NetNews Usenet Archive 1992 #16/NN_1992_16.iso/spool/sci/med/aids/1541

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Subject: CDC Summary 7/29/92
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                         AIDS Daily Summary
                           July 29, 1992
 The Centers for Disease Control (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
Clearinghouse, or any other organization.  Reproduction of this text is
encouraged; however, copies may not be sold.  Copyright 1992,
Information, Inc., Washington, DC
************************************************************************
 "Man With HIV Seeks Damages After Entry Into Canada Denied" Toronto
Globe and Mail (07/28/92), P. A6  (Fine, Sean)
     Craig Rowe, a Queens, N.Y. man with AIDS, is seeking $25,000 in
damages from the Canadian government, claiming in the Federal  Court of
Canada that border officials illegally prevented him  from attending a
New Year's party in Montreal last year because  of "irrational,
misguided, stereotyped prejudice about AIDS and  HIV and gay men."  He
said that he was publicly humiliated when  he was asked in front of
other passengers on a train whether the  drugs he was carrying were to
treat AIDS, then taken off the  train, detained for several hours, and
subsequently sent back on  a nine-hour bus ride at his expense.
According to the  Immigration Department, officials can prohibit entry
on medical  grounds if the medical condition could result in a large
demand  on health or social services during the person's visit.  The
department said the policy would probably not apply to AIDS.   Perrin
Beatty, the health and welfare minister, said in April  1991 that short-
term visitors with AIDS could no longer be denied entry into Canada,
mentioning the conclusion of his advisory  committee that during short
visits, HIV-positive individuals are  not a threat to public health.

"In the World: French Blood Bank Must Pay in AIDS Case" Baltimore Sun
(07/29/92), P. 6A
     A state-operated blood bank in Nice, France, was directed by a
court to pay $400,000 in damages each to three people who  acquired HIV
as a result of contaminated blood transfusions.  The directive came
during national controversy over the extent to  which government
ministers were aware of HIV-infected blood  transfusions in the mid-
1980s.  The damages paid in Nice were  provided for people who were
given the transfusions at the time.  Since then, one of the three has
died, so the money will go to  his family.  In addition, four former
leading health officials  are being tried in Paris on fraud charges
linked with the several thousand people who contracted HIV in the mid-
1980s.

"Haitians With AIDS Await Court Ruling" United Press International
(07/27/92)
     Miami--Haitian refugees with AIDS have been forced to temporarily
stay at the United States Navy base in Cuba while they await  ruling on
political asylum claims, refugee advocates say.  The  U.S. Immigration
and Naturalization Service has kept the Haitians since they left their
homeland and were restrained at sea by the  Coast Guard.  Though refugee
advocates concede that Haitians are  probably receiving better food and
medical care than they would  at home, they  maintain that the Haitians
are being held in a  "cruel limbo."  Among the 293 Haitians remaining at
the camp, 233 are HIV-positive and the remaining 60 are their spouses
and  children.  The INS decided that the Haitians likely have grounds
for pursuing political asylum claims in the U.S., but the  refugees
cannot enter the United States because of a law  prohibiting immigrants
with AIDS and other infectious diseases.   The INS cannot send them back
to Haiti without further  examination of their asylum claims.  However,
the agency cannot  continue with those examinations until the courts
decide whether  the Haitians have the right to consult attorneys, said
INS  spokesman Duke Austin.

"AIDS Epidemic: No End in Sight" Baltimore Sun (07/29/92), P. 15A
     While humans have subdued their large natural predators,  something
as tiny as HIV can wipe out an even larger population,  write the
editors of the Baltimore Sun.  The international AIDS  conference in
Amsterdam last week brought with it some sobering  news.  Researchers
became confused over reports of at least two  dozen people who
experienced symptoms of AIDS but tested negative for HIV, potentially
signalling that the virus has mutated into a different strain
unrecognized by current testing techniques--or  that there exists an
entirely new virus.  The uncertainty of  these questions looms as large
as the urgency to answer them, the editors write, as  about 40 million
people will be HIV-positive  worldwide by the year 2000, and some
estimates go as high as 110  million.  AIDS is a heterosexual disease in
most of the world,  and even in America the disease is losing its
identity as  predominantly affecting gay men.  Women are becoming a
growing  percentage of AIDS cases, especially in the Third World, a
disheartening statistic because their roles are key to the health and
economic well-being of the family.  Consequently, more  children will be
born with HIV infection, the editors conclude.

"Miss Manners: When and How to Say You Have AIDS" Washington Post
(07/29/92), P. C5  (Martin, Judith)
     It is very important to distinguish between a warning and a
confidence when disclosing HIV-positive or AIDS-infected status.  writes
Judith Martin (a.k.a. Miss Manners).  A warning is  "morally obligatory"
to anyone who might be in jeopardy of  becoming infected--a potential
romantic partner, for example.  A  warning should be given to anyone who
is attempting to "pick you  up," writes Martin, because it is
essentially their "business."   A confidence is voluntary and should be
given only to those  people whose are expected to react positively.
With people who  are only acquaintances, one should not feel obligated
to disclose his or her condition, even if they are likely to learn of it
later.  However, if an AIDS patient wants to discuss the disease  for
social, educational, or conversational reasons, and he or she  is
prepared to receive potentially unsympathetic responses, then  it should
be alright.  When two people first meet, it is socially acceptable for
an AIDS patient to say, "I'm an engineer, but I'm  retired now because
of my AIDS" or "One of my chief interests is  AIDS education, since I'm
a victim of AIDS myself."  This allows  the other person to stay
interested or choose to leave.   Related Story: Boston Globe (07/28) P.
58

"Improved Diagnosis of Pneumocystis Carinii Infection by  Polymerase
Chain Reaction on Induced Sputum and Blood" Lancet (07/25/92) Vol. 340,
No. 8813, P. 203  (Lipschik, Gregg Y. et al.)
     Nested polymerase chain reaction (PCR) can detect P carinii in
induced sputum samples with greater sensitivity than standard  staining
methods, write Gregg Y. Lipschik and colleagues of the  National
Institutes of Health in Bethesda, Md.  Sensitivity and  specificity of
two PCR approaches were compared with those of  conventional staining
for detection of P carinii in induced  sputum, bronchoalveolar lavage
fluid (BAL) and blood.  Among the  71 sputum samples, 17 were from
patients with microbiologically  confirmed P carinii pneumonia.  A
nested PCR technique correctly  identified the presence of P carinii in
all 17 and found no  organisms in 50 of 54 microbiologically negative
samples.  PCR  with a single primer pair was 71 percent sensitive and 94
percent specific.  The sensitivity of conventional staining methods was
substantially less (38-53 percent) than that of nested PCR.  In  BAL,
neither PCR method was significantly better than the  conventional
staining methods.  P carinii was found in BAL or  sputum from 10
immunocompromised patients without microbiological proof of P carinii
pneumonia, which indicates that symptom-free  carriers or subclinical
infection can exist.  Nested PCR on  induced sputum provides a non-
invasive method of detecting  disseminated disease, conclude the
researchers.

"CD8 Lymphocytosis and Pseudotumoral Splenomegaly in HIV Infection"
Lancet (07/25/92) Vol. 340, No. 8813, P. 207 (Oksenhendler, Eric et al.)
     The HLA haplotype A1, B8, DR3 in HIV-positive patients indicates  a
genetically determined host immune response to infection with  the
virus, according to Eric Oksenhendler et al. of the Hopital  St. Louis
in Paris, France.  This haplotype is associated with  rapid progression
to AIDS and with rapid decline of CD4 T cell  counts.  The Three
patients with HIV infection, presented with  pseudotumoral splenomegaly,
CD8 lymphocytosis and  hypergammaglobulinaemia, had spleen and bone
marrow that  exhibited diffuse CD8 lymphocyte and plasma-cell
infiltration.   Amplification of the T-cell receptor gamma chain gene
did not  reveal any clonal T-cell population.  Phenotypic analysis
demonstrated a predominance of CD8/CD57 suppressor T cells with
expression of activation markers.  No cytotoxic T lymphocytes  specific
for HIV infection could be identified.  All three  patients shared the
HLA haplotype A1, B8, and DR3.  Preferential  direct interaction of HIV
or some of its strains with these HLA  molecules may yield, in some of
these patients, the amplification of a spontaneous cycle of persistent
antigenic stimulation,  B-cell and T-cell activation, defective
cytotoxic T-lymphocyte  functions, and lack of clearance of the
infectious agent, the  researchers conclude.

"A Potent Drug for Fighting AIDS" Business Week (08/03/92) No. 3277, P.
32
     The synthesis of a drug, BHAP-E, is in the test tube more  powerful
than AZT, DDI, and other AIDS drugs, Upjohn announced on July 22.
Clinical trials on healthy people are scheduled for  September.
However, Irwin Chen, an Upjohn researcher, mentioned  that the virus
eventually becomes resistant to the new drug and  will most likely be
used in combination with other drugs to treat AIDS, said Chen.  Merck
and Boeringher-Ingelheim created drugs  similar to BHAP-E, Chen said,
but they abandoned the drugs after  learning that HIV exhibited
resistance to the treatments.  He  said it was unfortunate for those
companies because the chances  for success increase as more drugs become
available for combining against AIDS.

"The Hidden Cost of AIDS: Shooting Up the Future" U.S. News + World
Report (07/27/92) Vol. 113, No. 4, P. 55   (Black, Robert F. et al.)
     While IV-drug use is on the rise in Brazil, so are the number of
AIDS cases that bring along tremendous health-care bills.  The  port of
Santos, near Sao Paulo, has the highest rate of AIDS  cases in South
America as a result of needle sharing and  prostitution.   Few
Brazilians understand the impact of the AIDS  epidemic because they are
more concerned with the economic  turmoil currently existing in the
country.   A total of 22,583  people in Brazil have AIDS and an
estimated 700,000 are  HIV-positive.  Also, the number of HIV-positive
Brazilians will  likely increase by more than fourfold by 1995.  The
medical costs for the increasing number of ill AIDS patients will add to
the  government's already insufficient health sector.  The majority of
Brazilian companies do not offer comprehensive medical insurance  and
private insurers commonly exclude AIDS from coverage.  The  city of Sao
Paulo needs to triple its number of available beds  for AIDS patients to
1,000.  Hesio Corderio, dean of the  University of the State of Rio de
Janeiro, said that hospital  bills for AIDS patients average more than
$20,000 a year.

"The Hidden Cost of AIDS: Harvesting a Crop of Sorrow" U.S. News + World
Report (07/27/92) Vol. 113, No. 4, P. 57   (Black, Robert F. et al.)
     Uganda may have the most AIDS cases in the world and as a result,
the country's crucial agricultural sector is expected to  dramatically
dwindle.  Nearly 1.5 million people out of a total  population of 18
million are HIV-positive--8.3 percent.  About 19 percent of the sexually
active population is infected with HIV,  and approximately 4 million
people will contract the virus by the year 2010, and an estimated
870,000 will be dying of AIDS.   Uganda's work force is mostly comprised
of the agricultural  sector, employing 86 percent of the labor force.
Uganda's  robusta coffee bean has been declining as the epidemic has
exacerbated decades of neglect caused by economic strife.  In  parts of
Uganda, like Rakai, entire families have been eliminated by AIDS.  The
disease will leave behind approximately 1 million  to 2.8 million
Ugandan orphans in the next two decades.  Despite  the murky situation
the country faces, it has implemented one of  the most "enlightened"
AIDS policies in Africa.  Monies from  international donors like USAID
and the World Health Organization are allotted to provide AIDS
education, home health care, HIV  testing, and counseling.