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$Unique_ID{BRK03436}
$Pretitle{}
$Title{AIDS (Acquired Immune Deficiency Syndrome)}
$Subject{AIDS (Acquired Immune Deficiency Syndrome) AIDS DISORDER SUBDIVISIONS
AIDS AIDS related complex, also known as ARC, AIDS prodrome, Wasting/Lymph
Node Syndrome, and Mini-AIDS}
$Volume{}
$Log{}

Copyright (C) 1986, 1987, 1990, 1991, 1992, 1993 National Organization
for Rare Disorders, Inc.

78:
AIDS (Acquired Immune Deficiency Syndrome)

** IMPORTANT **
It is possible that the main title of the article (Acquired Immune
Deficiency Syndrome) is not the name you expected.  Please check the SYNONYMS
listing to find the alternate names and disorder subdivisions covered by this
article.

Synonyms

     AIDS

DISORDER SUBDIVISIONS

     AIDS
     AIDS related complex, also known as ARC, AIDS prodrome, Wasting/Lymph
Node Syndrome, and Mini-AIDS

General Discussion

** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only.  It should not be used for diagnostic or treatment
purposes.  If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.


In the acquired immune deficiency syndrome (AIDS) the body's ability to
ward off infection progressively deteriorates.  Organisms which in a healthy
person would either fail to cause disease, cause mild disease, or at least
provoke immunity, completely overwhelm the AIDS patient.  Patients with
severe AIDS also contract various uncommon, life threatening infections,
particularly pneumocystis carinii pneumonia, and have an unusually high
incidence of a rare cancer, Kaposi's sarcoma.  Individuals in the early
stages of the disease are unusually susceptible to many milder infections.

Symptoms

AIDS may be preceded by a period of asymptomatic immune abnormalities, or by
a prodromal state lasting as long as 36 months.  This "AIDS related complex"
is characterized by otherwise unexplained lymphadenopathy (swelling and
disease of lymph nodes) for a period of at least three months, recurrent flu-
like symptoms, fatigue and malaise, loss of weight or appetite, fever, night
sweats, unexplained diarrhea, or diarrhea due to amebiasis, idiopathic
thrombocytopenic purpura in some cases, and an unusual susceptibility to mild
infections.  Commonly, infections are by yeasts such as oral thrush, by
amoebas, fungi, viruses such as Herpes Zoster and molluscum contagiosum, and
staphylococcus bacteria, leading to purulent skin infections.

Researchers now believe the AIDS virus may be present in a patient as
much as 5 to 7 years before symptoms appear.  In 1988, scientists at the
federal Centers for Disease Control (CDC) in Atlanta, GA, reported many
individuals infected with the AIDS virus show a sharp increase in virus-
infected white blood cells in the year before these patients develop the full
blown disease.  A decrease of one type of disease-fighting white blood cells
known as T-4 helper cells also occurs as the infection progresses.  Other
studies have suggested that increases in chemicals in the blood signaling
viral reproduction might serve as clues to early diagnosis of AIDS in
susceptible patients.

Full blown AIDS continues to manifest fever, wasting, lymphadenopathy,
and susceptibility to infections.  The infections become much more severe,
however, and are often due to uncommon organisms.  They may be difficult to
treat, and if treated successfully, may still recur repeatedly.  Several
infections often coexist.  A particularly serious threat is infection by the
protozoan pneumocystis carinii.  Serious infections may also be viral,
bacterial, or fungal.  See table below.

VIRAL INFECTIONS:
     Cytomegalovirus
     Herpes simplex virus types I and II
     Epstein-Barr virus (normally associated with mononucleosis)
     Varicella-Zoster (normally associated with Chicken Pox)
     Papova virus

BACTERIAL INFECTIONS:
     Mycobacterium tuberculosis (the organism causing tuberculosis)
     Mycobacterium avium-intracellulare
     Legionella pneumophilus (the organism causing Legionnaire's disease)
     Klebsiella pneumonae

FUNGAL INFECTIONS
     Candida albicans (yeast infection)
     Cryptococcus neoformans
     Aspergillus species
     Histoplasma capsulata

PROTOZOAN INFECTIONS:
     Pneumocystis carinii
     Toxoplasma gondii
     Entamoeba histolytica ("amoebas")
     Giardia lamblia (causes diarrhea)
     Cryptosporidium
     Isopora bellii

Pneumonias, central nervous system infections, involvement of the eyes,
particularly the retina, gastrointestinal symptoms (especially persistent
diarrhea) and general wasting, fever, and weakness may be one or more of
these organisms.  Often diagnosis is difficult because symptoms and signs of
the infections in the immunosuppressed patient differ from those in
immunologically normal individuals.

Malignant neoplasms are also characteristic of AIDS.  Kaposi's sarcoma is
especially common, occurring in as many as 37% of the patients.  In this type
of cancer, the skin and often the viscera are covered with small brown
plaques and nodules representing vascular tumors.  Patients who have only
Kaposi's Sarcoma have a somewhat better prognosis than those with
opportunistic infections, apparently because their immune systems retain
slightly better function.  Other cancers associated with AIDS include certain
malignant undifferentiated and differentiated lymphomas, such as Hodgkin's
disease, and carcinomas of certain cells of the tongue and rectum.

Another feature of AIDS is a decrease in the total number of lymphocytes
(cells responsible for immunity) in the blood.  An absence of allergic skin
reactions and abnormalities in the relative numbers and functioning of the
different kinds of lymphocytes in the circulation also indicate cellular
immunodeficiency.  Evidence of exposure to the causative virus and abnormal
proportions of the different lymphocyte types has been found in many members
of the groups at risk for AIDS.  Clearly, not all these people develop the
disease.

Recent research suggests that as many as 60% of AIDS patients may develop
dementia.  The dementia may occur at any age.  According to the National
Institute of Neurological Disorders and Stroke, as the number of patients
affected by the AIDS retrovirus continues to grow, the associated
neurological syndromes are recognized with increasing frequency.
Neurological involvement may be apparent before severe immunodeficiency is
recognized.

Dementia is one of the more common and devastating neurological
complications of AIDS.  As many as 60 percent of patients with AIDS may
develop dementia that cannot be attributed to opportunistic infections.  The
dementia may occur at any stage; it is often manifested very early in the
clinical course of the illness.  Some of these patients also develop spastic
paraplegia and ataxia associated with vacuolar changes in the myelin of the
spinal cord.

Infection with the AIDS retrovirus is also associated with the
development of peripheral nerve disease in a lesser number of patients.
Although neuropathy may affect 10 percent or more of patients with AIDS, the
clinical and pathological features are not completely characterized.  The
spectrum of symptom complexes includes sensory and motor neuropathies and
multiple mononeuropathy.

Developmental abnormalities in children with AIDS, characterized by loss
of cognitive ability and progressive long-tract signs, are now encountered
with increasing frequency.  An AIDS-associated dysmorphic syndrome in
children due to intrauterine infection has also been described.

Researchers have found that the drug DHPG (dihdroxypropoxymethyl guanine)
is effective against cytomegalovirus retinitis in AIDS patients.  The
patient's eye sight often can be protected by this treatment.

For more information on AIDS, see the articles in the AIDS Update section
of NORD Services.

Causes

AIDS is caused by a Human T-cell Leukemia Virus, known as HIV or human
immunodeficiency virus (previously the virus was referred to as HTLV-III).
Its transmission is not well understood, but is probably via the introduction
into the body of fluids from an infected person, i.e. via blood transfusions
(rare), sharing of contaminated needles, and intimate sexual contact, but
apparently not via saliva.  About 55% of the homosexual population in certain
communities have been found to have antibodies to HIV, suggesting that,
although exposure to it has been widespread, some other cofactors may be
necessary for AIDS or its prodrome to develop.  Possible cofactors include
genetic predisposition and coinfection by cytomegalovirus or Epstein-Barr
virus.  These viruses are also linked with many of the cancers associated
with AIDS.  Cytomegalovirus, for example, is suspected to be responsible for
Kaposi's sarcoma.

Kaposi's sarcoma, immunologic evidence of exposure or infection with HIV,
and AIDS-like syndromes are exceptionally common among both sexes in central
Africa, and it has been suggested that the disease originated there.

At an October, 1986, AIDS conference at Montefiore Medical Center in New
York, researchers reported the proportion of American AIDS cases clearly
traced to heterosexual intercourse is two percent, up from one percent in
earlier years of the epidemic.  Intravenous drug addicts and their sex
partners are the primary sources of AIDS infection among heterosexuals.  Four
out of five cases reported among this group are women.  Among immigrant cases
in this country, the proportion attributed to heterosexual contact is four
percent.  Three percent of cases seem to have no explained cause, but there
are questions as to accurate admission by these patients of past drug use
and/or sexual practices.

In New York City, as of Sept. 15, 1986, only two percent of AIDS cases
were attributed to heterosexual contact.  Eighty percent of these patients
are black or Hispanic.

Data from blood donors screened from April through December, 1985 in New
York City revealed 0.08 percent had antibodies to the AIDS virus, a sign of
infection.  Further investigation revealed that ninety percent of those with
the virus had homosexual or drug experience, or a sex partner who did.  In
only eleven cases, could the source of infection not be identified.

In tests of military applicants in New York City from October, 1985
through July 1986, 1.06 percent of men and 0.83 percent of women had evidence
of AIDS infection.  Most of these infections could be traced to homosexual
contact or drug use and the proportion attributed to heterosexual relations
was "minor."

Growing statistics support the conclusion of some researchers that the
passage of the AIDS virus from female to male during intercourse is extremely
rare.

However, two new studies on risks of unprotected intercourse with a virus
carrier have raised some puzzling questions.  One study found that half or
more of steady, long-term heterosexual partners of AIDS patients with no
other possible exposure, were also infected.  The virus seemed to pass as
readily from women to men as the reverse, and ordinary vaginal intercourse
was a sufficient means.

Sixteen AIDS patients in one of these studies continued to have
unprotected intercourse from one to three years.  Thirteen of their partners
became infected, for a transmission rate of over eighty percent.  Of twelve
AIDS patients and their partners who continued having sex but used condoms,
the infection spread in only two cases.  This low rate of transmission seems
disturbing given the presumed safety of condoms.  In both of the latter
cases, the virus spread from man to woman.  Oral sex involving semen
discharges might be to blame.

Some studies find inconsistent rates of sexual spread of the AIDS virus
depending on how the first partner became infected.  The virus was passed
through intercourse far more readily from drug abusers than from people
exposed by contaminated blood products in one study.  Another study indicated
that rates of infection may vary among individuals or in the same person over
time.

Available evidence indicates that the likelihood of viral transmission in
a single heterosexual encounter is "less than one percent."  Scientists
suspect that the virus spreads more easily in anal intercourse, which more
often involves tearing of tissue that would aid the entry of the virus into
the bloodstream.  For anyone having sex with multiple partners, the danger of
infection with the AIDS virus is rising dramatically.

Recent evidence suggests that the AIDS virus can live in insect hosts
such as mosquitoes and other blood-sucking insects.  However, there is no
evidence that these insects can transfer the virus to humans.  To date, no
case of AIDS has been linked to an insect bite in the United States.

Affected Population

AIDS is now known to be caused by a virus.  As of December, 1991, the CDC

reported that approximately one million Americans are infected with the AIDS
virus; 206,392 cases of AIDS have been diagnosed and 133,232 deaths from AIDS
have occurred in the United States.  The population at highest risk for AIDS
comprises homosexual or bisexual males.  Other high risk populations include
past or present intravenous drug abusers, blood transfusion or blood product
recipients, including hemophiliacs, female sexual partners of bisexual males
or IV drug abusers, or women who themselves are IV drug abusers, and children
whose parents are in one of the other risk groups.  Most cases have occurred
in the United States, but several hundred cases have been reported from
Europe, the Caribbean, and Africa.  Although there is a high incidence of
AIDS in Haiti, Haitians in United States are no longer considered to be a
risk category of individuals.  It is possible that the disease originated in
central Africa.

NOTES FROM NORD

According to the Centers for Disease Control (CDC), 980 children have
been diagnosed with AIDS as of May 1988.  Some of these acquired the disease
in the womb from infected mothers, and some contracted the disease from blood
transfusions before the AIDS blood screening program was initiated in 1985.
A recent study of 20 children who contracted the AIDS virus through
transfusions before 1985 indicated that one-third of the children have died
or are ill with AIDS, one-third show no sign of the illness, and one-third
have more than the usual number of childhood infectious diseases but their
health is within the normal range of children their age.  This data compares
to adults with the AIDS virus; one-third of carriers have died or are ill
with AIDS five to six years after infection.

A pregnant woman with AIDS always passes the AIDS antibodies to her
fetus, but she only passes the actual virus to the baby forth percent of the
time.  When the babies become fifteen months old, they start making their own
antibodies if the virus is present.

There is no way to predict which babies of infected mothers will get the
AIDS virus.  To date, sixty percent of children born to mothers with AIDS
antibodies show no sign of infection.

Acquired Immune Deficiency Syndrome can no longer be regarded as a
disease restricted to certain populations.  However, major cities seem to
have higher numbers of reported cases.  Nationally, 4 in 10,000 persons are
affected, with thirteen men to one woman contracting this disorder.  In
Manhattan (New York City), there are 200 cases for every 10,000 persons.
These statistics are based on data from blood banks.  The uninfected partner
of a person with AIDS will have a forty to fifty percent chance of contacting
the disease.

Therapies:  Standard

The treatment of choice for AIDS (Acquired Immune Deficiency Syndrome) is the
Orphan Drug Zidovudine, Brand name Retrovir (formerly known as azidothymidine
or AZT).  The drug appears to halt the progression of AIDS (and in some cases
allows the immune system to rebuild itself) by inhibiting production of an
essential enzyme that is necessary for the AIDS virus to reproduce itself.
(A $30 million emergency fund to help low-income AIDS patients buy AZT, has
been established by the Health Resources and Services Administration.
Eligibility will be determined by states; for more information, call (800)
843-9388).  In 1990, AZT was approved by the FDA in treating pediatric AIDS
patients as young as six months old.  The drug was approved in 1987 for
patients 13 years of age and older.  The combination therapy of AZT
(Retrovir) with Hoffman LaRoche's HIVID (DDC) has been approved by the FDA.
This combination therapy is more effective than AZT alone.

The primary treatment for AIDS is prevention.  Use of condoms and changes
in sexual behavior are recommended.  Promiscuous sex may increase the
likelihood of contracting AIDS.

Many of the infections associated with AIDS respond to antibiotic,
antifungal, etc., treatment, although recurrences are very common.  Nystatin,
clotrimazole, and ketoconazole have controlled episodes of esophageal and
oral candidiasis.  In this fungal infection as well as in cryptococcal
meningitis, amphotericin-B has been useful.  Herpes simplex has responded to
a course of treatment with acyclovir.  Toxoplasmosis may be controlled in
some cases with sulfadiazine or pyrimethamine, although these drugs have
immunosuppressive effects and thus may render the patient more vulnerable
than ever to opportunistic infections.  Cryptosporidiosis may be treated
symptomatically with tincture of opium, diphenoxylate, or cholestyramine;
spiramycin, an antibiotic used in Canada and Europe, but not yet approved in
the United States, appears to resolve or diminish diarrhea associated with
cryptosporidiosis.  (See below for manufacturer of spiramycin.)  A
combination of quinine and clindamycin has also been reported effective.

Pneumocystis carinii pneumonia is more difficult to treat.  At present,
trimethoprim-sulfamethoxazole co-trimoxazole, Dapsone and pentamidine are the
three drugs known to be effective.  Pentamidine isethionate (Pentam 300), an
orphan drug, is commercially available in the United States.  For further
information on this drug, contact:  LyphoMed, Inc., 2020 Ruby Street, Melrose
Park, IL 60610.

However, researchers have recently published scientific information
indicating that about one-third of AIDS patients who were treated with
pentamidine were likely to develop a serious form of chronic low blood sugar
(hypoglycemia).  When using pentamidine to treat Pneumocystis Carinii in AIDS
patients, physicians are advised to check glucose levels daily and creatinine
every other day during and after (for several days) pentamidine therapy.  The
drug should be given in a hospital setting where patients can be carefully
monitored.

No treatment has been found for some kinds of AIDS related infections.
These include Mycobacterium avium intracellulare, cytomegalovirus, and
Epstein-Barr virus.

Kaposi's sarcoma, as well as other neoplasms occurring in AIDS, respond
to chemotherapy.  Drugs have included vinblastine, etoposide, doxorubicine,
bleomycin, and combinations of these.  Interferon in high doses, which does
not seem to be useful in treating the underlying disorder or opportunistic
infections, does appear to be effective in treating Kaposi's sarcoma.  Also
reportedly effective in this cancer is vincristine; this drug has antitumor
activity without causing further immunosuppression due to bone marrow
suppression.

The National Institutes of Health are supporting studies to determine the
effectiveness of suramin, a drug usually used as an antiparasitic, in
inhibiting the virus' replication and capacity to damage immune cells.
Treatment with interleukin II to promote T-lymphocyte growth, and with
various types of interferon, an antiviral protein, have not been effective;
nor has treatment with acyclovir, vidarabine, various other drugs, white cell
transfusions, thymic factors, and thymus and bone marrow transplants.

Among the precautions against contracting or spreading AIDS recommended
by the Public Health Service are the following:

     1) Sexual contact with persons known or suspected to have AIDS should be
avoided.  Multiple sex partners increase the probability of developing the
disease.
     2) No members of high risk groups should donate blood or blood products.
     3) Blood transfusions should only be performed when absolutely necessary.
     4) Screening procedures for plasma or blood likely to transmit AIDS have
been developed, and safer blood products for hemophilia patients.
     5) Health care personnel, laboratory workers, and others in frequent
contact with AIDS patients should take great care to avoid wounds from
contaminated needles and similar sharp objects, and contact with blood soiled
materials.

A new drug for the treatment of Candidiasis, Crytococcal Meningitis, and
other persons with weakened immune systems such as AIDS patients has recently
been approved by the FDA.  The drug, diflucan (fluconazole), has been found
effective against these types of infections in persons with depressed immune
systems.

The Food and Drug Administration has approved the antiviral drug
didanosine (DDI) for treatment of adults and children with advanced AIDS who
cannot tolerate or are not helped by AZT.  DDI can cause pancreatitis in
patients with AIDS.  Pancreatitis is a potentially fatal inflammation of the
pancreas.  Patients taking DDI should avoid alcoholic beverages and seek
medical help immediately if they have abdominal pain, nausea, or vomiting.
As of March 13, 1990, of the 8,300 AIDS patients taking DDI, 78 developed
pancreatitis and seven of them died.

Therapies:  Investigational

Tests to identify individuals infected with the AIDS virus before they
develop the disease have shown an increase in virus-infected white blood
cells in the year before AIDS symptoms become apparent.  Since present tests
to detect these cells (peripheral blood mononuclear cells or monocytes) are
very time consuming and expensive, the Centers for Disease Control (CDC) is
trying to develop simpler tests.  Treatments of AIDS when identified early
enough may be more effective than treating the disease after symptoms appear.

The experimental drug, Kemron, is being used in several African countries
as a treatment for AIDS.  The drug was developed by the Kenya Medical
Research Institute.  The World Health Organization (WHO) is conducting
studies with Kemron in several African countries.

Gene therapy is being investigated as a possible treatment for AIDS
patients; however, this type of therapy has so far only been tested in
animals.

The Food and Drug Administration (FDA) has given a 1987 Orphan Drug
research grant to John E. Conte, Jr., M.D. for studies on pentamidine
pharmacokinetics related to AIDS patients on hemodialysis.  Another grant was
given for studies on the drug diethyldithiocarbamate for treatment of AIDS to
Evan M. Hersh, M.D., University of Arizona, Tucson, AZ.

ORPHAN DRUGS

Merrell Dow has been testing the experimental orphan drug Eflornithine
hydrochloride (DFMO) for treatment of pneumocystis pneumonia, a frequent
cause of death among AIDS patients.  Preliminary studies indicate that 74% of
patients responded favorably to this treatment.  DFMO does not affect the
AIDS itself; it simply alleviates this type of pneumonia which is often a
fatal complication of AIDS.  For additional information about eflornithine
HCl (DFMO), physicians can contact:

     Merrell Dow Research
     P.O. Box 6300
     2110 East Galbraith Road
     Cincinnati, OH  45215-6300

Clinical trials are being conducted on the following orphan drugs for
treatment of AIDS.  For additional information, physicians can contact (the
name of the drug proceeds the address):

     Diethyldithiocarbamate (Imuthiol)
     Merieux Institute, Inc.
     7855 NW 12th St., Suite 114
     Miami, FL  33126

     2'3'-dideoxycytidine
     The Division of Cancer Treatment
     National Cancer Institute (NCI)
     Bldg. 31, Rm. 3A49
     National Institutes of Health (NIH)
     9000 Rockville Pike
     Bethesda, MD  20892

Experimental Orphan Drugs for the treatment of AIDS include Spiramycin,
HPA-23 and others.  Patients and doctors wishing to apply for admission into
clinical trials of any AIDS drug should call the FDA at 1-800-9388.

For additional information about HPA-23, physicians can contact:

     Rhone-Poulenc Pharmaceuticals
     Division of Rhone Poulenc, Inc.
     P.O. Box 125
     Black Horse Lane
     Monmouth Junction, NJ  08852

Four other orphan drugs are being tested for treatments for AIDS patients
who develop Pneumocystic Carinii Pneumonia.  Physicians can contact the
following companies for information on these orphan drugs (the name of the
drug proceeds the address):

     Diethyldithiocarbamate (Imuthiol)
     Merieux Institute, Inc.
     7844 NW 12th St., Suite 114
     Miami, FL  33126

     Pentamidine isethionate (no brand name established)
     Phone-Poulenc, Inc.
     52 Vanderbilt Ave.
     New York, NY

     Pentamidine isethionate
     LyphoMed, Inc.
     2020 Ruby St.
     Melrose Park, IL  61060

     Trimetrexate glucuronate
     Warner-Lambert Co.
     2800 Plymouth Road
     P.O. Box 1047
     Ann Arbor, MI  48106

Two orphan drugs are undergoing clinical trials for treatment of AIDS-
related Kaposi's Sarcoma.  For additional information, physicians can contact
(the name of the drug proceeds the address):

     Interferon alfa-nf (Wellferon)
     Burroughs Wellcome Co.
     3030 Cornwallis Rd.
     Research Triangle park, NC 27709

     Interferon alfa-2b (Intron A)
     Schering Corp.
     2000 Galloping Hill Rd.
     Kenilworth, NJ  07033

Reports about the possibility of the drug Cyclosporine being an effective
treatment for AIDS were released prematurely from researchers in France in
1985.  This drug is commonly used to suppress the immune system in patients
who have received a transplanted organ.  The French reports were issued after
the drug had been used for only 6 days on a very limited number of patients
all of whom died after transient initial improvement.

Tests are proceeding on an AIDS vaccine.  If successful, the vaccine may
be available to the general public during the 1990's.

Due to the toxicity of Pentamidine when it is injected into the veins,
researchers are conducting studies on an aerosol form of the drug.
Preliminary results indicate that the drug may be as effective but less toxic
than the injectable drug.

For more information on AIDS, see the AIDS Update section listed on the
NORD Services menu.

For information on additional therapies that have been designated as
Orphan Drugs in the last few months, please return to the main menu of NORD
Services and access the Orphan Drug Database.

Investigational New Drugs (IND'S) for Opportunistic Infections and
Cancers as of 1990.

More than 80 ongoing human studies have been approved by FDA to test
potential drugs to treat opportunistic infections and cancers often found in
AIDS patients.

Anti-infective therapies and their sponsors include:

Trimetrexate, Warner-Lambert Co., Morris Plains, NJ, [phone], and
National Institute of Allergies and Infectious Diseases (NIAID), Bethesda,
MD, [phone], for PCP.

Eflornithine (DMFO), Merrell-Dow Pharmaceuticals Inc., Cincinnati, OH,
[phone], for PCP.

Aerosol Pentamidine, Fisons Corporation, Bedford, MA, [phone];
LyphoMed, Rosemont Park, IL, [phone]; and National Institute of
Allergies and Infectious Diseases (NIAID), Bethesda, MD, [phone], for
PCP.

Foscarnet, Astra Pharmaceutical Products, Inc., Westboro, MA, (508), 366-
1100, and National Institute of Allergies and Infectious Diseases (NIAID),
Bethesda, MD, [phone], for cytomegalovirus retinitis.

Ansamycin (in combination with other drugs), Adria, Laboratories, Dublin,
OH, [phone], for mycobacterium avium intracellulare infection.

Spiramycin, Rhone-Poulenc, Inc., Monmouth Junction, NJ, [phone],
for crytosporidiosis.

Piritrexim, Burroughs Wellcome Co., Research Triangle Park, NC, (919)
248-3000, for PCP.

Immune Globulin IG-IV, Sandoz Pharmaceuticals Corp., East Hanover, NJ,
[phone]; Alpha Therapeutics, Los Angeles, CA, [phone]; and
Miles, Inc., West Haven, CT, [phone], for various opportunistic
infections.  Also, National institutes of Health (NIAID), Bethesda, MD,
[phone], and National Institute of Child Health and Human
Development, (NICHD), Bethesda, MD, [phone] for prevention of various
opportunistic infections in children.

Fluconazole, Pfizer, Inc., New York, NY, [phone], for esophageal
candidiasis and crytococcal meningitis.

Nystatin, Squibb Co., Princeton, NJ, [phone], for oral candidiasis
prevention.

Clofazimine, San Francisco General Hospital, San Francisco, CA, (415)
821-5531, for mycobacterium avium intracellulare.

Sandostatin, Sandoz Research Institute, East Hanover, NJ, [phone],
for AIDS-related diarrhea.

Diclazuril, Janssen Pharmaceutica, Piscataway, NJ, [phone], for
crytosporidial diarrhea.

Dapsone, Jacobus Pharmaceutics, Princeton, NJ, [phone], for PCP
prevention.

Clindamycin, mark Jabcobson, M.D., San Francisco, CA, for toxoplasmic
encephalitis.

Pyrimethamine (DARAPRIM), Burroughs Wellcome Co., Research Triangle Park,
NC, [phone], for toxoplasmosis prevention.

Itraconazole (SPORANOX), Janssen Pharmaceutica, Piscataway, NJ, (201)
524-9591, for histoplasmosis.

Experimental immuno-modulating agents and their sponsors include:

Lymphoblastoid interferon, Burroughs Wellcome Co., Research Triangle
Park, NC, [phone], for KS.

Experimental Anti-neoplastic agents and their sponsors include:

Piritrexim Isethionate, Burroughs Wellcome Co., Research Triangle Park,
NC, [phone], for KS.

Doxorubicin, National Institute of Allergies and Infectious Diseases
(NIAID), Bethesda, MD, [phone], for KS.

Tumor Necrosis Factor, Genentech, Inc., San Francisco, CA, (415) 266-
1000, for KS.

Menogaril, National Cancer Institute (NCI), Bethesda, MD, [phone]
for KS.

M-BACOD (with Retrovir), National Institute of Allergies and Infectious
Diseases (NIAID), Bethesda, MD, [phone], for primary lymphoma.

Dr. Thomas J. Smith of the University of Kentucky Research Foundation in
Lexington, KY, has been awarded a New Grant Award from the Office of Orphan
Products Development in 1990.  His work studies the linear release of
Ganciclovir in related CMV Retinitis.

The FDA has approved the following drugs for testing as treatments for
AIDS patients:

The orphan Dronabinol (Marinol) is being tested as a stimulation of the
appetite in AIDS patients.  The drug is manufactured by Unimed, Inc.,
Somerville, NJ.

Lactobin is an orphan drug being tested to control diarrhea in AIDS
patients who don't respond to initial anti-diarrheal therapy.  The drug is
manufactured by Roxane Laboratories, Columbus, OH.

Treatment of AIDS-related Pneumocystis carinii pneumonia with the orphan
drug 566C80 is being tested by Burroughs Wellcome, Co., Research Triangle
Park, NC, under the approval of the FDA.

The Public Health Services and the Centers for Disease Control (CDC) run
a toll free hotline (1-800-HIV-INFO) to provide information about A IDS and
referrals to local service providers.

The drug company, Genentech, Inc., 460 Point San Bruno Blvd., South San
Francisco, CA, 94080, is developing a new orphan drug, Recombinant Human CD4
Immunoglobulin G, for use in the treatment of AIDS resulting from infection
with the human immunodeficiency virus.

Treatment of Toxoplasmosis in AIDS patients with Poloxamer 331 (Protax)
is being tested.  The drug is manufactured by Cytrx Corp., Norcross, GA.

Granulocyte-colony stimulating factor, recombinant-methionyl, trade name
Neupogen, is being tested for CMV-Retinitis in AIDS patients who are also
taking ganciclovir.  The sponsor is Amgen, Inc., 1840 DeHavilland Dr.,
Thousand Oaks, CA, 91320-1789.

Gynex, Inc., 1175 Corporate Woods Parkway, Vernon Hills, IL, 60061, is
the sponsor for the new orphan therapy for AIDS patients with HIV Wasting
Syndrome.  The trade name for the drug is Oxandrin (Oxandrolone).

Clinical trials are underway to study lymphoma, Kaposi's sarcoma and
secondary tumors in pediatric patients with AIDS.  Interested persons may wish
to contact:

     Dr. Yvonne J. Bryson
     Dept. of Pediatrics
     UCLA School of Medicine
     10833 LeConte Ave.
     Los Angeles, CA  90024
     [phone]

to see if further patients are needed for this study.

Clinical trials are underway to study 2',3'-Dideoxyinosine (ddI)
administered orally twice daily to Zidovudine (ZDV) intolerant patients with
HIV infection.  Interested persons may wish to contact:

     Robert T. Schooley, M.D.
     University of Colorado Health Sciences Center
     Box B168
     Denver, CO  80262
     [phone]

to see if further patients are needed for this study.

The treatment of Cytomegalovirus Retinitis in AIDS patients with the
orphan drug SDZ-MSL-109 is being sponsored by Sandoz Pharmaceuticals Corp.,
59 Route 10, East Hanover, NH, 07936.

The orphan product, Somatropin for injection, is being studied for the
treatment of AIDS-associated weight loss.  The drug is sponsored by Serono
Laboratories, Inc., 100 Longwater Circle, Norwell, MA, 02061.

The orphan product Cryptosporidium Hyperimmune Bovine Colostrum IgG
Concentrate, sponsored by Immucell Corp., 966 Riverside St., Portland, ME,
04103, has received testing permission from the FDA.

Dapsone USP has received orphan product from the FDA.  The drug is
sponsored by Jacobus Pharmaceutical Co., P.O. Box 5290, Princeton, NJ, 08540.

The orphan product, Sermorelin Acetate for injection used for the
treatment of AIDS-associated catabolism/weight loss, is being sponsored by
Serono Laboratories, Inc., 100 Longwater Circle, Norwell, MA, 02061.

The orphan product Immupath is being studied as a treatment for AIDS.
The product is being sponsored by Hemacare Corp., 4954 Van Nuys Blvd.,
Sherman Oaks, CA, 91403.

The antiviral drug stavudine (d4T) is now available to more AIDS
patients, those who cannot tolerate other antiviral drugs or those who have
worsened while taking those drugs.  Physicians may call Bristol-Myers Squibb
Co. at [phone] for further information.

This disease entry is based upon medical information available through
March 1993.  Since NORD's resources are limited, it is not possible to keep
every entry in the Rare Disease Database completely current and accurate.
Please check with the agencies listed in the Resources section for the most
current information about this disorder.

Resources

For more information on AIDS, please contact:

     National Organization for Rare Disorders (NORD)
     P.O. Box 8923
     New Fairfield, CT  06812-1783
     [phone]

     Computerized AIDS Information Network (CAIN)
     1213 North Highland Avenue
     P.O. Box 38777
     Hollywood, CA 90038
     [phone], ext. 450

     National Gay Task Force (NGTF)
     80 Fifth Avenue, suite 1601
     New York, NY 10011
     Provides a handbook listing support groups, fund raising organizations,
etc.

     National Hemophilia Foundation
     19 West 34th Street
     New York, NY 10001
     [phone]

     NIH/National Institute of Allergy and Infectious Diseases
     9000 Rockville Pike
     Bethesda, MD 20892
     [phone]

     Centers for Disease Control
     1600 Clifton Road, NE
     Atlanta, GA 30333
     [phone]

     National Sexually Transmitted Diseases Hotline
     [phone]

     American Social Health Association
     100 Capitola Dr., Suite 200
     Research Triangle Park, NC  27713
     [phone]

     Council for Sex Information and Education
     444 Lincoln Blvd., Suite 107
     Venice CA  90291

The AIDS Information Clearinghouse has been set up by the ICOA Health
Information Network to continuously provide updated information on AIDS to
the public.  This electronic news and information service is available via
AT&T's ACCUNET packet or AT&T Mail and provides information on research,
screening and prevention programs, health care costs, confidentiality and
discrimination issues.

The National Cancer Institute has developed PDQ (Physician Data Query), a
computerized database designed to give doctors quick and easy access to many
types of information vital to treating patients with this and many other
types of cancer.  To gain access to this service, a doctor can contact the
Cancer Information Service offices at 1-800-4-CANCER.  Information
specialists at this toll-free number can answer questions about cancer
prevention, diagnosis, and treatment.

The National Library of Medicine has developed a computerized database
called AIDSLINE with scientific articles about AIDS.  Health professionals
can request access to the database from the MEDLARS management section at 1-
800-638-8480.

Information on privately funded clinical trials of drugs and biologics
used to treat AIDS and AIDS-related illnesses is now available through a
toll-free telephone service.  The toll-free telephone service is staffed by
specially trained information specialists, including some who speak Spanish.
Service for the hearing impaired is also available.  Information from the
phone service is also accessible through DIRLINE, the National Library of
Medicine's online computer database.

All inquiries are kept confidential.

By dialing 1-800-TRIALS-A, callers can find out where studies are located
and the eligibility criteria for participants, the name of the product being
studied and the purpose of the study, and a contact person and phone number
for the company that is sponsoring the clinical trials.

References

Reports on AIDS Published in the Morbidity and Mortality Weekly Report
June 1981 through the present.  Centers for Disease Control.

Justification of Appropriation Estimates for Committee on Appropriations.
Public Health Service Supplementary Budget Data (Moyer Material) A through L.
Fiscal Year 1986, Vol. VII.  (This publication is available from the National
Institute of Health (NIH) and contains information on all AIDS research being
funded by NIH.)

National Institute of Health Conference.  Acquired immunodeficiency
syndrome:  epidemiologic, clinical, immunologic, and therapeutic
considerations.  Fauci, A.S., et al.  ANN INTERN MED 1983 Jan; 100(1):92-106.

Acquired Immunodeficiency Syndrome.  Macher, A.M.  AM FAM PHYSICIAN 1984
Dec; 30(6):131-44.

Acquired immune deficiency syndrome:  an update and interpretation.  Daul,
C.B., et al. ANN ALLERGY 1983 Sep; 51(3):351-61.

The acquired immune deficiency syndrome.  Pinching, A.J.  CLIN EXP
IMMUNOL 1984 Apr; 56(1):1-13.

Treatment of Kaposi's sarcoma and thrombocytopenia with vincristine in
patients with the acquired immunodeficiency syndrome.  Mintzer, D.M., et al.
ANN INTERN MED 1985 Feb; 102(2):200-2.

Treatment of intestinal cryptosporidiosis with spiramycin.  Portnoy, D.,
et al.  ANN INTERN MED 1984 Aug; 101(2):202-4.