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1996-03-11
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AIDS Daily Summary
March 7, 1996
The Centers for Disease Control and Prevention (CDC) National AIDS
Clearinghouse makes available the following information as a public
service only. Providing this information does not constitute endorsement
by the CDC, the CDC Clearinghouse, or any other organization. Reproduction
of this text is encouraged; however, copies may not be sold, and the CDC
Clearinghouse should be cited as the source of this information.
Copyright 1996, Information, Inc., Bethesda, MD
************************************************************
"AIDS Council Likely to Back Needle Programs"
"Victims of Tainted Blood May Not Live to See Report"
"States Fight to Limit Federal Courts' Power Over Medicaid"
"White House: More AIDS Education Needed"
"HIV Strain Resistant to New Protease Inhibitors"
"Late-Stage AIDS Patients Susceptible to Pseudomonas Aeruginosa
Infection"
"HIV Prevalence High Among Male Teens Who Have Homosexual
Encounters"
"DNA Vaccine Set to Tackle HIV Infection"
"The Rolling Uncertainties of Antiprotease Prescribing"
"Drug Program Revived"
************************************************************
"AIDS Council Likely to Back Needle Programs"
New York Times (03/07/96) P. B6; Preston, Jennifer
The Governor's Advisory Council on AIDS in New Jersey is expected
to recommend that the state allow needle exchange programs and
the sale of syringes without prescriptions, in an attempt to
reduce the transmission of HIV among injection drug users. Gov.
Christine Todd Whitman has opposed such programs, but the panel
she appointed to evaluate them has decided to recommend that the
Governor support changing the law. Most members of the advisory
council said they were swayed by studies which show that needle
exchanges slow the spread of HIV among injection drug users.
David Troast, chairman of the council, said his opposition to
needle exchanges was reversed when he visited one such program in
the Bronx as well as when he saw a study that found that
needle-sharing was reduced by 40 percent in Connecticut after a
1992 law allowed drug stores to sell syringes without
prescriptions. Connecticut is one of five states that has such
a law. Related Story: USA Today (03/07/96) P.9A
"Victims of Tainted Blood May Not Live to See Report"
Toronto Globe and Mail (03/06/96) P. A3; Picard, Andre
Justice Horace Krever, the judge leading the inquiry into
Canada's tainted blood incident, says the commission's report may
be delayed by months, possibly years. More than 1,200
hemophiliacs and transfusion recipients were infected with HIV
from contaminated blood and blood products between 1980 and 1985.
Krever made this prediction in a letter to the Clerk of the Privy
Council following a government lawyer's announcement that the
lawsuit being brought by the federal government, provinces, the
Canadian Red Cross, and pharmaceutical companies would not
interfere with the completion of the inquiry. The suit is an
attempt to keep Krever from making any findings of wrongdoing,
and contends that such findings could be used in civil or
criminal cases against them. The inquiry has compiled more than
300 potential findings of misconduct, which consumer advocates
say are important to the case and do not imply any legal
liability. Such groups say delaying the report, which had a
deadline of Sept. 30, 1996, hurts the public's faith in the blood
system.
"States Fight to Limit Federal Courts' Power Over Medicaid"
Washington Post (03/07/96) P. A27; Havemann, Judith
The Medicaid reform plan proposed by U.S. governors includes a
provision to ban individual Medicaid beneficiaries--or their
doctors, hospitals, and nursing homes--from suing states in
federal courts. Costly court battles inspired the provision,
which was criticized by Rep. John Dingell (D-Mich.) Wednesday at
a hearing. Dingell said that prohibiting the suits would
"eliminate the effective enforcement of federal rights." States
pay 20 percent to 50 percent of the total costs of Medicaid, and
argue that the courts interfere with state activities. In 1989,
for example, the Missouri state legislature tried to ban Medicaid
payments for AZT, an expensive AIDS drug, but the courts ruled
that the state had to pay.
"White House: More AIDS Education Needed"
Miami Herald (03/06/96) P. 17A
U.S. teens are contracting HIV at the rate of more than one an
hour, and the White House said Tuesday that more AIDS education
is needed. The White House Office of AIDS Policy issued a report
urging strong AIDS education for children, so that when they
later have sex or use drugs, they will know how to protect
themselves. For some young people, like 24-year-old Lam Duckim,
the report is more government talk and no action. Duckim, who is
HIV-positive, said "this report isn't really doing something for
youth. There is a need for accountability." While most U.S.
school districts provide some AIDS education, many do not include
discussions of sexual intercourse, homosexuality, bisexuality,
and condom use. Furthermore, the report did not suggest how to
reach gay teens, noted the Los Angeles Gay & Lesbian Center. The
center said that some 60 percent of AIDS cases among men under
age 25 are due to unsafe homosexual sex. To improve AIDS
education in Florida, legislators are considering a system in
which school districts would compete for AIDS education grants.
"HIV Strain Resistant to New Protease Inhibitors"
Reuters (03/07/96)
Some HIV-infected patients, who have not been treated with the
new protease inhibitors, have already developed strains of the
virus that are resistant to the new drugs, report researchers at
the University of California at Los Angeles. Dr. Andrew Kaplan
and colleagues say that nearly one-third of 246 protease coding
sequences from 12 HIV-positive patients had mutations that seemed
to be resistant to the virus. If some of the viruses in a
patient are resistant to the drug, Kaplan said, the virus has "a
huge head start."
"Late-Stage AIDS Patients Susceptible to Pseudomonas Aeruginosa
Infection"
Reuters (03/06/96)
Four cases studies of community-acquired Pseudomonas aeruginosa
infection in late-stage AIDS patients suggest an increase in P.
aeruginosa infection as a late manifestation of advanced AIDS,
said Dr. Orlando Schaening and colleagues of the Maimonides
Medical Center and SUNY in Brooklyn, N.Y. Schaening recommends
that a secondary prophylaxis for AIDS patients with documented
Pseudomonas infection be considered. In an editorial
accompanying the study, which was published in the journal
Infectious Medicine, Barry Sieger of the Orlando Regional Medical
Center notes that AIDS patients require frequent antibiotic
treatments, which promotes bacterial overgrowth and
superinfection with fairly resistant pathogens, like Pseudomonas.
"HIV Prevalence High Among Male Teens Who Have Homosexual
Encounters"
Reuters (02/13/96)
A national survey of young homosexual and bisexual men revealed
that 7 percent are infected with HIV. Five percent of the men
aged 15 to 19 and 9 percent of those aged 20 to 22 were
HIV-positive, and 38 percent of those surveyed reported having
had unprotected anal sex within the previous six months. Linda
Valleroy of the Centers for Disease Control and Prevention (CDC)
led the survey and presented the findings at the annual meeting
of the American Association for the Advancement of Science in
Baltimore. Valleroy called the prevalence of unprotected anal
sex "alarming, given that these young men grew up in an era of
HIV awareness." The CDC's John M. Karon suspects that young men
underestimate the risk of getting HIV because they assume that
only older men are infected. Data on the epidemiology of
HIV/AIDS was also presented at the meeting, and HIV infection was
reported to be the leading cause of death among men aged 25 to 44
and the fourth leading cause of death among women in that age
group. The World Health Organization reported more than one
million cases of AIDS in 192 countries in 1995, but estimates
that more than 4.5 million cases have occurred globally.
"DNA Vaccine Set to Tackle HIV Infection"
Science News (02/17/96) Vol. 149, No. 7, P. 100; Travis, J.
The Food and Drug Administration (FDA) has granted researchers at
the University of Pennsylvania and the biotech firm Apollon
permission to inject a DNA derived vaccine into healthy,
HIV-negative volunteers. In recent years, researchers have found
that injecting a gene into an animal provokes a positive immune
response to the protein that gene encodes. The new study, the
first conducted with the hope of preventing HIV infection, is
expected to determine the safety of such an injection. The
vaccine involved is made from a gene that codes for one of the
proteins that form the surface of HIV and should therefore
generate HIV antibodies and activate HIV-killing immune cells.
The FDA agreed to the trial because the cancer and HIV-infected
patients previously injected with DNA have experienced no
significant side effects thus far.
"The Rolling Uncertainties of Antiprotease Prescribing"
Journal of the International Association of Physicians in AIDS
Care (02/96) Vol.2, No.2, P. 6; Mascolini, Mark
The first protease inhibitor, Hoffmann-LaRoche's Invirase
(saquinavir), has been approved, and at least four others are in
various stages of development. The variety of drugs becoming
available can be potentially confusing to clinicians, as they are
left to themselves to interpret the results of new studies.
Currently, Roche is working on a new formulation of saquinavir
because of the existing version's low bioavailibility.
Meanwhile, Abbott's Norvir (ritonavir) and Merck's Crixivan
(indinavir) are both now in phase III trials and could be
approved this summer. In addition, patients are being enrolled
for phase II/III trials of Agouron's nelfinavir, and Vertex/Glaxo
Wellcome began a phase I/II study of its VX-478/141W94 late last
year. Protease inhibitors work best when combined with
nucleoside analogs, and in some cases have resulted in viral load
decreases to undetectable levels. However, treatment with one
protease inhibitor can induce resistance to others, complicating
decisions about beginning therapy with one drug and switching to
a more promising one later. The cost of the new drugs adds
another problem for treatment. A combination of saquinavir,
zidovudine, and 3TC (lamivudine), for example, costs $11,830
wholesale per year. Researchers advise that combining a high
dose of a protease inhibitor with one or more nucleoside analogs
is the best strategy to slow the virus.
"Drug Program Revived"
Washington Blade (02/16/96) Vol.27, No.7, P. 1; Fox, Sue
Washington D.C.'s program to provide AIDS drugs to low-income
patients was recently shut down for three days due to a lack of
funding, but is once again functioning. The city government
brought the service back by paying off old bills and redirecting
$115,000 in leftover federal AIDS support to the D.C. CARE
Consortium, which runs the program. The city's agency for
HIV/AIDS is now working on ways to ward off another closure. At
the time of the shutdown, the program was owed about $222,000 in
federal funds. In addition, December's payment was late, thereby
delaying the disbursement of funds. Using the recent payments,
the service will probably have enough money to operate through
March, and will receive new funds in April.