NetNews Usenet Archive 1992 #27/NN_1992_27.iso/spool/sci/med/aids/2017

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Subject: CDC Summary 11/18/92
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Date: 18 Nov 92 15:48:10 GMT
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                      AIDS Daily Summary
                       November 18, 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 CDC
Clearinghouse, or any other organization.  Reproduction of this text is
encouraged; however, copies may not be sold. Copyright 1992,
Information, Inc., Bethesda, MD
************************************************************************
 "U.S. Blood Blamed for Cases of AIDS" Toronto Globe and Mail
(11/17/92), P. A4  (Picard, Andre)
The transmission of HIV-positive blood to nearly 800 Canadian
hemophiliacs could have been prevented if Canada had produced its own
blood products instead of importing them from the United States,
according to the head of the Canadian Red Cross. Secretary-general
George Weber announced yesterday that the Red Cross backs a proposed
independent investigation into Canada's tainted-blood controversy.  He
said what is especially needed is a "public examination of the decision-
making process and the performance of 13 governments in that process."
But federal Health and Welfare Minister Benoit Bouchard opposes any type
of public inquiry, and says the government fulfilled its obligation
toward hemophiliacs with HIV by launching a compensation program in
1989.  Weber emphasized that the Canadian Red Cross has "nothing to
hide," and he indicated that the improper decisions made in the past
were primarily the responsibility of the federal and provincial
governments and their bureaucrats.  Recently, the Canadian Hemophilia
Society made similar allegations, claiming bureaucratic foot-dragging
and an emphasis on economics instead of public health concerns
contributed to the infection of hemophiliacs.  Over 40 percent of
Canadian hemophiliacs have tested HIV-positive.  Experts agree that most
of those people were infected by blood products and plasma imported from
the U.S. in the early 1980s--before Canada started heat-treating blood
to kill HIV and before testing for HIV became mandatory.

"Suit Over AIDS Victim's Death Is Allowed" Wall Street Journal
(11/18/92), P. B13 (Lambert, Wade and Woo, Junda)
Parents of a man who died of AIDS can sue their son's longtime sex
partner for allegedly infecting him with HIV, a New York state judge
ruled.  The lawsuit is one of the first in which an HIV-positive person
has been accused under a wrongful death law of transmitting HIV.  The
New York case involved the parents of Anthony Blanco, who died in
September, 1990.  They accused John Sullivan, their son's lover of 15
years, of fraudulently and negligently hiding that he was positive for
HIV.  Sullivan claimed in court documents that he was unaware of his
infection until a year before Blanco's death.  He also said that his
partner was an IV-drug user before the two men met, and that Blanco was
sexually promiscuous during their relationship. Sullivan said that the
suit be dismissed because the parents, Mamie and Joseph Blanco, would be
able to prove that he transmitted the virus to their son.  However,
State Judge Louis Sangiorgio didn't rule on the merits of the case, but
he said the suit should be allowed to proceed.  The judge said that
although there had been no other court order in the state which has
ruled on whether HIV transmission could fall under the wrongful-death
statute, judges in other cases have allowed suits by sex partners "for
wrongful transmission of sexually transmitted diseases on theories of
either fraud or negligence."  Since Blanco could have sued his partner
for damages for transmission of HIV, the surviving parents can sue for
wrongful death, ruled Judge Sangiorgio.

"Clinton Urged to Fight AIDS" Philadelphia Inquirer (11/18/92), P. A12
President-elect Bill Clinton must lead the nation in its efforts to
fight AIDS, former Secretary of Health, Education, and Welfare Joseph
Califano said yesterday to the National Commission on AIDS.  Califano
referred to Clinton's campaign promise to boost spending in research,
prevention, and treatment of AIDS, and said, "President Clinton has the
moral obligation to deliver on his promises."  Califano served as former
President Jimmy Carter's health secretary for two years and was a top
aide to President Lyndon B. Johnson in the 1960s.  On Oct. 29, Clinton
pledged to give AIDS a high priority.  "We have still not done enough as
a nation to stop the spread of AIDS or to help those who are living with
it," he said.  The commission expects to submit recommendations to
Clinton on how to deal with the epidemic in early January.  Daniel Boss
of the AIDS Action Council, a Washington, D.C.-based lobbying group,
said that until a vaccine was developed, national prevention programs
were the only way of curbing the spread of HIV.  He added that the
president must exhibit as much compassion for AIDS patients as for those
affected by other maladies.  Mathilde Krim, chairwoman of the American
Foundation for AIDS Research, requested that Clinton eliminate
government bans on homosexuals in the military and admit people with HIV
infection into the country.  She also demanded increased spending on
AIDS research.

"Around the Nation: Anti-AIDS Law Tested in Courts" Washington Post
(11/18/92), P. A2
A Louisiana case is believed to be the first constitutional challenge to
a law that prohibits the transmission or the intentional exposure of HIV
infection to others.  A total of 25 states have similar laws, but
prosecutors rarely applied them until recently.  Salvadore Gamberella is
on trial for allegedly violating Louisiana's 5-year-old law against
exposing anyone to HIV infection.  The American Civil Liberties Union
filed a motion to have the charges dismissed based on the fact that the
law is too ambiguous and infringes the Constitution's equal protection
clause.  Gamberella is accused of allegedly exposing a former girlfriend
and their child to AIDS by having sex with the women without disclosing
his HIV-positive status.  Gamberella could face as many as 20 years in
prison and a $10,000 fine if he is convicted.

"Flynn Again Rejects Condom Ordinance" Boston Globe (11/17/92), P. 29
(Rezendes, Michael)
Boston Mayor Raymond Flynn has vetoed for the second time a  measure
that would require some restaurants and bars to install  condom vending
machines.  Flynn's decision has fueled the City  Hall controversy over
AIDS prevention.  Flynn, in a veto message  filed on Friday, based his
opposition to the legislation on a  range of legal and policy issues.
He said that the ordinance,  which is sponsored by City Councilor David
Scondras, would  infringe upon the First Amendment free speech rights of
bar and  restaurant owners who do not want to sell condoms.  Flynn also
said that he does not feel that enlisting city government in an  attempt
to distribute condoms more widely will reduce the spread  of HIV.
Scondras argued that Flynn's free speech argument is  "grasping at
straws," and added that he believes the mayor vetoed the measure because
"he's uncomfortable with the issue of condoms and sex."  Similar
legislation sponsored by Scondras was adopted  by the Council and vetoed
by Flynn previously this year.  The  Council failed to gain enough votes
to overrule Flynn's veto.   However, Scondras said he will persevere in
filing versions of  the condom vending machine legislation until Flynn
changes his  mind.

"Experienced Personnel Keep AIDS Patients Alive Longer" United Press
International (11/18/92)
Chicago--AIDS patients who attend hospitals with the most  experience in
dealing with AIDS are likely to live longer,  according to a new study
published Tuesday in the Journal of the  American Medical Association.
Dr. Valerie Stone and colleagues  at the Boston University School of
Medicine said that AIDS  patients were more than twice as likely to die
in low-experience  hospitals or within 30 days of discharge when
compared to  hospitals more familiar with HIV infection and its
complications. The researchers said in the study, "This finding is not
because  of greater severity of illness, differences in discharge
patterns of terminally ill or less intensive use of resources.  Rather
it  may be because of differences in quality of care."  During 1987.
Hospitals were categorized as having a high level  of AIDS experience if
they discharged more than 43 people with  AIDS per 10,000 discharges in
the sample year.  Eight hospitals  out of the 40 studied were in this
category.  The researchers  said, "Even after controlling for multiple
patient-level and  hospital-level variables, the relative risk of death
was more  than twice as high at hospitals with lower AIDS familiarity
than  at hospitals more experienced with AIDS care."  The study said
the results may support policies to establish regional AIDS care
referral networks, which would channel people with AIDS to more
centralized services staffed by specially trained medical  personnel.

"New AIDS Disability Rule May Come Soon, Official Says" United Press
International (11/18/92)
Washington--New rules that could hasten Social Security  disability
benefits to HIV-positive patients will most likely be  released before
the Bush administration leaves office, according  to officials.  Dr.
James O. Mason, assistant secretary of the  Health and Human Services
department, told the National  Commission on AIDS Tuesday that officials
expected to complete  the new regulations before the administration
leaves office.  "We would not want to promulgate something that would be
controversial and that President-elect Clinton would reverse as  soon as
we put out," said Mason.  Dr. David Rogers, vice chairman of the AIDS
commission, said, "This needs the fast track and not  the bureaucratic
track."  The new regulations were introduced in  December 1991 to better
define and facilitate eligibility for  Social Security disability
payments for HIV-positive individuals. AIDS advocates have long argued
that too many people are rejected for benefits and it takes too long for
those who qualify to  receive their benefits.  James Brown of the Social
Security  Administration said, "The final regulations have been written
and are under review process now." He indicated that a law prohibited
him from revealing any details, but he did say that "a lot of  people
will be delighted with the definition."

"Hepatitis C Viraemia With Normal Liver Histology in Symptomless  HIV-1
Infection" Lancet (11/07/92) Vol. 340, No. 8828, P. 1161   (Vento,
Sandro et al.)
HIV-1-positive individuals may be healthy carriers of hepatitis C virus
(HCV), write Sandro Vento et al. of the "A. Puliese"  Hospital in
Catanzaro, Italy.  Dr. Alberti and colleagues suggest in the Sept. 19
Lancet that serum HCV-RNA is a marker of liver  disease in subjects with
antibodies to HCV, independent of  alanine aminotransferase (ALT) values
and challenge the idea of  the existence of true healthy carriers of
HCV.  The researchers  investigated 19 subjects with HIV-1 antibodies,
no symptoms or  signs of liver disease, and persistently normal serum
ALT values. A total of 11 subjects had been IV-drug users, 4 were
homosexual  men, and 4 were female sex partners of HIV-1-positive
individuals.  None of these 19 subjects had HIV-1-p24  antigenaemia
(EIA).  A total of 12 subjects were CDC stage II  (symptom-free) of HIV
infection; the remaining 7 were CDC III  (lymphadenopathy syndrome).
The average CD4 positive lymphocyte  count was 392--11 participants with
fewer than 500 CD4 cells had  taken AZT for 6-17 months.  By using a
recombinant immunoblotting assay, anti-C22 and anti-C33c reactivity was
shown in all 19  subjects, with co-existing anti-C100 positivity in
eight.  Serum  HCV-RNA was positive in all 19 subjects.  Percutaneous
liver  biopsy was done on the same day that serum samples were obtained,
and specimens were tested for HCV-RNA.  Liver histology was  normal in 8
cases and showed slight changes in 2, chronic  persistent hepatitis in
5, and chronic active hepatitis in 4.  It is still undetermined whether
HIV co-infection affects the rate  of HCV replication and why AZT
treatment, which is linked with  remission of HCV-induced chronic active
hepatitis in patients  with high ALT values, has no such effect in
subjects with normal  ALT.

"Antibody-Capture Particle-Adherence Test for Antibody to HIV-1  in
Urine" Lancet (11/07/92) Vol. 340, No. 8828, P. 1161   (Lim, W.L. and
Cheng, K.C.)
While the IgG antibody-capture particle-adherence test (GACPAT)  is
economical and simple for use in large-scale anti-HIV  screening, it can
give a high number of false positive reactions  in urine samples from
IV-drug users, write W.L. Lim and K.C.  Cheng of the Queen Mary Hospital
in Pokfulam, Hong Kong.  The  researchers had used the GACPAT for
antibody to HIV-1 on urine  samples from IV-drug users attending
methadone clinics in Hong  Kong.  Among the 1,259 samples, 66 (5.2
percent) were initially  and 37 (2.9 percent) were repeatedly reactive.
Among the 37  repeatedly reactive samples, only seven remained reactive
after  being heated in a water bath at 60 degrees Celsius for 20
minutes.  As controls, concurrently heat-treated urine samples  from
confirmed HIV-positive individuals did not show any change  in endpoint
titres.  The seven repeatedly reactive samples were  negative by
antibody-capture enzyme immunosorbent assay and  western blot.  Heat
treatment of repeatedly reactive samples  removed non-specific reactions
in most samples.  The nature of  the heat-labile substance in the urine
of IV-drug users that  causes the non-specific reaction remains to be
determined.

"More Widespread and Earlier HIV Testing Is Urged" American Medical News
(11/16/92) Vol. 35, No. 43, P. 9   (Staver, Sari)
More people should be encouraged to get tested for HIV, despite  the
lack of resources for counseling and early intervention, said Dr. Donald
Francis, a recently retired federal health official.   At the Fifth
National AIDS Update Conference in San Francisco,  Dr. Francis stressed
the significance of identifying more  HIV-positive individuals to
generate the "political force" needed to obtain additional funding for
research and treatment.  He said that those who receive early treatment
will probably extend their lives.  Dr. Francis, a former senior medical
epidemiologist at  the Centers for Disease Control and now an HIV
consultant based  in Hillsborough, Calif., said that patients who test
HIV-positive should receive sufficient counseling and treatment.  But he
admitted that such services are not available even for all those  who
have been diagnosed with HIV infection.  Testing should be  performed in
hospitals, doctor's offices, public health clinics,  jails, and prisons,
he said.  Settings like emergency departments are less desirable, but
should be used in places such as New York City's South Bronx, where the
emergency department serves as  primary care physician to many low-
income residents.  He added  that as many as one-fourth of patients who
come to these  departments are infected with HIV.  The government
currently  believes that at least 110,000  HIV-positive people do not
know  they are infected.  Dr. Francis projects that 40,000 to 80,000
new people nationwide become infected with HIV annually.  He said that
although testing and counseling programs seem to be costly,  at least
$100,000 could be saved from each new HIV transmission  prevented.

"Cost of Lifetime AIDS Treatment Up" American Medical News (11/16/92)
Vol. 35, No. 43, P. 9   (Staver, Sari)
The costs of treating HIV-positive patients throughout their  lifetime
are slowly increasing, according to speakers at the  Fifth National AIDS
Update Conference held in San Francisco.  The speakers repeatedly
mentioned the difficulty in predicting costs  accurately because of
problems in measuring expenses and  comparing studies.  Dr. Peter Arno,
a health economist in the  epidemiology and social medicine department
at Albert Einstein  College of Medicine, said that national data
indicate that  lifetime-care costs for AIDS patients were between
$82,000 and  $187,000 in 1991, a slight increase from the previous year.
The  total cost of treating HIV patients in the United States will
reach $10 billion this year, representing 1.25 percent of health  care
expenditures, said Dr. Arno.  It is estimated to reach $15.8 billion by
1995.  Those factors that contribute to the rising  health care costs
include inflation, improved survival, and more  aggressive outpatient
treatment.  The average length of hospital  stays has greatly decreased
for patients with HIV infection;  longer survival means that patients
now average six stays,  compared with four several years ago.  In
addition, outpatient  care now comprises an increased proportion of
total medical costs at about 62 percent, up from 55 percent in 1989,
said Robert  Padgug, director of health policy development at Empire
Blue  Cross-Blue Shield in New York City.  Moreover, prescription
prices have contributed to increasing costs.  Dr. Arno said that  over
the past decade, prices rose at three times faster than  general
inflation.