                     AIDS Daily Summary 
                       March 28, 1996

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 National AIDS
Clearinghouse, or any other organization. Reproduction of this
text is encouraged; however, copies may not be sold, and the CDC
National AIDS Clearinghouse should be cited as the source of this
information. Copyright 1996, Information, Inc., Bethesda, MD


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"Across the USA: Tennessee"
"Across the USA: Massachusetts"
"Health-Insurance Measure Is Running Into Problems"
"Zimbabwe's AIDS Orphans to Reach 600,000 by 2000"
"Death Rates High Among New York Welfare Recipients--Study"
"Influenza Immunization in HIV-Positive Children Does Not Enhance
HIV Replication"
"Zimbabwe's Maternal Mortality Deaths Rising"
"Physicians' Experience with the Acquired Immunodeficiency 
Syndrome as a Factor in Patients' Survival"
"Rogue Science or Reality?"
"Principals in HIV Blood Scandal Should be Summoned by Diet"
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"Across the USA: Tennessee"
USA Today (03/28/96) P. 11A
     Tennessee's health care program Tenn-Care will cover
protease inhibitors, new AIDS drugs that experts say are
particularly promising.  Tenn-Care covers about 2,000
HIV-infected individuals.
      
"Across the USA: Massachusetts"
USA Today (03/28/96) P. 11A
     AIDS-related deaths in Massachusetts increased 21 percent
from 1993 to 1994, and doubled from 1990 to 1994, according to a
new report.  The 1994 total was 938.  AIDS was the leading cause
of death among Hispanics in the state that year.
      
"Health-Insurance Measure Is Running Into Problems"
Wall Street Journal (03/28/96) P. A4
     The chances of a health-insurance reform bill, aiming to
restrict insurance companies' ability to refuse coverage to
people with pre-existing conditions and guarantee continued
coverage to those who lose or change jobs, may be complicated by
amendments from Senate Republicans.  The bill's sponsors, Sens.
Nancy Kassebaum (R-Kan.) and Edward Kennedy (D-Mass.), urged
lawmakers not to amend the legislation.  Amendments may be
proposed to raise the health-insurance tax deduction for the
self-employed and to add provisions for medical savings accounts
and medical-malpractice awards.
      
"Zimbabwe's AIDS Orphans to Reach 600,000 by 2000"
Xinhua News Service (03/28/96)
     Zimbabwe will have more than 600,000 orphans due to AIDS by
the year 2000, Margaret Mehlomakulu, deputy director of the
National AIDS Coordinating Program, said at a workshop Wednesday.
She said that AIDS would be a heavy burden on the government and
the community as they would be forced to stretch available
resources to take care of the orphans.  Mehlomakulu called for
health officials to work with the community to help prevent young
people from becoming HIV-infected.  An estimated 1 million
Zimbabweans, of a total 10.5 million, have the virus.
      
"Death Rates High Among New York Welfare Recipients--Study"
Reuters (03/27/96)
     Rates of AIDS, tuberculosis (TB), and death are much higher
among New York City welfare recipients and applicants who have
been abusing alcohol, drugs, or both, an eight-year survey has
found.  The research, led by Lloyd Friedman of the Yale
University School of Medicine, found that between 1984 and 1992,
5.5 percent of the 858 people studied developed TB, 10 percent
had AIDS, and 21 percent died.  All 858 had a history of abusing
drugs, alcohol, or both.  The TB rate for these individuals, the
majority of whom are single black men, is nearly 15 times the
usual rate in New York City, while the AIDS rate is 10 times the
average, and the death rate is five times the usual. 
Ninety-three percent of the participants agreed to undergo a
two-part medical exam, which the researchers hoped would result
in treatment for people at high risk for AIDS or TB.
      
"Influenza Immunization in HIV-Positive Children Does Not Enhance
HIV Replication"
Reuters (03/27/96)
     Although some researchers have suggested that influenza 
vaccination may activate T-cells and enhance HIV replication, new
research has revealed only short-term increases in viral load in 
children following immunization.  Octavio Ramillo and colleagues 
at the University of Texas Southwestern Medical Center in Dallas 
saw the increased HIV RNA in five of 16 children, and said the 
viral load returned to baseline in four of those five children 
within eight weeks.  The findings add to the evidence that the 
viral burden increases after immunization more often in 
HIV-positive adults than in children.
      
"Zimbabwe's Maternal Mortality Deaths Rising"
PANA News Service (03/27/96)
     The incidence of maternal mortality has increased in
Zimbabwe as the number of HIV-infected pregnant women has risen,
a local gynecologist reported Wednesday.  Kudakwashe Kangwende
said the infant mortality rate has been made worse by pre-natal
mortality associated with HIV infection and AIDS among pregnant
women.  Kangwende said that frequent and unwarranted pregnancies
among women with AIDS contribute to the increasing maternal
mortality rate, and suggested that women with AIDS should be
allowed to have abortions.  He also said the AIDS pandemic was
causing the spread of other diseases uncommon in Zimbabwe,
including genital herpes and cervical cancer.
      
"Physicians' Experience with the Acquired Immunodeficiency 
Syndrome as a Factor in Patients' Survival"
New England Journal of Medicine (03/14/96) Vol. 334, No. 11, P. 
701;  Kitahata, Mari M.;  Koepsell, Thomas D.;  Deyo, Richard A.;
et al.
     Mari Kitahata and colleagues examined the link between 
physicians' experience with AIDS and the survival of their AIDS 
patients.  They studied the cases of 403 men enrolled in a health
maintenance organization who were diagnosed with AIDS between 
1984 and mid-1994.  The patients' 125 primary care physicians 
were separated into three levels of AIDS experience, based on 
experience with AIDS during residency training and the cumulative
number of patients with AIDS they had treated in practice.  The 
authors concluded that patients cared for by doctors with the 
most experience had a 31 percent lower risk of death than 
patients cared for by physicians with the least experience.  
Among the 224 patients diagnosed with AIDS between 1989 and 1994,
the risk of death was 43 percent lower for patients of the most 
experienced doctors than for patients of the least experienced.  
The study suggests that physicians who treat AIDS patients go 
through a similar learning period and begin to improve their 
management skills early in their experience.  The authors found 
that certain methods of treatment and a tendency to follow 
HIV-infected patients more closely were associated with higher 
levels of physicians' experience and longer patient survival.
      
"Rogue Science or Reality?"
Insight (03/11/96) Vol. 12, No. 10, P. 16;  Goode, Stephen
     Peter Duesberg, biology professor at the University of
California at Berkeley, member of the National Academy of
Sciences, and federal grant recipient, is criticized by many
scientists because he opposes the accepted belief that HIV causes
AIDS.  Duesberg's book "Inventing the AIDS Virus" outlines his
arguments and challenges his colleagues to answer them.  He says
the HIV-AIDS theory was announced hastily by federal health
officials in 1984 because groups like the National Institutes of
Health were under intense pressure to come up with an answer to
the growing AIDS epidemic.  No one questioned the connection
later, he says, because billions in federal funding was being
spent on confirming it.  Furthermore, Duesberg criticizes AIDS
researchers for abandoning long-held principles about viruses. 
In other viral infections, antibodies are a sign of the body's
defense, but with HIV, antibodies are looked at as a sign that
the virus is still potent.  AIDS researcher Robert Gallo has said
that because AIDS was completely new, redefining the rules was
necessary.  Other researchers argue that HIV's ability to mutate
rapidly makes it a special case.  Duesberg says that lifestyle
factors--including drug use, repeated cases of sexually
transmitted diseases, and malnutrition--are to blame for AIDS. 
Duesberg is not alone in his beliefs--the 100-member Group for
the Scientific Reappraisal of the HIV-AIDS Hypothesis supports
him.
      
"Principals in HIV Blood Scandal Should be Summoned by Diet"
Nikkei Weekly (03/11/96) Vol. 34, No. 1713, P. 6
     In an editorial in the Nikkei Weekly, the authors note the
Diet's lack of involvement in Japan's tainted blood scandal,
which caused some 1,800 Japanese hemophiliacs to be infected with
HIV.  An investigation by the Ministry of Health and Welfare
revealed that contaminated blood products were distributed even
though members of government and industry knew of the HIV threat.
However, the investigation's interim report fails to answer 
whether or not the ministry proposed emergency imports of safe, 
heat-treated blood products.  The editors question the actions of
Takeshi Abe, who headed the AIDS task force, as well as those of 
his associate, Mutsumi Kazama, and the pharmaceutical companies 
who continued to ship the untreated products even after the 
threat of contamination was known.  The editors claim that the 
ministry investigation is not likely to provide satisfactory 
answers and that the participants should testify before the Diet.
      
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