Subject: CDC AIDS Daily Summary for 
Date: Tue Mar 28 06:31:01 PST 2000 (178 lines)
From: National AIDS Info Clearinghouse
Copyright 2000, Information, Inc., Bethesda, MD


CDC HIV/STD/TB Prevention News Update  
Tuesday, March 28, 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
"Rifampin and Pyrazinamide vs. Isoniazid for Prevention of 
Tuberculosis in HIV-Infected Persons"

GENERAL MEDIA
"Shamed Into Groups"
"AIDS Drug Assistance Programs Face Looming Crisis"
"HIV-1 Epidemic in Nepal Is Dominated by Subtype C"
"Zambia's Kaunda to Become Peace, AIDS Activist"
"Malawi: Donors Pledge 110 Million Dollars to Anti-AIDS Campaign"
"Sri Lankan AIDS Battle Bogged Down by Condom Controversy"
"AIDS: Electric Company Loses 567 Workers in Two Years"
"Tuberculosis on the Rise in Ghana"

 
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                    PEER-REVIEWED JOURNALS
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"Rifampin and Pyrazinamide vs. Isoniazid for Prevention of 
Tuberculosis in HIV-Infected Persons"
Journal of the American Medical Association (www.jama.com) 
(03/15/00) Vol. 283, No. 11, P. 1445; Gordin, Fred; Chaisson, 
Richard E.; Matts, John P.; et al.
     An international study compared a two-month regimen of daily 
rifampin and pyrazinamide with a 12-month regimen of daily 
isoniazid to prevent tuberculosis (TB) in HIV-positive patients. 
Clinics in the United States, Mexico, Haiti, and Brazil recruited
a total of 1,583 HIV-positive people aged 13 or over who tested 
positive for TB.  The patients were divided into two groups for 
each regimen.  After a follow-up of 37 months, the results showed
that 80 percent of the rifampin/pyrazinamide group completed the 
treatment, compared to 69 percent of the isoniazid treatment 
group.  The rates of TB among the two groups were similar, with 
2.4 percent of the rifampin/pyrazinamide group and 3.3 percent of
the isoniazid group developing confirmed disease at rates of 0.8 
and 1.1 per 100 person-years, respectively.  Overall, the study 
revealed that a two-month course of daily rifampin and 
pyrazinamide is similar in terms of safety and efficacy to the 
12-month isoniazid treatment for preventing TB in HIV patients.  
Adherence in both groups was high and toxicity was low.  The 
authors note the shorter regimen is an effective alternative that
has advantages for patients and TB control efforts, especially in
poorer areas with drug-resistant patients.  The research was 
conducted for the Terry Beirn Community Programs for Clinical 
Research on AIDS, the Adult AIDS Clinical Trials Group, the Pan 
American Health Organization, and the Centers for Disease Control
and Prevention Study Group.

 
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                         GENERAL MEDIA
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"Shamed Into Groups"
Washington Post--Health (www.washingtonpost.com) (03/28/00) P. 6;
Colburn, Don
     Diseases associated with embarrassment or social stigma, such as 
AIDS and alcoholism, are most likely to attract patients into 
support groups, according to a new survey from the University of 
Texas.  The survey revealed that AIDS patients are 250 times more
likely than hypertension patients to be in a support group.  
People with AIDS, alcoholism, breast cancer, depression, and 
anorexia were more likely to join a support group than 
individuals with heart disease, high blood pressure, migraines, 
or chronic pain.  The survey, published recently in the journal 
American Psychologist (2000;55), tracked support groups in four 
cities and through America Online and other Internet bulletin 
boards.
 
"AIDS Drug Assistance Programs Face Looming Crisis"
Reuters Health Information Services (03/27/00)
     A new survey by the Henry T. Kaiser Foundation shows that higher 
drug costs and an increasing number of patients are burdening 
U.S. AIDS drug assistance programs (ADAPs), despite rises in 
funding.  The advent of combination drug therapy has resulted in 
significant growth for ADAPs, with the number of new clients 
doubling between 1996 and 1999, as monthly drug expenditures in 
the programs tripled.  The research also showed continuing gaps 
in ADAP in some areas, with 20 states having at least one current
or projected ADAP limitation.
 
"HIV-1 Epidemic in Nepal Is Dominated by Subtype C"
Reuters Health Information Services (03/27/00)
     A team led by Dr. Robert Oelrichs of the Thai Red Cross Society 
in Bangkok has found that the outbreak of HIV among injection 
drug users (IDUs) in Nepal involves HIV-1 subtype C.  Oelrichs' 
group studied the HIV-1 RNA of 36 blood samples from HIV-infected
IDUs in Kathmandu.  The only subtype found was HIV-1 subtype C, 
the group reported in the February issue of the Journal of 
Virology (2000;74:1149-1157).  The researchers detected two 
separate Nepalese clusters, which indicates there were at least 
two sources of HIV entering the population.
 
"Zambia's Kaunda to Become Peace, AIDS Activist"
Reuters (03/28/00); Esipisu, Manoah
     Former Zambian President Kenneth Kaunda, who recently resigned as
head of the United National Independence Party, has announced his
intention to help fight the AIDS epidemic and work toward peace 
in Africa.  Statistics show that 25 percent to 30 percent of 
Zambia's adult urban population has HIV or AIDS.  Kaunda, who led
the nation for 27 years before losing the 1991 election, also 
admitted for the first time that his son died of AIDS nearly 15 
years ago, leaving him to raise his five grandchildren.
 
"Malawi: Donors Pledge 110 Million Dollars to Anti-AIDS Campaign"
Africa News Service (03/27/00); Tenthani, Raphael
     Malawi has received $109.1 million in donations to help fight 
AIDS, as a two-day meeting brought together government, AIDS 
groups, and donor agencies.  The latest plan in Malawi to fight 
AIDS is the Strategic Framework for HIV/AIDS for 2000-2004, which
will emphasize civic education, particularly for the rural poor. 
The donations came from several nations, including the United 
States, the Netherlands, Norway, Canada, and Germany.  At the 
meeting, participants stressed the need to protect individuals 
who were still HIV-free, while also supporting those already 
infected.
 
"Sri Lankan AIDS Battle Bogged Down by Condom Controversy"
Agence France Presse (03/27/00); Jayasinghe, Amal
     Sri Lanka's ban against advertising condoms is hampering the 
country's fight against AIDS.  Experts warn that unless HIV 
prevention is made a top priority, there could be an explosion of
cases in the coming years.  Sri Lanka has recorded about 300 
cases of AIDS, with about 75 deaths from the disease since 1986; 
however, some say an additional 7,500 people may carry HIV, and 
the United Nations estimates 80,000 Sri Lankans could contract 
the disease within five years' time.  Private and state-run radio
and television stations do not accept ads for condoms, and one 
activist has charged that religious leaders in the nation are 
pressuring officials to maintain the ban.
 
"AIDS: Electric Company Loses 567 Workers in Two Years"
Africa News Service (03/27/00)
     The Tanzania Electricity Supply Company has launched a new 
campaign against AIDS following the deaths of 567 of its workers 
from the disease within two years.  The company announced last 
week that it has allocated 100 million Tanzanian shillings to 
fight the disease.  The new effort will emphasize HIV's toll both
at work and at home.  HIV is the leading cause of death for 
Tanzanians between the ages of 15 and 60, and a recent report 
estimated there are hundreds of thousands of AIDS orphans in the 
country.
 
"Tuberculosis on the Rise in Ghana"
PANA Wire Service (03/25/00)
     New statistics show that tuberculosis (TB)in on the rise in 
Ghana, and health officials are calling for new measures to 
combat the disease.  According to Deputy Health Minister Charles 
Martey-Akrasu Kpabitey, there will be about 30,000 new TB cases 
every year, with thousands of TB-related deaths, if prevention 
and control efforts are not stepped up.  Kpabitey noted that 
there was only a 44 percent cure rate for TB cases treated with 
directly observed therapy, in part because of a lack of support 
and because some patients were unable to complete the treatment. 
The TB problem, he said, is being exacerbated by overcrowding, 
poverty, and HIV infection.

 
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