Subject: CDC AIDS Daily Summary for Date: Thu Oct 25 11:31:01 PDT 2001 (367 lines) From: National AIDS Info Clearinghouse Copyright 2001, Information, Inc., Bethesda, MD 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 NATIONAL NEWS "'Poppers' Link to HIV Prompts Call for Warnings in San Francisco" INTERNATIONAL NEWS "No Immediate Changes Planned to South Africa's AIDS Policy, Says Mbeki" "China Begins HIV/AIDS Tests for Military Recruits" "South Korea Remains Largely Inactive in Prevention of AIDS Epidemic" MEDICAL NEWS "Effect of Concomitant HIV Infection on Presentation and Outcome of Rotavirus Gastroenteritis in Malawian Children" LOCAL AND COMMUNITY NEWS "Roanoke NAACP Chapter to Begin Educating Minorities on HIV, AIDS" EDITORIALS AND COMMENTARY "South Africa Needs to Tell the Truth About AIDS" NEWS BRIEFS "Teen AIDS Survivor Will Speak to Youths" "School Alert as Hospital Checks Student for TB" "World's First AIDS Vaccine Factory to be Built in Inchon" ************************************************************ NATIONAL NEWS ************************************************************ "'Poppers' Link to HIV Prompts Call for Warnings in San Francisco" San Francisco Chronicle (10.25.01)::Christopher Heredia A Board of Supervisors' panel has recommended that the San Francisco Department of Public Health (SFDPH) and the district attorney's office revive health warnings about "poppers," a chemical inhalant whose use as a sexual stimulant has been shown to increase the risk of HIV transmission. The resolution, which will go before the full board on Monday, requests that a letter be sent to the SFDPH and the district attorney asking that merchants selling poppers be required to post warnings about health hazards. "It's about having the education material there, and allowing people to make an informed decision," said board President Tom Ammiano, who proposed the resolution. Poppers have been linked to immune suppression and to the AIDS-related skin cancer Kaposi's sarcoma, and they raise the risk of HIV transmission. In the 1980s, health officials banned their use in public places and required merchants to post warnings about their dangers. But the warnings disappeared in the late '80s and early '90s, and no one seems to know why. Often labeled video head cleaner or leather cleaner, poppers are still sold at adult bookstores and on the Internet. And despite posted rules, poppers continue to be used at Bay Area gay bathhouses, activists said. "The fact is, rates of HIV infection are increasing among men who have sex with men," said James Loyce, deputy director of health for SFDPH AIDS programs. "We know unprotected sex goes up when you mix poppers or other drugs together. It's a lethal cocktail." Loyce would like to see the new ordinance include language requiring businesses that sell poppers to provide free condoms. AIDS activists at the Monday meeting of the Board of Supervisors Health and Environment Committee said poppers appear to be staging a comeback. But Steve Gibson, co-executive director of the Stop AIDS Project, said increased awareness "is going to have to be a movement based in the community. If guys perceive that Tom Ammiano or Survive AIDS are telling them they can or can't do something, that is sure to be met with resistance." ************************************************************ INTERNATIONAL NEWS ************************************************************ "No Immediate Changes Planned to South Africa's AIDS Policy, Says Mbeki" Associated Press (10.24.01)::Mike Cohen In a statement before Parliament on Wednesday, President Thabo Mbeki said South Africa has no immediate plans to adjust its program of fighting AIDS or to put more money into efforts to stop the disease. The statement came a week after a controversial study by the highly respected Medical Research Council indicated that 7 million South Africans could die of the disease by 2010 if more is not done to fight the epidemic. According to Mbeki, the study, which said about 40 percent of adult deaths last year were AIDS-related, was being evaluated by a government taskforce. "We are not considering any reapportionment of funding until this process is complete," Mbeki said. In August, he wrote a letter asking the health department to review spending on AIDS in light of 1995 World Health Organization figures, found on the Internet, which showed that 2.2 percent of South African deaths were caused by AIDS. In light of these figures, Mbeki said all statistics had to be taken into consideration to find the true incidence of the disease. Tony Leon, leader of the opposition Democratic Alliance, said updated figures from WHO and UNAIDS indicated that the disease killed 250,000 South Africans in 1999, making it the country's biggest killer. Just 0.6 percent of the health budget was spent on AIDS, complained Leon. Patricia de Lille, a lawmaker from the opposition Pan Africanist Congress, criticized government officials who refuse to provide AIDS drugs because they claim they are toxic. Noting that many lawmakers themselves were taking the drugs and that the drugs have been approved for use in South Africa, de Lille asked, "Why are these drugs only toxic for poor people?" Current government guidelines recommend the drugs not be prescribed until patients are sick, to spare them needless side effects. "China Begins HIV/AIDS Tests for Military Recruits" Agence France Presse (10.24.01) The People's Liberation Army in China added HIV testing to the physical examination for new recruits in a move that reflects growing government concern about the spread of the virus. The Shanghai Morning Post said HIV testing will begin in three districts in Beijing this year and will widen across China in coming years. Men ages 18 to 20 with at least a junior high school education can apply to China's military. The new screening process for recruits reinforces a growing fear among China's authorities that the country faces an AIDS epidemic. China recently admitted that tens of thousands of people could have contracted HIV through selling blood to dealers who used unsanitary collection methods, including pooling the blood in a tub and returning it to the donors after extracting the plasma. Some independent experts believe as many as 1 million people could have been infected this way in one central Chinese province, Henan, alone. China acknowledged the gravity of the crisis in August, saying the risk of HIV infection from a blood transfusion in parts of the country was as high as one in 2,500 transfusions, compared to one in 660,000 in the United States. Authorities have implemented a five-year action plan to keep the annual increase in cases of HIV and STDs below 10 percent. Over the past few years, cases have grown 30 percent a year, according to state media reports. "South Korea Remains Largely Inactive in Prevention of AIDS Epidemic" Korea Herald (10.23.01)::Yoo Soh-jung On Oct. 8, Korea's National Institute of Health (NIH) released the latest AIDS statistics on South Korea, placing the total number of HIV/AIDS cases at 1,515. Of those infected, 1,326 are men and 189 women. The NIH said the number of new AIDS cases reached 235 in the first nine months of the year, representing a 43 percent increase from 164 in the same period last year. "At the current rate the disease is spreading in South Korea, it is fair to say that this country is on the brink of facing an AIDS epidemic," said Lee Chang-woo, director of the Korean Alliance to Defeat AIDS (KADA). "Unless preventive efforts are made very soon, we may ultimately not even be able to contain the problem." The surge reflects a larger AIDS problem now threatening Asia, which includes the most densely populated regions in the world. According to a report released Oct. 4 by an international panel of experts affiliated with UNAIDS, many parts of Asia are experiencing an AIDS epidemic. "We are kidding ourselves if we think Asia is not at risk of a major AIDS epidemic. It is already there," said Peter Piot, executive director of UNAIDS. The UN report found that countries facing an AIDS crisis within certain populations included China, Indonesia and Vietnam, whereas countries such as Thailand, Myanmar and Cambodia had already experienced nationwide epidemics. In South Korea, the hike in HIV/AIDS cases this year can be attributed mainly to unprotected sex, the NIH study said. It found that of 1,515 reported cases, about 97 percent of people with HIV had contracted the virus through sexual encounters. Of the 1,233 people infected through sex, 25.3 percent were infected by a foreign partner of the opposite gender; 44 percent by a Korean partner of the opposite gender; and 27.4 percent by a partner of the same gender. "The best preventive method is abstaining from sexual activity," said Lee Joo-hil, head of a center for AIDS research at NIH. ************************************************************ MEDICAL NEWS ************************************************************ "Effect of Concomitant HIV Infection on Presentation and Outcome of Rotavirus Gastroenteritis in Malawian Children" Lancet (08.18.01) Vol 358; P 550-555::Nigel A Cunliffe; Carl D Kirkwood, Stephen M Graham; Ndina M Nhlane; Benson D M Thindwa; Winfred Dove; Robin L Broadhead; Malcolm E Molynexu; C Anthony Hart Rotaviruses are the main cause of severe, dehydrating diarrhea in infants and young children throughout the world. By contrast with more-developed countries, in which rotavirus causes few deaths (<40 per year in the United States), an estimated 500,000 to 870,000 deaths annually are caused by rotavirus infection in less-developed countries. Infection with HIV is common among children in many countries in sub-Saharan Africa, and diarrheal disease is a leading cause of illness and death in HIV-infected children in these areas. The objectives of this study were to examine the effect of host HIV infection on the severity of rotavirus disease, and on the duration of fecal shedding of rotavirus and the serum immune response to rotavirus infection. Researchers enrolled 786 inpatients (median age 8 months, 34 percent of whom were HIV-1 infected) and 400 outpatients (median age 9 months, 16 percent of whom were HIV- infected) in the study. Early rotavirus vaccines seemed to be less effective in tropical settings, but newer vaccines have shown similar levels of protection (80-100 percent) against the most severe outcomes of rotavirus infection in more-developed and less-developed countries. Most rotavirus vaccines in development include live, oral, attenuated strains, and concern exists regarding their use in infants who might be immunocompromised. Specifically, the CDC's Advisory Committee on Immunization Practices recommended that the (now suspended), tetravalent rhesus-human reassortant rotavirus vaccine should not be given to infants born to HIV- infected mothers (unless HIV infection in the infant has been excluded), and suggested further research in this area. Understanding the behavior of natural rotavirus infections in HIV-infected children is an important first step in this process. In this 2-year hospital-based study of rotavirus gastroenteritis, researchers found that rotavirus was less commonly identified among HIV-infected children than among HIV- negative children. In those with HIV infection, the contribution of rotavirus might have been diluted by the effect of other enteropathogens - e.g. parasites, bacteria and perhaps viruses such as astroviruses and picobirnaviruses, which have been associated with diarrhea in HIV-infected adults. Researchers were unable to find significant differences in the clinical severity of rotavirus diarrhea between hospitalized children with and without HIV infection. However, significantly more deaths occurred during follow-up after hospital discharge among HIV- infected children than among HIV-negative children, and death was related to low CD4 count on presentation. In conclusion, rotavirus was detected less frequently among HIV-infected children, who were able to clinically resolve rotavirus infection irrespective of their immune status, and could mount a seroresponse similar to children without HIV infection. The finding of more frequent deaths among HIV-infected children during short-term follow-up after rotavirus infection requires further study, including assessment of the effect of rotavirus on HIV replication. The observation of (clinically inapparent) prolonged shedding in some HIV-infected children also merits further investigation, and would be best addressed in a large, longitudinal study with long-term follow-up. ************************************************************ LOCAL AND COMMUNITY NEWS ************************************************************ "Roanoke NAACP Chapter to Begin Educating Minorities on HIV, AIDS" Roanoke Times & World News (10.23.01)::Kathy Lu With blacks accounting for 51 percent of all HIV/AIDS cases in Roanoke, Va., the local chapter of the NAACP decided it needed to take action. On Monday, outside the Roanoke City Health Department, the organization declared a health state of emergency in the Roanoke Valley. For at least the next year, it will work with several area groups to solve the problem. "By this time next year ... we want to see the numbers decrease by at least 20 percent," said Brenda Hale, president of the local NAACP chapter. "Of course, our ultimate goal would be eradication." Nationally, blacks make up 13 percent of the population but 47 percent of all HIV/AIDS cases. Of particular concern are middle-aged black women, who account for an increasing number of new cases, and Latinos. "For some reason, people of color are not getting the message ... of this dreadful pandemic," said Dale Anthony, a former Roanoker who has AIDS and travels around the country organizing AIDS-prevention programs. "I'm so glad the brothers and sisters of Roanoke are getting the message." Anthony, who lives in New York, provides these programs through Tough Talk, a nonprofit organization he founded to help educate people about HIV/AIDS. He plans to give two-hour presentations at five area black churches through Saturday. Groups that will be working with the NAACP on the initiative include the Roanoke Health Department, the AIDS Coalition of Southwestern Virginia, Kuumba Health Center and Planned Parenthood. ************************************************************ EDITORIALS AND COMMENTARY ************************************************************ "South Africa Needs to Tell the Truth About AIDS" Times-Picayune (New Orleans) (10.17.01) "Concealing the prevalence of AIDS in South Africa will not make the disease any less deadly. Nevertheless, that nation's government is delaying the release of a report on the prevalence of AIDS within its borders. A new report by the autonomous but government-funded Medical Research Council predicts that, without major changes in public policy and personal behavior among South Africans, the disease could kill up to 7 million people there by 2010 and reduce the average life expectancy from 54 to 41. "When South African officials got wind of those findings, they sought a delay in the report's release until December, when a government statistical agency is expected to finish a rosier evaluation of the problem. Fortunately, Medical Research Council scientists leaked key parts of the report to the media. "In the past, government officials have questioned whether HIV really causes AIDS. Even after winning a legal battle over access to life-saving drugs, the government has shown little interest in distributing them to infected citizens. "And now this. As the world's attention has turned to terrorism, governments that endanger the health of their own people won't necessarily get the international condemnation they deserve. But regardless of the other dangers that exist in the world, AIDS is a grave threat to South Africa's future. The government must not pretend otherwise." ************************************************************ NEWS BRIEFS ************************************************************ "Teen AIDS Survivor Will Speak to Youths" Indianapolis Star (10.23.01) Hydeia Broadbent, a 17-year-old AIDS activist, will give the keynote speech at the 2nd annual Mayor's Teen Summit on Saturday, Oct. 27, at the Murat Centre, 502 N. New Jersey St. in Indianapolis. Broadbent, who was born with HIV, was orphaned at 6 weeks and has lived with AIDS since she was 5 years old. Her adoptive parents, with philanthropists William and Claire Sams- Milligant, created the Hydeia L. Broadbent Foundation in 1993 to promote AIDS awareness. The event, sponsored by Mayor Bart Peterson and the Mayor's Youth Council, will run from noon to 6 p.m. Doors will open at 11 a.m. The summit will offer workshops and conclude with a peace rally at 5:25 p.m. Admission is free. "School Alert as Hospital Checks Student for TB" Daily Mail (London) (10.23.01)::Adam Powell Wellacre School in Flixton, Greater Manchester, was at the center of a TB scare Monday night after it was learned that a pupil had been hospitalized with a suspected case of the contagious and potentially fatal disease. Staff and 600 students are awaiting test results after a doctor gave an initial diagnosis that one of the students has TB. The boy has been treated in the hospital with antibiotics for about 10 days. Dr. Jennifer Hill, consultant in communicable diseases for Salford and Trafford Health Authority, said, "It is unusual for children to be infective, although not unknown." Last year about 7,300 TB cases were recorded in Britain, the most since 1982. "World's First AIDS Vaccine Factory to be Built in Inchon" Korea Times (10.22.01) The US-based vaccine firm VaxGen signed a 10-year factory site lease with the Inchon city government for a 3.3 square meters-facility in Songdo. The company plans to build production facilities as well as a research center. VaxGen is due to complete development and clinical tests for its AIDS vaccine, AIDSVAX, by 2005. Construction is due to begin in the second quarter next year. "Construction of the AIDS vaccine plant in Inchon is part of the national government's and Inchon city's plan to nurture Inchon into a global bioengineering industry leader," said Inchon city government.