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                     AIDS Daily Summary
                       June 09, 1994


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, and the CDC
Clearinghouse should be cited as the source of this information.
Copyright 1994, Information, Inc., Bethesda, MD


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"City, State, 4 HMOs Join to Keep Betak Open"
"The Renaissance Man as Radical"
"Landmark AIDS Trial Jury Deliberates"
"Columbia Laboratories Signs U.S. Agreement With Lake
Pharmaceutical to Market Its Newest Product, Advantage 24"
"The First Search for the Source"
"Good News and Bad News About AZT"
"Zidovudine for the Prevention of HIV Transmission From Mother to
Infant"
"Suppression of HIV Production in Resting Lymphocytes by
Combining Didanosine and Hydroxamate Compounds"
"Bereavement Reactions"
"HIV Vaccine Trials: Will Intravenous Drug Users Enroll?"
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"City, State, 4 HMOs Join to Keep Betak Open"
Philadelphia Inquirer (06/09/94) P. B1;  Collins, Huntly
     In a move to save Philadelphia's only exclusive AIDS nursing home
from immediate closure, the city, state, and four health
maintenance organizations agreed to donate more than $200,000 to
help Betak meet its payroll at least through next month.  The
news brought an end to the 17-day hunger strike of a handful of
activists who protested the nursing home's potential closing.
After July, officials expect to fashion a permanent solution to
the facility's financial woes, including the possibility of a new
owner for the 43-bed home.  Lutheran Home, which has been
subsidizing Betak, is plagued by its own financial troubles, and
says it can no longer underwrite the facility's $2.8 million
annual budget.

"The Renaissance Man as Radical"
Philadelphia Inquirer (06/09/94) P. F1;  Collins, Huntly
     Kiyoshi Kuromiya, the 51-year-old editor of "Critical Path," a
newsletter that dispenses treatment information to some 9,500
people, is the liaison that bonds hundreds of AIDS advocates in
Philadelphia.  Despite his own HIV infection, Kuromiya is
unflagging in his efforts.  A founding member of ACT UP, he runs
a computer bulletin board for AIDS patients and operates a
"community medicine chest," a supply of recycled drugs retrieved
from the cabinets of patients who have died or switched to other
drugs.  Kuromiya also uses his own personal phone number as a
24-hour AIDS hotline--which receives calls from all over the
country, at all hours of the day.  He is also one of a handful of
activists who sit on the government's AIDS Clinical Trials Group,
a network of 1,200 scientists, doctors, and other professionals
who oversee federally sponsored trials of experimental AIDS
drugs.

"Landmark AIDS Trial Jury Deliberates"
United Press International (06/08/94)
     The first jury ever asked to decide whether AIDS discrimination
is a breach of federal law continues deliberations today in the
case of a Fremont, Ohio, hospital accused of violating the
Americans with Disabilities Act by refusing to admit an AIDS
patient.  A lawyer representing the estate of Fred Charon asked
the Toledo federal jury to order Fremont Memorial Hospital and
the admitting physician to pay $1 million in damages, while
attorneys for the hospital and for Dr. Charles Hull maintained
that Charon received the best possible medical care with his
transfer from Fremont to Medical College Hospital in Toledo.
Hull admitted to saying "... once you get an AIDS patient, you'll
never get him out," but said he meant only that a seriously ill
AIDS patient could die in a small community hospital not equipped
to treat the disease.

"Columbia Laboratories Signs U.S. Agreement With Lake
Pharmaceutical to Market Its Newest Product, Advantage 24"
Business Wire (06/08/94)
     Columbia Laboratories Inc., a U.S.-based pharmaceutical firm, has
signed a letter of intent with Lake Pharmaceutical concerning
marketing of its Advantage 24 product, a sustained-release
contraceptive gel.  Columbia intends to grant Lake Pharmaceutical
exclusive U.S.-marketing rights of Advantage 24, whose benefits
include slow-release characteristics that allow the spermicide to
remain effective for up to 24 hours.  Considering Lake's
distribution capabilities, Columbia president and CEO Norman M.
Meier said the gel would be widely available by the end of 1995,
and would be "positioned to fully benefit when studies
demonstrate the effectiveness of Advantage 24 on the prevention
of chlamydia and the AIDS virus."

"The First Search for the Source"
Toronto Globe and Mail (06/08/94) P. A16;  Mickleburgh, Rod
     Hospitals in Canada, where more than 1,000 blood transfusion
recipients became infected with HIV, announced on Monday that
they intend to track down everyone who received the procedure
from 1978 to 1985, when the Red Cross began to screen donated
blood for the virus.  Under the trace-back procedure, when a
blood transfusion patient develops HIV, the patient's hospital
gives the Red Cross the code numbers of blood units donated to
the patient.  The Red Cross then tries to contact all of the
involved donors to urge them to undergo HIV testing.  This method
is largely based on protocol developed in 1985, according to Col.
Neville Robinson.  As administrator of Vancouver's Red Cross
Blood Transfusion Center, Robinson led that year's investigation
into the source of HIV-contaminated blood that infected two blood
transfusion recipients.  Operation 300, as it was called, was 150
days spent trying to contact the 301 donors to the first infected
patient and the 17 donors linked to the second patient.  The
detective work meant hours of telephone work at a time when fear
of AIDS had gripped the public.

"Good News and Bad News About AZT"
U.S. News & World Report (05/16/94) Vol. 116, No. 19, P. 88
     Recent studies with AZT have brought both triumph and
disappointment to the AIDS battle.  In a recent trial of AZT in
HIV-positive, pregnant women, scientists at the National
Institutes of Health calculated that those who took the drug were
only one third as likely to transmit the virus to their babies as
were those who took a placebo.  Another finding, however,
suggests that while AZT has demonstrated clear benefit to most
patients who are already sick, the common practice of prescribing
AZT before a patient exhibits symptoms of disease does not
ultimately prolong life.  In fact, according to the study, the
side effects from taking the drug--including chronic nausea and
fatigue--may outweigh its short-term benefits.  The finding has
left HIV patients in a "catch-22" situation: either to cope with
the side effects of taking AZT in order to delay sickness, or to
wait before taking the drug, possibly bringing illness on
earlier.  A panel of experts convened by the National Institutes
of Allergy and Infectious Diseases suggests that AZT use be
dictated by CD4 levels.  Those with counts under 200 should take
the drug.  Patients with counts between 200 and 500 should
consult a physician.  And those with CD4 counts over 500--about
half the normal level--should not take AZT, says the panel.

"Zidovudine for the Prevention of HIV Transmission From Mother to
Infant"
Journal of the American Medical Association (05/25/94) Vol. 271,
No. 20, P. 1567
     Although preliminary results of a trial of zidovudine to prevent
HIV transmission from mothers to their babies showed a 67.5% risk
reduction, the findings were subject to at least four
limitations.  First, the study did not measure the efficacy of
zidovudine among women whose T cell counts were below 200.  Nor
did it assess the efficacy of zidovudine among women who had
previously used the drug for extended periods and may have
developed zidovudine-resistant strains of HIV.  The study also
did not evaluate risk in the first trimester of pregnancy.
Third, the study failed to assess the independent or relative
contributions of  the antepartum, intrapartum, or treatment of
the infant; therefore, the efficacy and side effects of
zidovudine regimens restricted to only one or two of these
treatment periods were unknown.  Finally, the study has not yet
yielded any information about long-term side effects for the
infants and mothers treated with zidovudine.

"Suppression of HIV Production in Resting Lymphocytes by
Combining Didanosine and Hydroxamate Compounds"
Lancet (05/21/94) Vol. 343, No. 8908, P. 1292;  Malley, Serge D.;
Grange, Jacques M.;  Hamedi-Sangsari, Farid et al.
     Although the currently available AIDS drugs zidovudine,
didanosine, and zalcitabine exhibit strong HIV inhibition in
vitro in long-term dividing cell lines and activated peripheral
blood mononuclear cells, they are only partially effective in
suppressing viral replication in AIDS patients.  Malley et al.
suggest that it is the non-dividing "resting" cells that should
be targeted for antiviral activity, since quiescent peripheral T
lymphocytes may be an important and inducible HIV reservoir in
infected persons.  The researchers evaluated the anti-HIV
activity of the three drugs and found them, alone or in
combination, unable to fully inhibit viral production or protect
the cells from the cytopathic effect of viral replication.  The
drugs were then tested in combination with hydroxamates, known
for their inhibitory effect on ribonucleotide reductase in
replicating cells.  Didanosine in combination with '-hydroxamate
(DAH) or hydroxyurea (HU) yielded a synergistic effect resulting
in complete suppression of viral production, total protection
against the cytopathic effect induced by viral replication, and
non effect on the cells' ability to replicate normally after
treatment.  Trials are slated for May.

"Bereavement Reactions"
Focus (05/94) Vol. 8, No. 6, P. 7;  Neugebauer, R.;  Williams,
J.B.W.;  Rabkin, J.G. et al.
     New York City researchers who interviewed 84 HIV-negative and 123
HIV-positive gay and bisexual men in 1988 and 1989 found no
connection between loss and depressive symptoms for either
serostatus group.  Participants were subjected to medical,
psychiatric, and psychosocial examinations.  Half of the group
had experienced at least one loss since the onset of the
epidemic; more than 20 percent had suffered a loss within the six
months prior to the interview.  Neither level of depressive
symptoms nor rate of diagnosed depressive disorder was linked to
the number of losses the subject had endured.  This lack of
association held for both seropositive and seronegative men, and
held on three different depression scales.

"HIV Vaccine Trials: Will Intravenous Drug Users Enroll?"
American Journal of Public Health (05/94) Vol. 84, No. 5, P. 761;
Meyers, Kathleen;  Metzger, David S.;  Navaline, Helen et al.
     A number of HIV vaccines are currently in phase I/II clinical
trials, and as this work progresses towards phase III studies, a
relevant practical question emerges.  As of yet, little work has
been done to outline the issues surrounding recruitment and
retention of volunteers for HIV vaccine trials.  Crucial is the
need to determine whether individuals at high risk, particularly
intravenous drug users, will participate.  To assess the
willingness of addicts to participate in vaccine trials, Meyers
et al. analyzed the results of questionnaires completed by 257 IV
drug users.  The subjects were asked about risk behaviors,
interest in vaccine trials, and other vaccine-related
information.  Meyers et al. discovered that 30 percent of the
subjects did not even know what a vaccine was.  Of those that
did, however, 52 percent expressed willingness to be one of the
first to participate in a preventive HIV vaccine trial.
Twenty-two percent, however, said they would probably increase
needle-sharing if they were vaccinated.  The findings suggest
that some in-treatment drug users would enroll for preventive HIV
vaccine efficacy trials, but that education and counseling would
be required to make sure participants fully understand the
trial's purposes, methods, risks, and benefits.