Subject: CDC AIDS Daily Summary for Date: Wed Mar 29 06:31:01 PST 2000 (182 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD From: preventionews@cdcnpin.org Newsgroups: sci.med.aids Approved: Yes: shall@compassnet.com,Marty Howard Subject: [CDC News] CDC HIV/STD/TB Prevention News Update 03/28/00 Message-ID: <57987@sci.med.aids> Date: Tue, 28 Mar 2000 08:26:24 CDT Organization: unspecified 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" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "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. **************************************************************** GENERAL MEDIA **************************************************************** "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.