NetNews Usenet Archive 1993 #3/NN_1993_3.iso/spool/sci/med/aids/2242

Text File | 1993-01-23 | 13.8 KB | 225 lines

Newsgroups: sci.med.aids
Path: sparky!uunet!cs.utexas.edu!zaphod.mps.ohio-state.edu!usc!news.service.uci.edu!ucivax!ucla-cs!usenet
From: Billi Goldberg <[e-mail]>
Subject: CDC Summary 1/21/93
Message-ID: <[e-mail]>
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Sender: [e-mail] (Mr Usenet)
Nntp-Posting-Host: sole.cs.ucla.edu
Archive-Number: 8
Organization: unspecified
Date: Thu, 21 Jan 93 07:54:19 PST
Approved: [e-mail] (J. Philip Miller)
Lines: 210

                         AIDS Daily Summary
                         January 21, 1993
 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.  Copyright 1992, Information, Inc., Bethesda, MD

 "U.S. Set  Back in Vote on W.H.O. Chief" New York Times (01/21/93), P.
A8  (Altman, Lawrence K.)
     The World Health Organization, which coordinates worldwide  anti-
AIDS efforts, reelected the current head of the group,  despite an
aggressive diplomatic effort by the United States and  its European
allies to unseat him.  The WHO's executive board  voted 18-to-13 to
recommend Japanese physician Hiroshi Nakajima  over a rival candidate
Dr. Mohammed Abdelmoumene, an Algerian who was supported by the United
States, Canada, and the European  Community.  In the effort to oust Dr.
Nakajima, one State  Department memorandum asserted that the Japanese
Government had  resorted to "aggressive tactics, including the pursuit
of votes  in exchange for favors" in its attempt to defend him.  The
vote  by the executive committee is expected to be confirmed at the
annual assembly of WHO's 181 members in May.  Dr. Nakajima has  lead the
United Nation's agency for five years.  Critics said  that while WHO had
long had many first-rate health-care workers  on its staff, there were
fewer appointments of such high-caliber  people during Dr. Nakajima's
administration.  Morris Abram, the  United States representative to the
United Nations in Geneva,  argued, "It is essential that this agency be
well and efficiently managed."  Abram reaffirmed the United States'
continuing support for WHO and added that the nation's "long-standing
commitment to  the World Health Organization transcends any
personalities or  leadership."

"Capturing the Strained Social Life of Manhattan" New York Times
(01/21/93), P. C15  (Holden, Stephen)
     A new comedy at the WPA Theater in New York is about a gay man in
his mid-30's who is tired of negotiating safe sex and decides to  become
celibate.  The play, "Jeffrey," was written by Paul  Rudnick.  The title
character, Jeffrey, estimates that he has had about 5,000 sexual
encounters but remained HIV-negative.  He  says, "I'm not promiscuous.
It's such an ugly word.  I'm cheap." The play exhibits the strained
social tenor of Manhattan life as  it is currently lived, writes critic
Stephen Holden.  Holden adds that the "desperate, brittle tone of the
hilarity underscores the ghastly sense of the absurd that the AIDS
epidemic has brought to hyper-sophisticated Manhattan society."  Aside
from the humor,  "Jeffrey" copes with questions of life, death, and
erotic  partnership that many other people face as well.  The play's
other main character, Steve (Tom Hewitt), is a bartender whom  Jeffrey
meets in a gym and who could be his soul-mate.  However,  Steve is HIV-
positive, and Jeffrey fears of getting involved with someone who could
become ill and die at any moment.  Other  sketches in the play are
satirical and stress the complexities of safe sex.

"AIDS Spreading Faster in French Overseas Territories" Reuters
(01/20/93)
     Paris--AIDS has emerged as the leading killer of young adults in
France's overseas territories, where the rate of infection is  higher
than on the mainland, according to French Overseas Radio  (RFO).  RFO
conducted a survey which revealed that 931 cases had  been reported
among 2.3 million people living in French Guiana,  the Indian Ocean
island of La Reunion, and the Caribbean islands  of Martinique and
Guadeloupe.  Misleading information and poverty have contributed to the
disease's spread.  However, RFO said the  AIDS statistics appeared to be
unreliable because of inadequate  health facilities in the territories.
AIDS prevention efforts  such as the distribution of condoms were also
more difficult to  implement because of the local traditional values
which oppose  their use.  In addition, AIDS patients in the territories
are  more hesitant to publicly disclose their condition because of its
association with homosexuality, which is not as widely accepted  in the
overseas territories as it is in mainland France.

"Sports Doctor Shares Personal AIDS Tragedy to Deliver Vital  Message"
USA Today (01/20/93), P. 5C  (Woodward, Steve)
     Leading American skaters will gather this week to compete at the
U.S. Figure Skating Championships, but will also take in some  valuable
information about AIDS.  Steve McQueen, a Salt Lake City physician and
chairman of the U.S. Figure Skating Association's  (USFSA) sports
medicine committee, will speak to the sport's best and brightest and
enlighten them, in detail, about the  complications of AIDS.  McQueen's
brother died of AIDS at the age of 47.  Despite an influx of
controversial reports of  AIDS-related deaths among Olympic-caliber male
skaters in Canada  and Europe, the top U.S. competitors have been spared
losses.   The USFSA has acknowledged the growing AIDS threat throughout
society by incorporating AIDS awareness into its drug education  program
for national-level skaters.  Since the annual U.S.  Championships gather
top skaters in all age groups--343 are  registered for this week's
nationals--the event provides an ideal venue for addressing the AIDS
issue.  McQueen said, "Like a lot  of younger people, [skaters] feel
this is something that may not  concern them.  With more cases [of AIDS]
showing up among  skaters, we think we have to be even more open."  Last
December,  a report in the Calgary Herald had mentioned 40 skaters and
coaches in North America who have AIDS.  But the USA's most  renowned
male skaters of recent generations--Scott Hamilton,  Brian Boitano, and
Paul Wylie--claim they can't name one serious  competitor in the U.S.
who has AIDS or has died of the disease.   McQueen hopes to dispel all
of the myths about the disease among  the skating community.

"HIV Viraemia and Seroconversion" Lancet (01/09/93) Vol. 341, No. 8837,
P. 113  (Lu, Wei et al.)
     The disappearance of infectious viruses in plasma during and  after
seroconversion does not suggest the clearance of cell-free  HIV, write
Wei Lu et al. of the Universite de Paris V, in Paris,  France.  Dr.
Ariyoshi and colleagues report in the Nov. 21 Lancet that the first
autologous isolate-specific neutralizing antibody  activity was not
detectable during seroconversion, but recognized after seroconversion
and increased with time.  They indicate that humoral factors are not
responsible for the suppression of  primary viraemia in early HIV
infection because a rapid decline  in infectious virus titre in plasma
around the time of  seroconversion was not coincident with the
appearance of  isolate-specific neutralizing activity.  Ariyoshi et al.
were  misled by several inaccurate interpretations of the data.  They
use the neutralization assay that allows the titration of the  specific
virus-free neutralizing antibodies.  The virion-combined neutralizing
antibodies would not be detected by the assay.   Also, the neutralized
viruses in plasma would not be detectable  in an infectious viral
culture.  Therefore, a double-negative  result for both assays might
suggest either no virus and no  antibody or a virus-antibody equilibrium
event.  The high  concentrations of total free viral particles during
and after  seroconversion, together with the rapid decrease of high-
titre  viremia, indicates a rapid loss of viral infectivity other than
virus itself.  The specific neutralizing antibody response seems  to be
the most direct mechanism that can account for the rapidly  suppressing
infectivity of primary viremia in early HIV  infection, the researchers
conclude.

"HIV Progression and Immune Activation" Lancet (01/09/93) Vol. 341, No.
8837, P. 113   (Ludlam, C.A., and Steel, C.M.)
     Patients with A1B8DR3 and/or systemic lupus erythematosis (SLE)
have immune systems of increased activity which allows HIV  replication
to proceed faster, possibly because of an increased  density of CD4
receptors on lymphocytes, write C.A. Ludlam and  C.M. Steel of the Royal
Infirmary and Western General Hospital,  respectively, in Edinburgh,
U.K.  In the Oct. 10 issue of the  Lancet, Dr. Learmont and colleagues
report long-term asymptomatic HIV infection in five of six recipients of
blood from a single  donor who has been symptom-free for 10 years.  The
one recipient  who developed  AIDS and died of Pneumocystis carinii
pneumonia  after 4.3 years had SLE.  They conclude that the prednisolone
he  was administered resulted in immunosuppression, which allowed  more
rapid progression to AIDS, and mention an additional patient with SLE
treated with immunosuppression who fared poorly after  HIV infection, to
support their hypothesis.  However, Ludlam and  Steel believe there is
another explanation for the rapid  progression in individuals with SLE,
an autoimmune disorder  strongly linked with the HLA haplotype A1B8DR3.
The presence of  this haplotype in non-SLE patients infected with HIV is
associated with a more rapid drop in CD4 counts and clinical
progression of HIV disease, and this has been confirmed by  others.
Ludlam and Steel believe patients with SLE progress more rapidly because
their immune systems are hyperactive.  Thus,  immunosuppressive therapy
immediately after initial HIV infection may be an appropriate option.
Nevertheless, additional studies  are warranted to define why
individuals with HLA A1B8DR3 progress rapidly after HIV infection,
conclude the researchers.

"Microsporidia Infection in Patients with the Human  Immunodeficiency
Virus and Unexplained Cholangitis" New England Journal of Medicine
(01/14/93) Vol. 328, No. 2, P. 95 (Pol, Stanislas et al.)
     Infection of the biliary tract with E. bieneusi is related to and
may be the cause of AIDS-related cholangitis, write Dr. Stanislas Pol et
al. of the Unite d'Hepatologie, Hopital Laennec in Paris,  France.  The
researchers evaluated eight HIV-positive homosexual  men who were
referred because of cholangitis for which no  causative agent had been
found by standard tests.  All of the  patients received abdominal
ultrasonography and endoscopic  ultrasonography or endoscopic retrograde
cholangiopancreatography with collection of bile from the common bile
duct.  One patient  had transhepatic biliary catherization, and two
others had  cholecystectomy.  Bile samples, duodenal- and liver-biopsy
specimens, and gallbladder tissue were examined by light and  electron
microscopy.  All eight patients with unexplained  AIDS-related
cholangitis had biliary microsporidiosis.   Intraepithelial E. bieneusi
spores and supranuclear plasmodia  were identified in the six duodenal-
biopsy specimens.   May-Grunwald-Giemsa staining of bile samples showed
free forms of microsporidia in all eight patients, and the presence of
E.  bieneusi was confirmed by electron microscopy.  E. bieneusi was
also detected in ductal biliary cells on a liver biopsy, in one  common-
bile-duct smear, and in gallbladder epithelium in two  patients.  Four
patients were found to have associated but  previously undetected
biliary or duodenal cryptosporidiosis,  whereas another had biliary
infection associated with  cytomegalovirus.  E. bieneusi infection of
the biliary tract  could account for at least some of the cases of AIDS-
related  cholangitis that are not explained by cryptosporidium or
cytomegalovirus infection.

"New Ideas and Dark Holes" Advocate (01/12/93) No. 620, P. 49  (Delaney,
Martin)
     The federal government must stop funding studies of drugs that
have limited efficacy, such as AZT, ddI, and ddC, and start  funding
promising new approaches so they can soon become  practical, clinically
useful drugs, writes Martin Delaney,  executive director of Project
Inform, a non-profit gay community  foundation that supplies AIDS
treatment information.  One  encouraging approach called the leucine
zipper is designed to  stop HIV from infecting cells by blocking
mechanisms that the  virus uses to link up with cells.  It was named
such because it  is composed of identical amino acids in a repeating
chain, which  some believe resembles the chain of little metal tabs that
make  up a zipper.  The new product seemingly provides one side of the
zipper, while the other side is provided by a structure on the  outer
core of HIV.  It proved effective in laboratory tests by  completely
blocking further infection by HIV.  Another promising  technique was
developed by AIDS researcher Flossie Wang-Staal and her colleague,
Arnold Hempel.  They reported that they have  succeeded in creating a
molecule thatJliterally slices up the  virus' genes, which control all
its activities.  If genes are  eradicated or severely damaged, the virus
is weakened and unable  to reproduce or further any damage.  A third
approach developed  by Dennis Burton uses monoclonal (man-made)
antibodies, which are cloned in great numbers from a single antibody to
fight against  disease and link up with and block HIV.  All three of
these new  methods will be meaningless unless they are quickly developed
into real products that are ready for human testing and  treatment,
concludes Delaney.