug that prevents the virus from attaching itself to cells may reach the clinical trial stage this year. Other potential changes include once-per-day doses, rather than the complicated and difficult three to five doses per day, stopping HAART treatments while HIV is at low levels and letting the immune system fight back, and vaccines to help the immune system in the battle after HAART is discontinued. ****************************************************************