NetNews Usenet Archive 1992 #27/NN_1992_27.iso/spool/sci/med/aids/2025

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Subject: CDC Summary 11/20/92
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                       AIDS Daily Summary
                        November 20, 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
************************************************************************
 "No Need of Inquiry Now, Says Bouchard" Toronto Globe and Mail
(11/19/92), P. A21 (York, Geoffrey and Picard, Andre)
     Canadian Health Minister Benoit Bouchard announced yesterday that
he has not disregarded the possibility of a full inquiry into the 1980s
distribution of HIV-infected blood products. Opposition MPs demanded an
independent inquiry in the House of Commons, but Bouchard said he is not
yet convinced that one is needed.  An assistant to Bouchard said the
Health Minister contacted the Canadian Red Cross on Tuesday to show his
willingness to cooperate in any review it makes of the events of the
1980s.  The Red Cross said yesterday that it is "willing to assist in an
open examination" of the blood program in Canada. In the Commons,
Liberal MP David Dingwall said that 43 percent of Canada's hemophiliacs
have contracted HIV as a result of tainted clotting products.  He added
that there is no "plausible reason" for the government to oppose an
independent inquiry.  Bouchard has repeatedly rejected the notion that
the fault lies with the federal government, and claims that Ottawa
fulfilled its obligation to hemophiliacs when it offered a compensation
program for those who had been infected with the tainted blood products.
Canadian hemophiliacs and blood-transfusion patients have filed at least
80 lawsuits, claiming damages in excess of $350 million. According to
Canadian Red Cross Society secretary-general George Weber, these legal
and medical issues can be better dealt with in the courts than through a
major public inquiry.

"Teens' Risky Sex Declines; HIV Awareness Increases" Philadelphia
Inquirer (11/20/92), P. A2  (Neergaard, Lauran)
    The high percentage of American teenagers engaging in risky sexual
behavior is slowly declining, and schools are increasing education about
AIDS, federal officials from the Centers for Disease Control reported
yesterday.  The statistics from the CDC report came from yearly surveys
of about 12,000 teenagers, conducted in 1989, 1990, and 1991, said Lloyd
Kolbe, the CDC's director of adolescent and school health.  The report
said that 54 percent of teenagers surveyed in 1991 said they had had
sexual intercourse--down from 59 percent in 1989.  Those who said they
had two or more partners decreased from 40 percent to 35 percent. Also,
19 percent reported four or more partners--a decrease from 24 percent in
1989.  But between 1990 and 1991, condom use was up two percentage
points to 48 percent.  In 1989, students were not asked about condoms.
Students under age 15 reported the highest increase in condom use--57
percent, up from 46 percent.  The report discovered that 83 percent of
students received some sort of HIV education at school last year--up
from 54 percent in 1989. Even though there is no way to know how much of
the decline in teen sex is due to school efforts, the CDC urged schools
to begin education about HIV in kindergarten and intensify it by the
ninth grade.  Kolbe said that it does not mean that kindergartners
should be educated about condoms.  He added, "In the early grades, it's
important that young people start to understand that they can influence
their own health." Related Stories: Baltimore Sun (11/20) P. 24A; USA
Today (11/20) P. 1A

"Business Urged to Spearhead AIDS Fight" Washington Times (11/20/92), P.
C1  (Munroe, Tony)
     Businesses have all but neglected the AIDS epidemic and must move
past fears to take an active role in fighting the disease, according to
speakers at the two-day Business and Labor Conference on AIDS in
Washington, D.C.  The National Leadership Coalition on AIDS sponsored
the conference.  Only a handful of employers--many being large
corporations with huge resources--have begun to educate employees about
HIV.  However, the majority of U.S. companies have done little either to
inform employees or to address their concerns, said the speakers.  Lee
C. Smith, corporate vice president at San Francisco-based Levi Strauss +
Co. and chairman of the National Leadership Coalition  on AIDS, said,
"The workplace is one of the few locations that  adults can receive this
potentially life-saving information."  He added that "there is a fear of
AIDS.  AIDS is not a popular  disease."  From AIDS diagnosis to death,
it costs between $75,000 to $100,000 to treat an HIV-positive person,
say several sources. The primary reason business has not taken an
aggressive stance on AIDS is because the disease is perceived as an
issue for  homosexuals and because many companies, especially small
businesses, are fearful that the cost of insuring HIV-positive  workers
will be too high, speakers at the conference said.   Former tennis
champion Arthur Ashe, who contracted HIV through  open heart surgery,
attended the meeting and said, "I think what  is keeping businesses from
being a bit more proactive about  getting involved" is that "there are
not enough heterosexual  examples in place ... to mainstream the
discussion."

"Improperly Sterilized Dental Gear Can Harbor AIDS Virus" United Press
International (11/20/92)  (Levy, Douglas A.)
     Washington--HIV can be transmitted by dental tools as well as
other medical equipment that is not properly sterilized,  according to
researchers.  David Lewis, a microbiologist at the  University of
Georgia in Athens reported a study on how dental  tools can pick up HIV
from an infected patient.  Some  disinfecting methods, he explained,
fail to eliminate the risk of HIV transmission to another patient.  He
said that the proper  sterilization technique, however,--heating tools
with pressurized steam--reduces the risk to zero.  However, Lewis said
there is  similar infection potential with other medical devices used
for  invasive procedures, especially with endoscopes.  Lewis said that
the problem is that widely used disinfectant solutions do not  reach
every part of various medical tools.  Heat treating tools  should be
required, he said.  "[Chemical treatments] don't get  into the nooks and
crannies," said Lewis, adding that lubricants  used on dental drill
parts actually repel the chemical  disinfectants and may keep them from
reaching some viral material transmitted from an infected patient.
Lewis and his colleagues  tested dental tools used to treat two HIV-
positive patients and  one healthy patient.  They concluded in their
report published in the British medical journal the Lancet, "Our
results, from  laboratory and clinical studies, show that high speed
dental  handpieces and prophylaxis angles take up and expel patient
materials and so can potentially transfer infectious agents from  one
patient to another."

"Taylor Voices AIDS Cares as Eco-Hero" USA Today (11/20/92), P. 3D
(Gable, Donna)
     Elizabeth Taylor will join forces with animated environmental
heroes Captain Planet and the Planeteers in addressing the topic  of
AIDS among children.  Taylor will provide the voice for the  animated
character Donna, a mother whose teen son tests  HIV-positive.  Taylor
said, "I am delighted to be part of a  project like Captain Planet and
the Planeteers, which ... teaches children how they can be part of the
solution."  The episode  shows how misinformation and fear can prompt
prejudice against a  person with AIDS.  It airs Saturday and Sunday on
TNT and TBS.   Scott Sassa, Turner Entertainment Group president, said,
"We are  urging parents to watch the episode with their children and
discuss the issue of AIDS and HIV as a family."

"Kaposi's Sarcoma Trial Recruiting: TNP-470 (AGM-1470)" AIDS Treatment
News (11/06/92) No. 162, P. 1  (James, John)
     Human testing has begun at the U.S. National Cancer Institute for a
new treatment for Kaposi's sarcoma (KS).  The treatment is  called TNP-
470 (formerly called AGM-1470) and prevents the growth of new blood
vessels--KS is linked with excessive growth of blood vessels.  Those
eligible for the trial must be HIV-positive and  have KS, but with no
evidence of pulmonary or gastrointestinal  KS.  They should be
ambulatory and at least well enough to care  for themselves.  Also, they
should have taken a stable dose of  antiretroviral therapy for at least
a month.  The trial has  strict exclusions including criteria for
hematological  abnormalities such as hemoglobin less than 9, ANC less
than  1,000, platelets less than 100,000 or APTT or PT greater than 120
percent of normal, or known bleeding disorders.  Applicants are  also
excluded if they have pulmonary KS, active bleeding or  critically
located KS, or life-threatening KS which is responsive to other
treatments.  As many as 48 participants will be  recruited--two are
enrolled so far.  The drug is given  intravenously, during one hour,
every other day.  Eight dosage  levels will be tested with three to six
patients at each level,  unless toxicity prevents the higher doses from
being tried.  The  reason for the two-week break is that new drugs are
not usually  tested in humans for longer than the animal toxicity trials
have  been conducted--in this case four weeks.  The FDA permitted a
six-week test after the break since there was no sign of any  cumulative
toxicity in the animals.

"Anger at Women's History Study Delay" AIDS Treatment News (11/06/92)
No. 162, P. 3  (Solomon, Nancy)
     A two-year delay of a study that could help understand the
progression of HIV disease in women is impeding attempts to  extend the
lives of women with AIDS, according to doctors,  researchers, and
activists.  The National Institutes of Health  promised a natural
history study of women with HIV during the  December 1990 Women and HIV
Conference in Washington D.C.   However, the Request for Applications
(RFA), the governmental  process that allows researchers to apply for
funding and  participation in the study, has not been issued.  Dr.
Judith  Cohen, an epidemiologist who studies HIV in women at the
University of California--San Francisco, said, "We could have  good
answers by now.  While we waited last year, 10,000 more  women were
diagnosed."  The National Institute of Allergies and  Infectious
Diseases (NIAID) is organizing the women's study,  called the Women's
Interagency HIV Study, and has allotted $5  million for 1993.  According
to a nurse in the epidemiology  branch, the RFA was just approved by the
head office at the NIH  and it should be published by mid-November at
the earliest.   Miriam Galbraith, a nurse consultant for NIAID, who is
the deputy project officer for the study, said, "It just takes a long
time  for RFA to go through the approval process.  The idea has to be
approved before writing the RFA itself."  Once the study is  approved,
it would continue to recruit women as soon as they  learn they are HIV-
positive and monitor their health for four  years.

"Brain Biopsy for Intracranial Mass Lesions in AIDS" Lancet (11/07/92)
Vol. 340, No. 8828, P. 1135
     Central nervous system (CNS) disorders with a poor outlook in  AIDS
patients including primary CNS lymphoma and progressive  multifocal
leucoencephalopathy have gained prominence, write the  editors of the
Lancet.  There is no simple and accurate way to  distinguish between
these different pathological conditions.  For example, in 95 percent of
cases, acute toxoplasma encephalitis is a reactivation of previous
infection with little or no change in  serological variables or parasite
concentrations.  Therefore,  treatment for toxoplasma is often begun
experimentally and may be unwarranted.  Brain biopsy is usually
undertaken when a mass  lesion has not responded to at least one week's
antitoxoplasma  therapy, has an atypical scan appearance, or is
producing  neurological instability.  Any treatment algorithm that
includes  a brain biopsy must consider the balance between an
individual's  quality and quantity of life.  Few reported studies
address this  issue, although it seems wiser to consider biopsy in
patients  with reasonably well-maintained CD4 lymphocyte counts and no
previous AIDS diagnosis than in those with end-stage disease.   Some
data indicate that brain biopsy should be reserved for CNS  mass lesions
that occur during early AIDS.  Patients with early  AIDS should receive
empirical antitoxoplasma treatment, with a  view to biopsy if there is
no response after two weeks.  Patients with late disease should also be
given antitoxoplasma therapy,  but should undergo biopsy only in
exceptional circumstances.   Although brain biopsy itself is a safe
procedure, science's  inability to treat either progressive multifocal
leucoencephalopathy or CNS lymphoma argues against its regular  use in
AIDS patients in late disease when antitoxoplasma therapy  has failed.

"Issues in HIV Testing in Developing Countries" Lancet (11/14/92) Vol.
340, No. 8829, P. 1218
     The United Kingdom National and International Non-Governmental
Organization (NGO) AIDS Consortium held a seminar on Nov. 5 to  address
the difficulties in testing for HIV in developing  countries.  Those
agencies that were represented at the seminar  included NGOs, ministries
of health, technical and ethical  interest groups, and the WHO Global
Program on AIDS.  The most  prominent issue discussed was the inability
of developing  countries to guarantee the quality of all blood used in
transfusions.  For instance, it is projected that as much as 30  percent
of all blood supplies in India is untested.  While there  was general
agreement on the need and conditions for the  screening of blood,
diagnostic testing raised complex questions  that did not elicit any
concrete answers.  However, experienced  field program planners believe
that knowledge is a powerful tool  in changing behavior and a
prerequisite for community involvement in plans that incorporate care
and prevention.  However,  voluntary and anonymous testing in
conjunction with counseling,  offered by various NGOs, is a sought-after
service.  One result  has been post-test clubs which offer continuous
support, with  members taking an active role in peer education.
Consortium  members agreed that the seminar should signify the beginning
of a process and that work should continue to develop guidelines on
justification and preconditions for testing, provision versus  promotion
of testing, and implementation.