                     AIDS Daily Summary 
                       April 4, 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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"Whitman Panel Urges Needle Exchange Program"
"New Program Offers AIDS Patients Free Assistance with Tax 
Questions"
"Assisted-Suicide Debate Summed Up in Opposite Actions of 2 
Doctors"
"Internet Ad for HIV Cure Draws Restraining Order" 
"Why Kessler Must Go"
"New AIDS Drug Wins Approval"
"Former Blood Official Contests Probe" 
"Schools Alter Their HIV Rules"
"Australia Reports on AIDS: Nef Deletions, Live Vaccines, Chinese
Travelers"
"Tuberculosis Program Changes and Treatment Outcomes in Patients 
with Smear-Positive Pulmonary Tuberculosis in Blantyre, Malawi" 
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"Whitman Panel Urges Needle Exchange Program"
New York Times (04/04/96) P. B8;  Preston, Jennifer
     Despite New Jersey Gov. Christine Todd Whitman's own
opposition to providing clean needles to drug addicts, her 
advisory council on AIDS voted on Wednesday to recommend that the
state allow needle exchange programs and the sale of syringes 
without a prescription at pharmacies.  It is unlikely the 
recommendations will be carried out, however, in light of 
Whitman's opposition.  The panel advised that the programs also 
offer other services including drug and AIDS education and 
counseling, HIV testing, and referrals to drug treatment 
programs.  New York and Connecticut allow needle exchanges, and 
Connecticut is one of five states that allows the sale of 
syringes without a prescription.  In New Jersey, intravenous drug
use accounted for 51 percent of the state's AIDS cases from the 
early 1980s through December 1995.  The panel's chairman, David 
W. Troast, said the programs could save about 650 lives a year by
reducing the transmission of HIV.  Related Story: Philadelphia 
Inquirer (04/04) P. B5
     
"New Program Offers AIDS Patients Free Assistance with Tax 
Questions"
Washington Post (04/04/96) P. A19;  Crenshaw, Albert B.
     AIDS patients may have problems preparing their tax returns,
with complications including disability income, part-year wages, 
and part-year Social Security disability income.  This year a 
group of gay Internal Revenue Service (IRS) workers, known as IRS
GLOBE, has created a volunteer force providing free tax help to 
people with HIV and AIDS.  The service is offered at clinics in 
Washington, D.C., and three other cities.  Jeffrey Brooke, 
co-chair of GLOBE, said the service was created to fill a need. 
"It's not that their returns are incredibly complicated, but they
are unusual," he noted.  The group also sees AIDS patients who 
have not filed returns for several years and want to get back 
into compliance.
     
"Assisted-Suicide Debate Summed Up in Opposite Actions of 2 
Doctors"
Washington Post (04/04/96) P. A18;  Goldstein, Amy
     The debate over assisted suicide is illustrated by two
doctors who chose different sides.  In the first case, a 
Washington, D.C. doctor who specializes in AIDS provided 
information to help a pain-stricken AIDS patient die.  Meanwhile,
a doctor in Charlottesville, Va., refused to comply with another 
AIDS patient's request for death.  He started the patient on 
morphine, steroids, and physical therapy, and the patient lived 
to enjoy one last summer with his family.  An appeals court in 
New York ruled this week that it should not be against the law 
for doctors to help patients commit suicide.  The decision echoes
a recent Washington state ruling and suggests that the Supreme 
Court will face the issue this year.
     
"Internet Ad for HIV Cure Draws Restraining Order" 
Wall Street Journal (04/04/96) P. B8
     A Brockton, Mass., woman who advertised a cure for HIV on
the World Wide Web has removed the ad after a judge issued a 
temporary restraining order.  Massachusetts Attorney General 
Scott Harshbarger, in his first action against misleading 
advertising on the Internet, said the case should be a warning to
other "cyber-snakeoil salesmen."  The state seeks to obtain a 
permanent injunction against the advertisement, which gives users
a 900-number to call for more information, as well as restitution
and penalties from Marjorie Phillips, the woman who placed the 
ad.  Expressing her surprise at the state's action, Phillips has 
maintained that the cure, a combination of three herbs, is 
effective.
     
"Why Kessler Must Go"
Wall Street Journal (04/04/96) P. A12;  Goldberg, Robert M.
     In a Wall Street Journal editorial, Robert M. Goldberg, of
the American Enterprise Institute, points out why he thinks Food 
and Drug Administration Commissioner David Kessler should be 
removed from his position.  He says that under Kessler, the 
development and approval times for new drugs has been extended
and that Kessler has no real reason for the delay.  Kessler, he
says, has let politics drive accelerated review, citing the
example of vocal AIDS activists getting rewarded with faster drug
approvals.  Goldberg also takes issue with Kessler's role in the
delayed consideration of a home HIV test.  More than 10 years
after an application for such a test was submitted, it has been
found accurate and safe by the agency, but not approved for
marketing.  Goldberg concludes that Kessler's leadership of the
FDA has followed a trend of wanting to hold on to power but not
letting people make important medical decisions for themselves.
     
"New AIDS Drug Wins Approval"
Toronto Globe and Mail (04/03/96) P. A4
     The Canadian government has approved the sale of the
protease inhibitor saquinavir, Roche Canada announced Tuesday. 
In clinical tests, saquinavir, being sold by Roche as Invirase, 
has been shown to boost the immune system and reduce the amount 
of HIV in the blood.  Other protease inhibitors, including 
indinavir by Merck & Co. and ritonavir from Abbott Laboratories, 
are awaiting approval in the country.
     
"Former Blood Official Contests Probe" 
Toronto Globe and Mail (04/04/96) P. A4
     A former director of the Canadian Blood Committee has asked
the Federal Court of Canada to stop a government investigation 
into the destruction of records associated with the tainted-blood
scandal.  Denise Leclerc, who headed the now-defunct committee 
from 1982 to 1988, has held that federal Information Commissioner
John Grace does not have the authority to investigate the 
committee because it was not a federal agency.  The committee was
responsible for supervising the blood system when the blood 
supply became contaminated with HIV.  A federal inquiry into the 
blood system suggested that documents were destroyed to ensure 
that they would not be disclosed to journalists under the Access 
to Information Act.
     
"Schools Alter Their HIV Rules"
Chicago Tribune (03/02/96) P. 1-7;  Martinez, Michael;  
Dell'Angela, Tracy
     The Chicago school board updated its policies on HIV last
week, eliminating rules suggestive of discrimination that had 
been made in 1986.  A legal group privately warned the school 
leaders that the policy, which called for a job applicant to 
disclose his HIV-status, mode of infection, and treatments, 
violated the 1990 Americans With Disabilities Act.  Similar 
problems with old policies could occur in other districts 
nationwide, since many schools implemented AIDS and HIV policies 
during the panic over HIV in the late 1980s.  Law experts say 
they suspect such policies are more common among small private 
employers.
     
"Australia Reports on AIDS: Nef Deletions, Live Vaccines, Chinese
Travelers"
Journal of the International Association of Physicians in AIDS 
Care (03/96) Vol. 2, No. 3, P. 6;  Mascolini, Mark
     One focus of the Seventh Annual Conference of the Australian
Society for HIV Medicine was the nef gene's role in HIV and AIDS.
Nicholas Deacon of the Macfarlane Burnet Center for Medical 
Research in Fairfield, Victoria, presented research that 
suggested that, without the nef gene, HIV is weakened.  His 
conclusion is based on the cases of seven people who were 
infected with HIV through blood transfusions from a single 
infected donor but did not develop AIDS.  The meeting also 
highlighted the controversy over testing a live attenuated HIV 
vaccine.  If exposed to the virus, the immune system may be able 
to better defend itself, but critics say the virus may be able to
mutate and take hold.  Ronald Desrosiers of Harvard Medical 
School said he supports testing a live vaccine in humans as a 
result of his work on vaccines for simian immunodeficiency virus 
(SIV), including a successful vaccine in which the nef gene was 
deleted from the virus.  Concerns about that vaccine were raised 
by another study which found that offspring of the vaccinated 
monkeys were infected with SIV.  Other topics discussed at the 
conference included AIDS-related dementia and tuberculosis.
     
"Tuberculosis Program Changes and Treatment Outcomes in Patients 
with Smear-Positive Pulmonary Tuberculosis in Blantyre, Malawi" 
Lancet (03/23/96) Vol. 347, No. 9004, P. 807;  Harries, A.D.;  
Mbewe, L. Nyong'Onya;  Salaniponi, F.M.L.; et al.
     Malawi, one of the world's poorest nations, has experienced
an increase in tuberculosis (TB) cases since 1985, primarily as a
result of the spread of HIV.  The national TB cure rate decreased
from 80 percent in 1988 to 63 percent in 1992, as the TB program 
tried to keep up with increasing numbers of patients.  A.D. 
Harries, of the College of Medicine in Blantyre, and colleagues 
analyzed TB data in the city of Blantyre between 1989 and 1993.  
They found an increase in the proportion of patients being 
treated outside Queen Elizabeth Central Hospital, which they 
attributed to the hospital's saturation.  From 1989 to 1991 the 
number of TB cases at the hospital rose, and treatment outcomes 
deteriorated as a result.  In 1991 and 1993, improvements in 
staffing, staff activities, treatment, and education were made, 
and the cure rate consequently rose from 40 percent in 1991 to 52
percent in 1993.  Since 1987, HIV-seroprevalence in TB patients 
in Malawi has risen to at least 70 percent, contributing to the 
increasing death rate in TB patients.  The higher death rate 
among HIV-positive TB patients has been attributed to bacterial 
infections, so the authors therefore suggest that better 
treatment of these infections may reduce the TB mortality rate.
     
     
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