Subject: CDC AIDS Daily Summary for Date: Wed May 10 06:31:01 PDT 2000 (166 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Wednesday, May 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 "Effect of Hepatitis B Virus Mutants on Efficacy of Vaccination" "Hepatitis B Booster Vaccination for Healthcare Workers" GENERAL MEDIA "AIDS Battle Shifts From Drugs to Reinforced Immune System" "Bill for Cheaper AIDS Drugs in Africa Dies" "California Tissue Bank Won't Fight FDA on Disease Test" "Tests Urged for Drug-Resistant HIV" "No End in Sight to Syphilis Outbreak" "South Africa Defends Rights of AIDS 'Dissidents'" "HIV Variants in Vaginal Tract Increases Perinatal Transmission Risk" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Effect of Hepatitis B Virus Mutants on Efficacy of Vaccination" Lancet (www.thelancet.com) (04/22/00) Vol. 355, No. 9213, P. 1382; Zuckerman, Arie J. About 350 million people carry hepatitis B virus, and 25 percent of them develop serious liver disease, which could mean vaccines against HBV are losing their efficacy. A study of a mutation in HBsAg, found 10 years ago, shows variant strains in several countries, from Singapore to Germany and West Africa. In southeast Asia, most cases occur as perinatal transmission. A report by H.Y. Hsu and colleagues in Taiwan suggests that new vaccines are needed to protect children against HBV mutations and to prevent vertical transmission to newborns. "Hepatitis B Booster Vaccination for Healthcare Workers" Lancet (www.thelancet.com) (04/22/00) Vol. 355, No. 9213, P. 1464; Yoshida, Tadashi; Saito, Ikuo Two scientists from the Keio University School of Medicine in Tokyo have analyzed the immune response of 526 health workers who had anti-hepatitis B titres that rose one month after immunization. In Japan, healthcare workers are urged to get the hepatitis B vaccine and to get boosters to keep the antibodies in the blood. The findings suggest that booster shots are the best way to keep immunity stable, especially for the at-risk healthcare workers. **************************************************************** GENERAL MEDIA **************************************************************** "AIDS Battle Shifts From Drugs to Reinforced Immune System" USA Today (www.usatoday.com) (05/10/00) P. 6D; Sternberg, Steve A meeting sponsored by the University of Maryland Institute of Human Virology in Baltimore hosted doctors who discussed ways to restore the body's immune system while keeping HIV under control. New antiviral drugs keep HIV at undetectable levels for many patients, so researchers want to prevent organ damage and maintain the immune system's health. T cells and B cells fight viruses and bacteria, but HIV kills T cells quickly. If T cells drop too low, people with HIV become troubled by opportunistic infections. Ways to rebuild the immune system are under study, including Remune, a therapeutic vaccine to increase T cells; interleukin-2, another way to help T cells reproduce; CD40 Ligand, a protein that activates killer T cells; and IL-15, which helps form memory T cell pools. Researchers Julianna Lisziewiz and Franco Lori of the Research Institute for Genetic and Human Therapy have used the idea of drug holidays to help HIV patients' immune systems strengthen, but the concept is still being debated. "Bill for Cheaper AIDS Drugs in Africa Dies" Philadelphia Inquirer (www.phillynews.com) (05/10/00) P. A15; Koszczuk, Jackie Congress has dropped legislation that would have allowed African nations to make or import cheaper versions of AIDS drugs. Sen. Dianne Feinstein (D.-Calif.) wants to convince President Clinton to use his powers to keep the legislation alive. AIDS activists have focused on the need for generic versions of AIDS drugs for Africa, but the pharmaceutical industry has protected its patents with sanctions. House Ways and Means Chairman Bill Archer (R-Texas) and Senate Leader Trent Lott (R-Miss.) criticized Feinstein's measure. Few Africans can afford AIDS treatment that could help save their lives. "California Tissue Bank Won't Fight FDA on Disease Test" Reuters (05/09/00) The Pacific Coast Tissue Bank has announced it will discard all bone donated from people who tested positive for any test of the hepatitis B virus. The tissue bank is acting at the request of the U.S. Food and Drug Administration. The bank's medical director, Eli Gendler, said the donors were tested thoroughly and those with traces of the virus had cleared it from their systems. Gendler was critical of the FDA's antigen testing methods. "Tests Urged for Drug-Resistant HIV" Minneapolis Star-Tribune Online (www2.startribune.com) (05/10/00); Tanner, Lindsey A recommendation in today's Journal of the American Medical Association calls for tests of drug-resistant strains of HIV to allow customized treatment for AIDS patients. Patients can quickly develop resistance to AIDS drugs, and must change treatments often because the virus mutates. Genotype and phenotype testing would help doctors determine the best drugs for treatment. Dr. Charles Flexner of Johns Hopkins University School of Medicine said the tests cost $400 to $1,000 each and are not foolproof. "No End in Sight to Syphilis Outbreak" Seattle Times Online (www.seattletimes.com) (05/10/00); King, Warren A syphilis outbreak among gay men in King County, Wash., continues after it surfaced eight months ago. Dr. Hunter Handsfield said unsafe sex is the chief problem. Seventy-five percent of the syphilis cases are among men with HIV. Handsfield said not all gay men are having unsafe sex, but interviews of 100 gay men do show that two-thirds have had unprotected sex at least once recently. The health department has also interviewed over 500 men in bathhouses and bars, linking the unsafe sex to drug use. Terry Stone of the Northwest AIDS Foundation in Seattle said gay men may be tired of hearing the safe sex messages, and are misled by the fact that new AIDS drugs are helping those with HIV live longer. "South Africa Defends Rights of AIDS 'Dissidents'" Reuters (05/09/00) South Africa's director general of the health department, Ayanda Ntsaluba, has defended the rights of "AIDS dissidents" who do not accept a link between HIV and AIDS. Ntsaluba said all sides in the debate need to be heard. Most scientists believe HIV causes AIDS, and fear that opening the debate again will be a waste of time. Ntsaluba clarified that there are dissidents who believe HIV contributes to AIDS. "HIV Variants in Vaginal Tract Increases Perinatal Transmission Risk" Reuters Health Information Services (05/09/00) Dr. Lori Panther of Beth Israel Deaconess Medical Center in Boston has found that gene mutations during HIV replication cause increased risk of transmission of the virus to a fetus. Dr. Panther and colleagues studied 24 pregnant women in their last trimester, all of whom received zidovudine during or before delivery. Seven of the women transmitted HIV to their babies, and these women had a greater diversity of HIV variants. The findings are published in The Journal of Infectious Diseases, where the authors suggest finding antiretroviral therapies that decrease viral load and inflammation of the birth canal during labor.