Subject: CDC AIDS Daily Summary for Date: Thu Mar 23 07:01:01 PST 2000 (188 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Thursday, March 23, 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 "Reactivation of Genital Herpes Simplex Virus Type 2 Infection in Asymptomatic Seropositive Persons" GENERAL MEDIA "Audit: Minorities With AIDS Getting Less Appropriate Care Than Whites" "WHO Urges Asia to Implement Low-Cost Strategy to Halt TB" "TB Cases Decline for Seventh Straight Year" "Health Officials Declare Syphilis Outbreak" "Dextrin Sulfate Appears to Be a Safe HIV Microbicide Candidate" "President Clinton Announces New Members to the Presidential Advisory Council on HIV/AIDS" "Recruitment of Volunteers 40 Percent Short" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Reactivation of Genital Herpes Simplex Virus Type 2 Infection in Asymptomatic Seropositive Persons" New England Journal of Medicine (www.nejm.org) (03/23/00) Vol. 342, No. 12, P. 844; Wald, Anna; Zeh, Judith; Selke, Stacy; et al. The majority of patients with serologic evidence of herpes simplex virus type 2 (HSV-2) have no symptoms. A prospective study of 53 subjects with antibodies to HSV-2 but who reported no history of genital herpes attempted to determine if they have less frequent viral reactivation than those with symptomatic infection. The researchers, led by Dr. Anna Wald of the University of Washington at Seattle, evaluated genital shedding of HSV-2 among the 53 subjects and compared it to the patterns of shedding for 90 subjects with symptomatic infection. After the individuals with no reported history of herpes received counseling, 26 of the women and seven of the men reported having ulcers or blisters in the genital areas typical to HSV-2. The research also showed that the total rate of viral shedding was significantly greater among those with a history of genital herpes than among HSV-2-seropositive patients with no reported history of the disease. According to the authors, it is possible for asymptomatic subjects to transmit the virus to others, especially during an outbreak of symptoms like shedding. Any patient with a history of HSV-2 or a diagnosed asymptomatic case should be aware of the risk of transmitting the virus to sexual partners or neonates. **************************************************************** GENERAL MEDIA **************************************************************** "Audit: Minorities With AIDS Getting Less Appropriate Care Than Whites" Fox News Online (www.foxnews.com) (03/23/00); Gullo, Karen A new audit from the General Accounting Office shows that African American and Hispanic AIDS patients receive "less appropriate care" compared to Whites with AIDS. The audit of how government funding for AIDS programs was requested by Rep. Tom Coburn (R-Okla.), who is also a physician. The funds involved are those administered to state and local AIDS service groups via the Ryan White Comprehensive AIDS Resource (CARE) Act, which has supplied almost $8 billion in government dollars. In terms of doctors' visits, emergency room visits, hospitalizations, and drug therapies, the audit concluded that African Americans, Hispanics, and women with AIDS received mediocre care compared to White AIDS patients. "WHO Urges Asia to Implement Low-Cost Strategy to Halt TB" Kyodo News Service (03/23/00); Johnson, Tim The World Health Organization (WHO) has warned that the failure to stop tuberculosis (TB) from spreading in Asia is alarming. A report given at a ministerial conference on TB in Amsterdam stated that 8 million people contract TB every year, with 2 million deaths. According to the report, however, only 21 percent of those stricken receive treatment with directly observed therapy, short-course. The WHO noted that 43 percent of the world's population had access to treatment in 1998; however, the rates in Pakistan, India, Afghanistan, and the Philippines are much lower, at 8 percent, 9 percent, 11 percent, and 17 percent, respectively. With approximately 1.8 million new cases in 1998, India was hardest hit by TB in terms of numbers, but Cambodia had the highest incidence rate in Asia, with 541 new cases per 100,000 people. The global average is 61 new cases per 100,000. "TB Cases Decline for Seventh Straight Year" Orange County Register Online (www.ocregister.com) (03/22/00); Lindlaw, Scott The California Department of Health Services reported Tuesday that the number of new, active cases of tuberculosis (TB) in the state dropped 6 percent in 1999, the seventh year of decline. In Orange County, new TB cases fell 17.4 percent last year, while in Long Beach, 88 new cases were reported, up from 57 in 1998. Despite the overall decline, California had the highest number of new cases last year, in part because of its significant immigrant population. The Health Department's Dr. Sarah Royce attributed the falling number of new cases to the state's increasing use of directly observed therapy, which keeps patients on the medication and helps prevent the development of drug resistance, and also to better infection control by the state in prisons and homeless shelters. "Health Officials Declare Syphilis Outbreak" MSNBC Online (www.msnbc.com) (03/22/00) A syphilis outbreak has been declared in Los Angeles County after 18 cases of the disease were reported in the last two weeks. According to health officials, all of the cases involved homosexual men. Syphilis can be treated with antibiotics, but testing of all sexual partners is necessary to stop its spread. Syphilis can be transmitted during oral, vaginal, or anal sex and starts with a single painless lesion. Without treatment, the disease can go unnoticed for years and then cause serious organ damage and even death. Local health officials are urging men to use condoms and also to limit their number of sexual partners. Free testing for syphilis and other sexually transmitted diseases is being offered by the county public health department for the next several weeks. "Dextrin Sulfate Appears to Be a Safe HIV Microbicide Candidate" Reuters Health Information Services (03/22/00) Early findings from a double-blind study of 0.125 percent dextrin sulfate gel show that the potential HIV microbicide does not harm the genital epithelium and is not systemically absorbed by healthy women at low risk for HIV. Dr. Naomi Low-Beer of the Imperial College School of Medicine in London conducted a two-part, 28-day trial with the vaginal gel used by 66 healthy women. In the first part of the study, the women's male partners also used latex condoms, while in the second part, the men had the option of not using the prophylactics. According to preliminary findings, three cases of epithelial disruption were detected in the women; however, none were related to use of the gel, the researcher said. "President Clinton Announces New Members to the Presidential Advisory Council on HIV/AIDS" M2 Presswire (03/22/00) President Clinton announced that Health and Human Services Secretary Donna E. Shalala has appointed 10 individuals to serve on the Presidential Advisory Council on HIV/AIDS and 16 members were reappointed for service. The council, formed in 1995, provides advice and information for programs and policies that promote prevention of HIV, as well as support of research on HIV and ways to improve quality services for those living with HIV/AIDS. The Honorable Ronald Dellums, a former member of the U.S. Congress representing California, will serve as Council chair. Other appointees include Terje Anderson of the National Association of People with AIDS, Regina Aragon of the San Francisco AIDS Foundation, Ignatius Bau of the Asian and Pacific Islander American Health Forum, and Judith Billings, who chairs the Governor's Advisory Council on HIV/AIDS in Washington state. "Recruitment of Volunteers 40 Percent Short" Bangkok Post Online (www.bangkokpost.com) (03/23/00); Thaitawat, Nusara Researchers in Thailand are looking to enroll 2,500 volunteers for the Phase III efficacy trial of an AIDS vaccine candidate made by VaxGen Inc. Thus far, however, only about 60 percent of the needed subjects have signed up. The potential vaccine uses gp120, a protein found in the B and E subtypes of HIV. The vaccine is also being tested on 5,000 volunteers in North America and Europe. Bangkok official Dr. Wonchat Subhachaturas noted that two reasons for the slow enrollment were that applicants were either HIV-positive already or they declined after learning more about the trial. Wonchat reported, though, that preliminary results of the trial suggest "good tolerance" with no adverse effects. ****************************************************************