                     AIDS Daily Summary 
                       April 2, 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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"Gene Therapy and AIDS"
"FDA Approves the Testing of Drug for AIDS Patients" 
"Blood Banks Adopt Stricter AIDS Test"
"The Tuberculosis Emergency"
"Mild Cytologic Atypia Associated with CIN in HIV-Positive Women"
"Human Herpes Virus 6 Linked to Disease Progression in AIDS 
Patients"
"Major Opportunistic Infections Are Developing Later in HIV 
Disease Progression"
"Invasive Pneumococcal Disease in a Cohort of Predominantly HIV-1
Infected Female Sex Workers in Nairobi, Kenya"
"Home HIV Tests Raise Issues of Counseling, Prevention" 
"Face to Face with TB"
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"Gene Therapy and AIDS"
Washington Post (04/02/96) P. A6
     A new study suggests that gene therapy may be able to keep 
critical immune cells active in HIV-infected individuals.  In the
study, which is reported in the Proceedings of the National 
Academy of Sciences, T cells usually attacked by HIV were removed
from three HIV-positive patients, genetically modified with an 
antiviral gene, and returned to the patients.  The procedure kept
the T cells alive four to five times longer than the unmodified 
cells.  The therapy may be able to prolong the time before an 
HIV-infected person develops AIDS, said author Gary Nabel of the 
Howard Hughes Medical Institute at the University of Michigan.  
Related Story: USA Today (04/02) P. 2D
     
"FDA Approves the Testing of Drug for AIDS Patients" 
Wall Street Journal (04/02/96) P. B5
     Unimed Pharmaceuticals Inc. said its drug to treat HIV
wasting syndrome has been cleared for testing by the Food and 
Drug Administration.  The new product, Androgel-DHT, will be 
tested in Phase II clinical trials at Beth Israel Hospital in 
Boston.  The drug also qualifies for orphan-drug status, which 
would give Unimed exclusive rights to sell the drug for a number 
of years if it is approved.
     
"Blood Banks Adopt Stricter AIDS Test"
Washington Post--Health (04/02/96) P. 6;  Squires, Sally
     As of March 14, some U.S. blood banks are beginning to use
an expensive new test that is more sensitive at detecting HIV. 
The new test detects p24 antigens, proteins on the surface of
HIV, while the standard tests detect human immune system cells
that are made by the body in response to the virus.  The risk of
getting HIV from a blood transfusion in the United States has
dropped from 6 in every 100,000 donations in 1993 to 1 in 450,000
in 1995.  Researchers from the Centers for Disease Control and
Prevention and the American Red Cross estimate that the new test
will decrease the risk to 1 in every 660,000 donations.  In
addition, the new test will detect HIV about 16 days after
infection, while the old test takes about 22 days.  The Food and
Drug Administration says that since 1989, four cases of HIV
infection have been the result of blood donations that tested
negative for HIV.  The new test is required for all blood banks
by June 14.
     
"The Tuberculosis Emergency"
Toronto Globe and Mail (04/01/96) P. A12
     In a Toronto Globe and Mail editorial, the authors urge
countries to follow World Health Organization (WHO) tuberculosis 
recommendations and increase resources spent on battling the 
disease.  TB, the cause of one-quarter of all preventable deaths 
in developing countries, infects 30 percent of homeless people 
using downtown shelters in Toronto, according to a new study.  
Furthermore, the disease has been increasing in parts of Africa 
and Asia as a result of AIDS, which weakens the body's defense to
infection.  New drug-resistant strains of TB are also appearing 
and spreading, infecting an estimated 50 million people 
worldwide.  Although drugs for TB are effective and cheap, they 
must be taken for at least six months and many patients do not 
complete the therapy, thereby allowing drug-resistant strains to 
develop.  Patients receiving directly observed treatment, in 
which health workers watch patients to make sure they take their 
medicine, have a 95 percent cure rate.  The WHO says, however, 
that most TB patients are not supervised, especially in Third 
World countries.  The editorial concludes that the WHO's 
recommendation to double the money allocated for TB, which would 
add $350 million to the cause, is worth the expense.
     
"Mild Cytologic Atypia Associated with CIN in HIV-Positive Women"
Reuters (04/01/96)
     A study of 453 HIV-positive women and 401 controls revealed
an association between mild cytologic atypia and cervical 
intraepithelial neoplasia (CIN).  In the multicenter study, 
conducted by Thomas C. Wright Jr. of Columbia University, 112 
HIV-positive women developed mild cytologic atypia, compared with
36 control subjects without HIV.  CIN was found in 38 percent of 
the 112 HIV-infected women, compared to 14 percent of the 36 
HIV-negative women.  The HIV-positive women with mild cytologic 
atypia were 2.7 times more likely to have CIN and 12 percent of 
the Pap smears from these women were classified as high-grade.  
Wright believes the high prevalence of CIN in this group 
indicates a need for colposcopy referral.
     
"Human Herpes Virus 6 Linked to Disease Progression in AIDS 
Patients"
Reuters (04/01/96)
     Human herpesvirus 6 (HHV-6) plays an important role in the 
progression of HIV infection, a new study says.  Konstance Kehl 
Knox and colleagues at the Medical College of Wisconsin at 
Milwaukee report that HIV appears to use HHV-6 as a tool for 
destruction.  The researchers took lymph node samples from 10 
HIV-positive patients and HIV-negative controls.  The samples 
from those with HIV contained a large number of cells that were 
actively infected with HHV-6, while none of the samples from the 
HIV-negative patients were infected with HHV-6.  Knox theorized 
that HIV infection may be dependent on activation by HHV-6, and 
that drugs to block HHV-6 and HIV simultaneously in the early 
stages of HIV infection could slow or stop the progression to 
AIDS.
     
"Major Opportunistic Infections Are Developing Later in HIV 
Disease Progression"
Reuters (04/01/96)
     Opportunistic infections and AIDS-related cancers are
developing at a more advanced stage of immunosuppression than 
previously reported, according to new analysis by Johns Hopkins 
researchers.  Compared with late 1980s estimates, the incidence 
of Pneumocystis carinii pneumonia (PCP) and Kaposi's sarcoma have
decreased.  Richard D. Moore and colleagues analyzed data from 
more than 1,200 HIV patients who were treated at an urban 
university clinic between July 1989 and April 1995.  The most 
common opportunistic disease was Candida esophagitis, followed by
PCP, Mycobacterium avium complex bacteremia, cytomegalovirus and 
AIDS dementia complex.  The least common complications were 
non-Hodgkin's lymphoma, M. tuberculosis, progressive multifocal 
leukoencephalopathy, and cryptosporidiosis.
     
"Invasive Pneumococcal Disease in a Cohort of Predominantly HIV-1
Infected Female Sex Workers in Nairobi, Kenya"
Lancet (03/16/96) Vol. 347, No. 9002, P. 718;  Gilks, Charles F.;
Ojoo, Sylvia A.;  Ojoo, Josephine C.; et al.
     To assess the interaction of pneumococcal disease and HIV 
infection in sub-Saharan Africa, Charles F. Gilks, of the Center 
for Tropical Medicine at Oxford University, and colleagues 
followed a group of 719 female sex workers in Nairobi between 
1989 and 1992.  Of the total, 587 were seropositive and 132 
remained seronegative.  Among those who were HIV positive, 79 had
pneumococcal disease, compared to just one in the HIV 
seronegative group.  The researchers were surprised that 
pneumococcal disease, not tuberculosis, was the earliest serious 
complication in the HIV-infected women, as well the most common. 
The overall risk for developing pneumococcal disease with HIV 
infection was 17.8.  The incidence rate in seropositive women was
42.5 per 1000 person-years, while the recurrence rate was 264 per
1000 person-years.  According to the researchers, pneumococcus is
an early, yet relatively treatable complication of HIV infection 
in sub-Saharan Africa.
     
"Home HIV Tests Raise Issues of Counseling, Prevention" 
American Medical News (03/18/96) Vol. 39, No. 11, P. 10;  
Shelton, Deborah L.
     A 1992 National Health Interview Survey found that 8 percent
of Americans said they would probably take an HIV test within the
year for reasons other than blood donation, insurance, or 
military service.  One-third of them said they would rather use a
home collection kit than visit a physician or clinic.  As the 
Food and Drug Administration considers three companies' 
applications to sell HIV home test kits, the South Carolina 
legislature is considering a bill to allow the sale of such kits.
Public health officials in the state oppose the home test kits 
because they say the kits would make it more difficult to track 
HIV and provide counseling and referrals, and partner 
notification.  Although the state requires doctors and 
laboratories to report by name people who test positive for HIV, 
the requirement would be waived under the proposed bill.  Texas 
has already passed a law that requires home HIV test kits to be 
sold as part of a package of services, including pre- and 
post-test counseling, testing by a qualified facility, 
verification of positive results, and verbal notification of 
results to the person tested, with referrals for care and 
treatment if needed.
     
"Face to Face with TB"
Federal Times (03/18/96) Vol. 32, No. 6, P. 13;  Rivenbark, Leigh
     Mary Ann Goeller, a Social Security Administration claims 
representative, believes she contracted tuberculosis (TB) from a 
customer she interviewed at work.  The customer had HIV and TB 
and was coughing during their interview in her small cubicle.  
Goeller tested positive for TB, and was treated aggressively for 
a year to prevent active TB from developing.  Social Security 
paid for her initial test, while workers' compensation paid for 
her time away from work for monthly tests and doctor visits.  
Goeller now wants to warn other federal workers to protect 
themselves while working.  Furthermore, she believes that Social 
Security should protect its employees by allowing them to wear 
masks or by requiring customers with TB to wear masks.
     
     
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