Subject: CDC AIDS Daily Summary for Date: Tue Jun 20 07:01:00 PDT 2000 (206 lines) From: National AIDS Info Clearinghouse Copyright 2000, Information, Inc., Bethesda, MD CDC HIV/STD/TB Prevention News Update Tuesday, June 20, 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 "Antiretroviral Therapy in Patients With Dual Infection With Human Immunodeficiency Virus Types 1 and 2" GENERAL MEDIA "Viable Blood Substitute Moves Closer to Reality" "Justices Hand AIDS Patients Insurance Victory; State's Top Court Bars Benefit Cuts After Two Years" "FDA Advisory Committee Agrees to Ease Approval Process for Rapid HIV Tests" "Measuring Sex on College Campuses" "A Few Intentionally Seeking Out HIV" "Baltimore Red Ribbon Question Mark Campaign Goes Door to Door to Fight AIDS for National HIV Testing Day" "South Africa Launches Battle Plan to Combat AIDS" "Uganda: AIDS Drug Prices on the Rise" *************************************************************** PEER-REVIEWED JOURNALS *************************************************************** "Antiretroviral Therapy in Patients With Dual Infection With Human Immunodeficiency Virus Types 1 and 2" New England Journal of Medicine (www.nejm.org) (06/08/00) Vol. 342, No. 23, P. 1758; Schutten, Martin; Van Der Ende, Marchina E. ; Osterhaus, Albert D.M.E. Researchers from the Erasmus Medical Center Rotterdam in the Netherlands note that a growing number of patients in western Europe are infected with HIV-2. They write that at their facility, they track 630 patients who are seropositive for HIV-1, 14 seropositive for HIV-2, and six who are seropositive for both HIV-1 and HIV-2. Each of the HIV-2-seropositive individuals has links to a group of West African immigrants now living in or around Rotterdam. Here, the researchers report, however, the failure of antiretroviral therapy in two treatment-naive patients who were dually infected. According to the authors, there was no decrease in plasma HIV-2 RNA in the first patient, while the second patient saw an initial decrease from 2,700 copies to an undetectable level, followed by a rebound to 48,000 copies per milliliter. The scientists determined that the HIV-2 and HIV-1 infections had replicated before treatment began. Therefore, treatment should not be started in such cases without taking into account the need for careful therapy that will be active against both viruses. **************************************************************** GENERAL MEDIA **************************************************************** "Viable Blood Substitute Moves Closer to Reality" USA Today (www.usatoday.com) (06/20/00) P. 1A; David, Robert A new milky white substance called Oxygent is being tested as a viable blood substitute used during surgery. The liquid has been used in many clinical trials and is expected to receive federal approval. Harvey Klein of the department of transfusion medicine at the National Institutes of Health believes the product will be licensed within the next year. Oxygent is called an oxygen carrier, not a blood substitute, and could save people during heart attacks or strokes, when quick blood transfusions are needed. If approved, Oxygent and similar products could help reduce the strain on the nation's blood supply, providing a safe alternative for donated blood. Even with new screening processes, hepatitis C is transmitted approximately once in every 100,000 transfusions, and the risk for HIV is about once in every 676,000 transfusions. Tests of a hemoglobin-based substitute, HemAssist, in the 1990s were halted following the deaths of several trauma patients due to a dramatic rise in blood pressure. While Oxygent must still be tested in trauma patients, smaller tests have revealed no serious side effects. "Justices Hand AIDS Patients Insurance Victory; State's Top Court Bars Benefit Cuts After Two Years" San Francisco Examiner (www.examiner.com) (06/19/00) P. A1; Egelko, Bob The California Supreme Court has barred insurers from denying benefits to AIDS patients who knew they had HIV when they applied for insurance and had paid premiums for over two years. AIDS activists call the decision a major win over the insurance industry. The decision overturned lower rulings that called for more than five years of policy coverage to keep insurance. The two years were ruled as enough time to screen policy-holders for disabilities or illness. The case involved Mark Galanty, who was tested for HIV more than a year before he applied for a disability policy in 1989; Galanty's test came back positive, but he was told the results were inconclusive. After he was diagnosed with AIDS in 1994, Galanty presented a disability claim to his insurer, Paul Revere Life Insurance Co. The company paid until April of the next year, but discontinued his benefits after it learned he had been tested for HIV in the past. The judge ruled this unlawful, citing a two-year limit for denying customers' eligibility. "FDA Advisory Committee Agrees to Ease Approval Process for Rapid HIV Tests" Reuters Health Information Services (www.reutershealth.com) (06/16/00); Gale, Karla The Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention have agreed to measures that should reduce the time needed to approve rapid HIV tests. Two issues the FDA discussed with the Blood Product Advisory Committee were lowering the number of subjects in clinical trials and using multiple tests for rapid diagnosis. Robert Janssen of the CDC's Division of HIV/AIDS Prevention said guidelines will establish how to use two or three rapid tests together to make a diagnosis in about 20 minutes. Janssen explained that if two tests performed at the same time came back with the same results, that would be sufficient for diagnosis, while a third test would be used to resolve discordant test results. "Measuring Sex on College Campuses" USA Today (www.usatoday.com) (06/20/00) P. 8D; Healy, Michelle A survey commissioned by the Foundation for Academic Standards & Tradition found that fifty-seven percent of college students say they are sexually active. However, the poll of 1,005 students found that promiscuity is not popular. Of those students who reported being sexually active, 72 percent said they had sex with only one partner during the previous semester and 8 percent said they had no sex in the last semester. "A Few Intentionally Seeking Out HIV" Boston Globe Online (www.boston.com/globe) (06/18/00) P. A18; Abraham, Yvonne Health professionals are seeing something unexpected in the gay community: a small group of men who want to contract HIV in the belief that it offers community and kinship. Increasing numbers of chat rooms and Web sites approach the subject of men who want to convert from HIV negative to positive. Marshall Forstein, medical director of mental health at Fenway Community Health Center in Boston, says some of the men feel lonely or shunned and believe that HIV will bring them attention from friends and caregivers. One California activist who stopped using condoms and later contracted HIV also noted, "When I was entering the gay community at the height [of the epidemic], I felt like I'd joined a war. And that somehow transformed HIV into this rite of passage as opposed to something to be reviled and avoided." Some Web sites even discuss "conversion parties," where uninfected men can have unprotected sex with HIV-positive men to try to contract the virus. The groups refer to HIV infection as a "rebirth" and a way to bond with a new family. "Baltimore Red Ribbon Question Mark Campaign Goes Door to Door to Fight AIDS for National HIV Testing Day" U.S. Newswire (www.usnewswire.com) (06/19/00) The Johns Hopkins Center for Communication Programs and Hopkins Bayview Hospital have announced their support for a program in which female volunteers will go door-to-door to encourage their peers to be tested for HIV. The volunteers, participants in the C.A.P. Program at the Center for Addiction and Pregnancy for pregnant women and new mothers who are fighting drug addiction, will visit Baltimore neighborhoods over the next week, in advance of National HIV Testing Day on June 27. The women will distribute referral cards and information to who to call or where to go to get tested for HIV. Jim Williams, project director for the Red Ribbon Question Mark HIV Campaign, noted, "These programs are really important because the HIV/AIDS epidemic in Baltimore is far more serious than most realize." According to the Maryland Department of Health and Mental Hygiene, more than 10,000 people in Baltimore have HIV or AIDS, and an estimated 5,000 more have contracted the virus but are not aware of their infection. "South Africa Launches Battle Plan to Combat AIDS" Reuters (www.reuters.com) (06/19/00); Swindells, Steven South Africa unveiled on Monday a five-year battle plan against AIDS. While the strategy document asked residents to change their sexual behavior, the plan offered no new funding for the millions of South Africans already infected with HIV. The plan highlighted the need to lower the number of new HIV infections, especially among the young, and committed the health ministry and other groups to studying research on antiretroviral drugs used to prevent mother-to-child virus transmission and for people who have been raped. Health Minister Manto Tshabalala-Msimang noted that anti-AIDS drugs are not part of the five-year plan, because even with an 80 percent discount, they are still too costly. "Uganda: AIDS Drug Prices on the Rise" Africa News Service (www.africanews.org) (06/19/00); Wendo, Charles Physicians at a recent workshop in Kampala said that prices for AIDS drugs in Uganda have increased, even after manufacturers announced price reductions of up to 80 percent. A month's supply of Combivir, for example, rose from 365,000 Ugandan shillings to 375,000 Ugandan shillings. The drug access conference, organized by Medecins Sans Frontiers and Health Action International, was attended by participants from 17 nations.