Subject: CDC NCHSTP Daily News Update Date: Thu May 11 12:21:04 PST 2000 (198 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Thursday, May 11, 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 "Chronic Lyme Disease: The Debate Goes On" GENERAL MEDIA "Makers of AIDS Drugs Agree to Slash Prices for Developing World" "Clinton Tries to Expedite AIDS Drugs Into Africa" "U.S. to Begin Study of Vaccine's Ability to Suppress H.I.V. Levels" "Nurse With Hepatitis C Sues Bergen Hospitals" "Students Make Commitment to Abstinence" "Structured Drug Interruption May Induce HIV-Specific Immunity" "AIDS Vaccine Trial Complete" "House OKs Bill to Repeal Hypodermic Law" "AIDS Patients to Receive Mental Health Care" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Chronic Lyme Disease: The Debate Goes On" Lancet (www.thelancet.com) (04/22/00) Vol. 355, No. 9213, P. 1436; Rowe, Paul M. Chronic Lyme disease is viewed differently in Europe and the United States. The United States only has one species of tick to deal with. In both areas, the first sign of disease is a red bull's eye rash, which may precede skin, joint, and muscle pain, leading to arthritis. In Europe, patients often have radiculomyelitis, peripheral neuropathy, or skin problems. Lyme disease can be treated with antibiotics, but late cases are harder to help. Chronic disease is when the patient still has symptoms after receiving antibiotic treatment. The case definition by the Centers for Disease Control and Prevention may not be broad enough to include all with the syndrome. Patients with no objective findings may not actually have Lyme, and a National Institutes of Health study will determine if long-term antibiotics help patients. Roland Martin of the National Institutes of Health and colleagues have suggested that autoimmune responses play a role, and that T-cells can cause organ damage. The cause of chronic Lyme disease is still being debated and more research is underway. **************************************************************** GENERAL MEDIA **************************************************************** "Makers of AIDS Drugs Agree to Slash Prices for Developing World" Wall Street Journal (www.wsj.com) (05/11/00) P. A1; Waldholz, Michael Driven by the fear that developing nations in Africa will buy inexpensive generic versions of their HIV drugs produced in Brazil, Thailand, and India despite the fact that the generics are violating patent laws, Bristol-Myers Squibb, Glaxo Wellcome, Merck, Boehringer Ingelheim, and Roche Holding have agreed to slash prices of their drugs for people living in poorer nations. While Pfizer had recently agreed to donate its AIDS-related fungal infection drug Diflucan to South Africa, Bristol-Myers had agreed to contribute $100 million over a five-year time period to improve healthcare services in Africa, and other companies had made similar promises, this agreement marks the first collaboration of pharmaceutical companies on how to address the prohibitive costs of AIDS drugs for developing countries. Glaxo has indicated that it will cut the cost of its Combivir, a cocktail of AZT and 3TC, to $2 a day, or one-third of its current daily cost in Uganda and one-fifth of its price in the United States, but the companies do not wish to suggest that they are selling the drugs at cost, since it would highlight the little-known fact that profit for these and other drugs can reach 90 percent of the prices charged after research and development are reimbursed. However, the pact is problematic, including the risk of creating a black market in AIDS drugs, the likelihood that it will fuel a demand for lower drug prices in the United States, the fact that even at the new prices the drugs will remain too costly for many people in said countries, and the fact that the drugs will be useless unless the health-care system is educated properly about how to administer the drug and is able to monitor the use and distribution of the drugs. "Clinton Tries to Expedite AIDS Drugs Into Africa" New York Times (www.nytimes.com) (05/11/00) P. A7; Lewis, Neil A. President Clinton has issued an executive order that will make AIDS drugs available at lower prices in southern Africa. The debatable order says the United States government will not oppose countries that may violate American patents to produce cheaper AIDS drugs. African countries can now produce generic versions of drugs or import drugs from other countries at a lower cost. Sen. Dianne Feinstein (D-Calif.) had sponsored a similar amendment that was removed from the Africa trade bill, calling for cheaper access to anti-AIDS drugs. Alan Holmer, president of the Pharmaceutical Research and Manufacturers of America, believes the executive order sets an undesirable precedent that focuses on pharmaceuticals. AIDS Action member Jeff Jacobs and other activists support the order. Jacobs said "Americans can be proud of their president today." "U.S. to Begin Study of Vaccine's Ability to Suppress H.I.V. Levels" New York Times (www.nytimes.com) (05/11/00) P. A18; Altman, Lawrence K. The National Institutes of Health will begin the first tests of a vaccine aimed for people with HIV. The vaccine Remune will be tested compared to standard drug therapy for HIV. The goal is for the vaccine to stimulate the immune system to kill HIV-infected cells and control HIV, but Remune is not a cure for AIDS. Remune could be the first therapeutic vaccine to work on patients already infected, although experts say the chances are slim. Previous therapeutic HIV vaccines have proven ineffective. Dr. Jonas Salk, the polio vaccine researcher, developed Remune in the 1980s. Dr. Anthony Fauci of the National Institute of Allergy and Infectious Diseases said the vaccine could help those HIV patients who fail antiviral drug therapy. A total of 472 volunteers will take part in the study over 96 weeks. "Nurse With Hepatitis C Sues Bergen Hospitals" Bergen Record Online (www.bergen.com) (05/10/00); Groves, Bob Nurse Susan DeGregorio of Ramsey, N.J., is claiming two hospitals in Bergen County refused to hire her because she has hepatitis C. The hospitals allegedly violated a law against discrimination, after one hospital refused to rehire her after an absence. The suit also claims that employees at Hackensack Hospital invaded her privacy and discussed her infection. DeGregorio feels she is being shunned for having hepatitis C, which she contracted from a work-related needle stick in 1995. The nurse was promised a job in cardiac care but then did not receive it, even though her job performance was considered good. No case regarding hepatitis C discrimination has gone to trial before. "Students Make Commitment to Abstinence" Miami Herald Online (www.herald.com) (05/11/00); Ifateyo, Ajowa Nzinga Nearly 20 children attended a 10-week class in the Miami area taught by Police Sergeant Matthew Locke that focused on teen pregnancy and sexually transmitted diseases and how to prevent them. The students pledged to remain abstinent until marriage, but admitted the promise would be hard to keep. The students graduated at the Restoration and Reconciliation Outreach in North Dade and received certificates. In 1996, the federal government voted to spend more money teaching students about abstinence instead of how to have safer sex. Joan Sampieri, president of Planned Parenthood of Greater Miami, said adults need to be realistic regarding sexual behavior among young adults. Miami's high HIV rates reflect unsafe sexual behavior, which should also be addressed. "Structured Drug Interruption May Induce HIV-Specific Immunity" Reuters Health Information Services (05/10/00) Spanish researchers led by Dr. Lidia Ruiz from the University Hospital Germans Trias i Pujol in Barcelona have found that one cycle of structured treatment interruption (STI) can provide immune stimulation in patients with HIV. Twelve HIV patients stopped antiviral treatment for 30 days, having no adverse effects. The viral load grew after an average of 14 days of treatment holidays among 10 patients. The findings are published in the journal AIDS and suggest the potential benefits of STIs. "AIDS Vaccine Trial Complete" Africa News Online (05/10/00); Wendo, Charles Scientists from the Joint Clinical Research Centre in Uganda have completed the shots of the first HIV vaccine tested in Africa. The last volunteer received the final injection in February. Each subject had four injections and the volunteers will continue to be observed. "House OKs Bill to Repeal Hypodermic Law" Providence Journal (05/10/00); Gregg, Katherine The Rhode Island House has approved legislation to repeal a law making it criminal to possess a hypodermic needle without a prescription. The bill passed with supporters saying it will stop the spread of AIDS among heroin addicts. Rhode Island ranks high among states with HIV infections caused by dirty needle sharing. "AIDS Patients to Receive Mental Health Care" Miami Herald (www.herald.com) (05/11/00) The Douglas Gardens Community Mental Health Center of Miami Beach received a $250,000 grant from the Florida Department of AIDS to help provide outpatient mental health care to HIV patients. Services include group therapy and medications, without cost to the clients. ****************************************************************