Subject: CDC AIDS Daily Summary for Date: Wed May 17 07:31:00 PDT 2000 (178 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Wednesday, May 17, 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 "NIH Revamps HIV Vaccine Trials Unit" GENERAL MEDIA "Drug-Resistant TB Overwhelms Typical Treatment" "US to Go Easy on Visiting Mbeki on AIDS--Activists" "South African Legislators Take AIDS Test to Fight Stigma" "Needle Exchange Program in Vermont Goes Unfulfilled" "Antiretroviral Therapy Increases Thymic Output in HIV-Infected Children" "Heterosexual Transmission of Hepatitis C by HIV-Positive Men Is Infrequent" "Health Tips: Trying Drug Holidays for HIV" "Uganda: 50 Percent of Bundibugyo Infected With AIDS" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "NIH Revamps HIV Vaccine Trials Unit" Nature Medicine (medicine.nature.com) (05/00) Vol. 6, No. 5, P. 488; Wickware, Potter The National Institutes of Health (NIH) will base its center of clinical trials for AIDS vaccines in Seattle's University of Washington. AIDS and herpes virologist Larry Corey will head the HIV Vaccine Trials Network (VTN) which now handles trials of microbicides. VTN will shift control from the NIH at Bethesda, Maryland, hopefully reducing tensions and creating more research programs. Corey expects the network will change greatly in a few years to expand clade development. The formation of VTN does separate the vaccine from behavioral intervention, but should make the groups easier to steer. **************************************************************** GENERAL MEDIA **************************************************************** "Drug-Resistant TB Overwhelms Typical Treatment" USA Today (www.usatoday.com) (05/17/00) P. 11D; Manning, Anita A study in today's Journal of the American Medical Association (2000;282:2537-2545, 2575-2576) states that the widely used treatment for tuberculosis (TB), called directly observed therapy, short course (DOTS), is not powerful enough to control drug-resistant strains of the disease. The World Health Organization (WHO) recommends DOTS, which is used in 119 countries, including the United States. A review of 6,402 TB cases in the Dominican Republic, China, Italy, Russia, Korea, and Peru found that 83 percent of all new cases were treated successfully; however, only 52 percent of patients with multidrug-resistant TB responded to treatment. The researchers suggest that the WHO policy include specific treatments used for drug-resistant TB when other therapy fails. "US to Go Easy on Visiting Mbeki on AIDS--Activists" Reuters (www.reuters.com) (05/16/00); Fox, Maggie South African President Thabo Mbeki's visit to Washington next week will likely not be a harsh condemnation of his decision to consider the advice of scientists who believe HIV does not cause AIDS. It is expected that the U.S. government will not highlight the controversy, although AIDS activists hope the White House can convince Mbeki to change his position and start providing treatment to HIV-infected individuals in South Africa. Many activists and scientists believe Mbeki is wasting time by discussing the dissident view of AIDS, as South Africa's number of AIDS cases grows rapidly. Mbeki's AIDS panel sparked controversy recently with the appointment of Peter Duesberg of the University of California at Berkeley and molecular pharmacologist David Rasnick, both of whom have questioned HIV as the cause of AIDS; however, the panel also includes Dr. Helene Gayle, head of the U.S. Centers for Disease Control and Prevention's National Center for HIV, STD, and TB Prevention; Dr. Luc Montagnier, the co-discover of HIV; and Salim Abdool-Karim, head of the HIV/AIDS Research Unit at South Africa's Medical Research Council. "South African Legislators Take AIDS Test to Fight Stigma" Boston Globe Online (www.boston.com/globe) (05/17/00) P. A23 In South Africa, politicians Stanley Mogoba of the Pan Africanist Congress and Kgomotso Ditshetelo, head of the United Christian Democratic Party, gave blood for a public HIV test on Tuesday. The results will be released in several days, as part of an effort to fight the stigma surrounding AIDS. Other politicians have offered to submit reports of their HIV status, although the heads of four large political parties declined, noting that HIV testing is a private, not political, issue. "Needle Exchange Program in Vermont Goes Unfulfilled" Boston Globe Online (www.boston.com/globe) (05/16/00) Although the Vermont legislature authorized a needle exchange program for drug addicts last year, a lack of funds and community support has prevented any programs from starting. The state has not set aside money for a needle exchange and federal funds cannot be used. Activists are frustrated; however, a group from Brattleboro hopes to launch a minimal project this summer with $18,000, while a Burlington organization plans to have needle exchange operating by the fall. As of 1995, there were an estimated 2,000 heroin addicts in Vermont, and experts say the current number could be much higher. "Antiretroviral Therapy Increases Thymic Output in HIV-Infected Children" Reuters Health Information Services (www.reutershealth.com) (05/16/00) A study of HIV-infected children by Dr. Savita Pahwa of North Shore University Hospital-NYU School of Medicine shows that increased thymic output helps increase the number of CD4-positive T cells undergoing antiretroviral therapy. The researchers measured the number of T cell receptor gene arrangement circles (TREC), which were correlated positively with the percentage of CD4 cells and naive T cells, but not age, viral load, or CD8 cells. The TREC levels were higher in children who responded to treatment. The findings were reported at the joint annual meeting of the American Association of Immunologists and the Clinical Immunology Society. "Heterosexual Transmission of Hepatitis C by HIV-Positive Men Is Infrequent" Reuters Health Information Services (www.reutershealth.com) (05/16/00) New research published in The Journal of Infectious Diseases (2000;181:1475-1478) suggests that co-infection with HIV and hepatitis C virus (HCV) does not significantly raise the heterosexual transmission rate of HCV. The relationship between HCV load and transmission risk is not entirely known. Dr. Michie Hisada of the National Cancer Institute and colleagues studied data from 393 men with a clotting disorder and found that 343 had HIV and HCV, while 42 had only HCV and six were infected with just HIV. The men had female sex partners, and one woman contracted HCV from the partner with only HCV infection, while 20 men with both infections transmitted HCV. "Health Tips: Trying Drug Holidays for HIV" United Press International (www.upi.com) (05/17/00); Manning, Elizabeth Researchers from the Wistar Institute at the University of Pennsylvania have started a trial of periodically stopping HIV-positive volunteers from taking their medications. The goal is to test whether drug holidays can force the immune system to control HIV. A report last year of a similar study involving a German patient showed that breaks in drug therapy can be beneficial and can keep the virus under control. "Uganda: 50 Percent of Bundibugyo Infected With AIDS" Africa News Service (www.africanews.org) (05/16/00); Justus, Sauza Uganda's deputy director of health services in Bundibugyo, James Ndyeziika, sparked concern recently after announcing that half Of the district is infected with HIV. Ndyeziika told participants at a recent workshop on disaster preparedness and response that rebel fighting has increased the spread of the virus, after three years of terrorism and rapes of women. He also said that tuberculosis and venereal diseases are on the rise. Some 30,000 condoms have been given to health centers, clinics, and hotels, and Ndyeziika noted that female condoms may be introduced after women are instructed about how to use them. ****************************************************************