Subject: CDC AIDS Daily Summary for Date: Wed Jun 14 07:01:00 PDT 2000 (194 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Wednesday, June 14, 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 "Spread of Mycobacterium Tuberculosis in a Community Implementing Recommended Elements of Tuberculosis Control" GENERAL MEDIA "FDA Is Hit on Rapid AIDS Tests" "WHO Chief Urges Fight Against Diseases" "U.S., India Pledge New Efforts to Cooperate in HIV/AIDS and Maternal and Child Health Research" "In Brazil, Some Bishops Suggest Allowing Condom Use to Halt AIDS" "State Battles New Surge in TB" "Nurses to Ask Lawmakers to Defend Against Needles" "Abuse Linked to Increased Medical Problems in Women With HIV" "Caught in the Act" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Spread of Mycobacterium Tuberculosis in a Community Implementing Recommended Elements of Tuberculosis Control" Journal of the American Medical Association (www.jama.com) (06/14/00) Vol. 283, No. 22, P. 2968; Chin, Daniel P.; Crane, Charles M.; Diul, Mukadi Ya; et al. Researchers studying the spread of tuberculosis in a community maintaining elements of tuberculosis (TB) control evaluated 221 TB case-patients in the San Francisco Bay area. The areas studied had high rates of poverty, homelessness, substance abuse, and HIV infection, according to the authors. Genotyping and epidemiological linkage revealed that 73 of the cases in 1996-1997 were caused by one strain of Mycobacterium tuberculosis. Just over half of those patients--53 percent, or 39 patients--developed TB because they were not recognized as contacts of source case-patients, and 20 patients developed TB due to delayed diagnosis of the sources. The authors note that 96 percent of the 51 TB cases identified with sources were infected within the two years prior to diagnosis. The researchers concluded that the reasons for disease development in a community that implements TB control will continue to exist unless TB is diagnosed earlier and contacts are determined more thoroughly. **************************************************************** GENERAL MEDIA **************************************************************** "FDA Is Hit on Rapid AIDS Tests" Washington Post (www.washingtonpost.com) (06/14/00) P. A20 The Centers for Disease Control and Prevention has voiced concerns that the Food and Drug Administration (FDA) is taking too long to approve new HIV tests that could provide rapid results. The CDC estimates that nearly 10,000 people who are tested for HIV each year never return to learn whether or not they are infected. The new, rapid HIV tests give results in minutes instead of days or even weeks, so treatment could be started much earlier. Jay Epstein, director of the FDA's office of blood research, said the tests must meet standards and prove to be reliable, so more studies are needed. An FDA advisory committee will meet this week to clarify what is anticipated in terms of the studies and the results. "WHO Chief Urges Fight Against Diseases" Reuters (www.reuters.com) (06/13/00) Gro Harlem Brundtland, director-general of the World Health Organization, has called for more action to fight such diseases as measles, malaria, tuberculosis, and AIDS, which kill 14 million people a year. Brundtland, who spoke Tuesday at a board meeting of the Global Alliance of Vaccines and Immunization (GAVI) in Oslo, noted that vaccines could have saved 3 million of those lives, as almost 1 million children die of measles alone each year. GAVI's Global Fund for Children's Vaccines expects to begin disbursements next month, aided by a $750 million grant from the Bill and Melinda Gates Foundation. "U.S., India Pledge New Efforts to Cooperate in HIV/AIDS and Maternal and Child Health Research" U.S. Newswire (www.usnewswire.com) (06/13/00) Joint statements signed Tuesday by U.S. Health and Human Services Secretary Donna Shalala and Indian Minister of Health and Family Welfare Chandreshwar Prasad Thakur agree to work together for HIV prevention research and child health research. Shalala noted that the joint statements "will help both countries develop new methods and programs that will improve the health of men, women, and children around the world." Minister Thakur also noted that the agreements should enhance ties between the two governments. The Indo-U.S. Vaccine Action Program has been useful in bringing together scientists to consider research plans that benefit both countries. Scientists from India and America want to expand HIV prevention research and improve maternal and neonatal health, reducing HIV transmission to newborns. "In Brazil, Some Bishops Suggest Allowing Condom Use to Halt AIDS" Boston Globe Online (www.boston.com/globe) (06/14/00) P. A17; Olmos, Harold Some Roman Catholic bishops in Brazil are overcoming Vatican doctrine and have suggested using condoms to stem the spread of HIV. The Most Rev. Eugenio Rixen, the bishop of Goias and a member of the Brazilian Catholic church's Health Pastoral, which debates health matters, said Tuesday that condom use should be allowed among high-risk groups, including homosexuals and prostitutes. The Vatican believes that artificial birth control is wrong and supports abstinence until marriage and faithfulness during marriage. Brazil, the world's largest Roman Catholic country, has recorded 200,000 cases of HIV; however, some experts believe that up to two times that number of infections may not have been reported. "State Battles New Surge in TB" Anchorage Daily News Online (www.adn.com) (06/13/00); Campbell, Larry A tuberculosis (TB) outbreak in southwest Alaska has health officials worried. There have been 21 active cases of TB reported in several villages since April, and 56 other people have tested positive for TB exposure. In Anchorage, 20 people have been diagnosed with TB since January, versus just 14 cases in all of 1999. To help control the outbreak, all patients diagnosed with active TB or testing positive for TB exposure are being flown to Kanakanak Hospital in Dillingham for treatment. Dr. Beth Funk, head of Alaska's infectious disease program, said 373 cases of active TB have been recorded in Alaska in the past five years, with up to 45 percent of the cases occurring in Anchorage. Funk noted that while Anchorage's TB rate per capita is similar to that seen in the rest of the United States, some rural areas of the state have much higher TB rates. "Nurses to Ask Lawmakers to Defend Against Needles" Las Vegas Sun Online (www.lasvegassun.com) (06/13/00) The Nevada Nursing Association will ask lawmakers to pass a bill that reduces the risk of nurses receiving accidental needle sticks. The bill would require hospitals to test safe needle devices and report all incidents to the Occupational Safety and Health Administration. Cynthia Bunch, the legislative coordinator for the Nevada Nursing Association, explained: "There will always be certain procedures that require a needle, but we're looking for ways to minimize the exposure and the needle stick rate itself." Statistics show that regular use of safe needles devices could eliminate up to 80 percent of the 600,000 accidental needle sticks each year. "Abuse Linked to Increased Medical Problems in Women With HIV" Reuters Health Information Services (www.reutershealth.com) (06/13/00) A report in the Archives of Internal Medicine (2000;160:1659-1664) reveals that HIV-infected women who are abused have more illnesses, including opportunistic infections. Dr. Jane Liebschutz of Boston University School of Medicine and colleagues examined physical and sexual abuse among 50 women with HIV and found by medical chart review that over 66 percent had evidence of abuse; only about half reported the abuse during a clinical interview. The women had more chronic illnesses, showing a link between stress and poor health. "Caught in the Act" New Scientist (www.newscientist.com) (05/27/00) Vol. 166, No. 2240, P. 18; Knight, Jonathan New research from Washington University in St. Louis indicates that protease inhibitors (PIs) may cause problems in the body by affecting a protein known as glucose transporter 4, or Glut 4. Mike Mueckler and colleagues observed that the symptoms of HIV patients with metabolic disorders and insulin resistance were similar to those seen in a strain of mice that did not have Glut 4. The researchers found that applying a PI to cultured mouse fat cells reduced the rate at which the cells absorbed glucose from their growing medium when prompted by insulin. The findings will be reported in an upcoming issue of The Journal of Biological Chemistry (www.jbc.org). Jonathan Purnell of Seattle's University of Washington said that while interesting, the findings do not show how Glut 4 could affect fat distribution, so further research is needed. ****************************************************************