                     AIDS Daily Summary
                      November 8, 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
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Copyright 1994, Information, Inc., Bethesda, MD


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"Penn Researchers Find Way HIV May Convert to AIDS"
"U.S. Cuts AIDS Research Grants in New York City"
"Israeli With HIV Reportedly Sought Sex"
"It's Cheap and Effective, With Wonders Still Being 
(Re)discovered"
"On the Trail of an AIDS Vaccine"
"A Controlled Trial of Intravenous Immune Globulin for the 
Prevention of Serious Bacterial Infections in Children Receiving 
Zidovudine for Advanced Human Immunodeficiency Virus Infection"
""Surrogate Markers": Current Status, Future Directions (Part I)"
"Update: HIV Prevention and Children"
"Community Acquired Pneumonia in Adults in Addis Ababa: Etiologic
Agents and the Impact of HIV Infection"
"Former Cold War Rivals Share Women's Health Challenges"
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"Penn Researchers Find Way HIV May Convert to AIDS"
Philadelphia Inquirer (11/08/94) P. A1;  Collins, Huntly
     Researchers at the University of Pennsylvania announced Monday 
that they may have discovered how HIV progresses from its 
"latent" stage to start its aggressive attack on the immune 
system.  A protein, unique to AIDS patients, appears to tell 
infected cells when to produce more HIV.  The discovery could 
lead to new treatments that could help people survive longer.  
The scientists found that the amount of protein--assembled by an 
HIV gene known as vpr--in the blood serum of HIV-infected people 
corresponded with their stage of disease.  People with full-blown
AIDS had high levels of vpr.  The research team found that by 
exposing the cells to antibodies of vpr in the laboratory, they 
could prevent the production of new virus.  David Weiner, the 
leader of the study, said that he is trying to develop a vaccine 
that would create vpr antibodies by injecting people with the vpr
gene.  He also suggested the existence of a "regulatory loop" in 
which as HIV infection progresses, the body's balance of vpr 
antibodies and vpr proteins shifts in favor of vpr protein, which
eventually causes cells far from the lymph system to begin 
reproducing HIV.  Related Story: Washington Times (11/08) P. A1; 
New York Times (11/08) P. C5
      
"U.S. Cuts AIDS Research Grants in New York City"
New York Times (11/08/94) P. A1;  Lee, Felicia R.
     In a decision that is prompting outrage and debate, three of the 
four community-based clinical trials on AIDS in New York City 
have been phased out.  New York community groups and politicians,
such as Senators Daniel P. Moynihan and Alfonse M. D'Amato, are 
protesting the cuts because they feel that a city with such a 
high proportion of AIDS patients should have an equally high 
amount of research funds.  There are also complaints that the 
cuts will mean that fewer drug users and minorities will be in 
the trials.  While noting that the decision was final, Dr. Jack 
Y. Killen, director of the National Institute of Allergy and 
Infectious Diseases, Division of AIDS, said that the money went 
to the best programs, not the ones with the largest number of 
AIDS cases.
      
"Israeli With HIV Reportedly Sought Sex"
Baltimore Sun (11/08/94) P. 4A
     AIDS-infected Israeli professor Yeshayahu Demner spent the last 
year of his life advertising for sex.  Documents show that after 
Demner learned he was infected in September 1993, he began 
advertising for "active partners" and noted that "age and color 
don't matter."  Police say that the Demner--who was bludgeoned to
death last week--was trying to get revenge for having AIDS and 
that he "could have infected 500 men."  He offered his partners 
money in return for not using condoms, police sources say.  It is
suspected that Demner was slain by a man he had infected.
      
"It's Cheap and Effective, With Wonders Still Being 
(Re)discovered"
Washington Post (11/07/94) P. A3;  Brown, David
     Vitamin A may be one of the few wonder drugs of the world.  Used 
in treatments for keratomalacia--a leading cause of blindness, 
measles, and anemia--safe and inexpensive Vitamin A may have uses
for AIDS patients.  Researcher Richard D. Semba of the Johns 
Hopkins School of Hygiene and Public Health is creating 
experiments to test the theory that supplementation of Vitamin 
A-deficient HIV patients is beneficial.  One important finding is
that Vitamin A may reduce maternal-infant transmission of HIV.  
Pregnant Malawi women who had sufficient amounts of Vitamin A 
transmitted HIV to their babies only 7 percent of the time, while
those who were severely Vitamin A deficient transmitted the virus
32 percent of the time.  While new studies show a dramatic 
decrease of such transmission when AZT is administered, the 
anti-viral drug is too expensive for use in many countries where 
AIDS is spreading quickly and Vitamin A deficiency is common.  
"In developing countries, there's no cost-effective option," said
Semba.
      
"On the Trail of an AIDS Vaccine"
Boston Globe (11/06/94) P. 92;  Rosenberg, Ronald
     Currently, only a few companies throughout the United States and 
Europe are focusing their research efforts on treatments and a 
potential cure for AIDS.  One of these, Therion Biologics, is at 
the forefront, with one vaccine currently in human testing and 
another in primate testing.  The latter, developed by Ronald 
Desrosiers, a Harvard Medical School microbiology professor, is 
very controversial due to its use of a live attenuated HIV virus.
Therion is starting to talk to drug companies about exchanging 
manufacturing, marketing, and distribution rights for funding.
      
"A Controlled Trial of Intravenous Immune Globulin for the 
Prevention of Serious Bacterial Infections in Children Receiving 
Zidovudine for Advanced Human Immunodeficiency Virus Infection"
New England Journal of Medicine (11/03/94) Vol. 331, No. 18, P. 
1181;  Spector, Stephen A.;  Gelber, Richard D.;  McGrath, Nuala 
et al
     HIV-infected children frequently experience recurrent serious 
bacterial infections.  A study was conducted to determine the 
efficacy of intravenous immune globulin in children with AIDS or 
AIDS-related complex who were being treated with zidovudine 
(AZT).  The trial followed 255 children between the ages of 3 
months and 12 years for approximately two years.  Each child 
received 180 mg of AZT orally four times a day.  The estimated 
two-year rate of serious bacterial infections was 16.9 percent 
for the group that received intravenous immune globulin.  The 
rate for the placebo group was 24.3 percent.  The researchers 
concluded that, for children with advanced HIV who are receiving 
AZT, intravenous immune globulin decreases the risk of serious 
bacterial infections.  The decrease was seen primarily among the 
children who were not taking trimethoprim-sulfamethoxazole as 
prophylaxis when entering the trial.
      
""Surrogate Markers": Current Status, Future Directions (Part I)"
AIDS Treatment News (10/21/94) No. 209, P. 1;  James, John S.
     Because HIV develops slowly and because of a lack of reliable 
ways to measure treatment effect quickly, researchers been 
searching for a "surrogate marker" for HIV disease progression.  
Although the T-helper count and the p24 antigen test have been 
used for several years, it has become evident that they are not 
reliable measures of whether or not a drug is working.  A new 
test, which has been used by researchers for years to measure the
number of copies of HIV RNA in blood plasma, appears to be a 
better measure of whether an antiviral treatment is working.  Few
physicians use the test, however, because of a lack of guidance 
and collective medical experience in interpreting what the 
numbers mean.  While most believe that reducing the HIV RNA level
in the plasma would be beneficial, definitive proof will take 
years to develop.  Scientists have calculated that for proof that
a particular blood test works reliably, the treatment error must 
be about four times the "standard error".  Large trials with 
thousands of patients would be required.  And even after these 
trials are completed, the surrogate marker being tested will only
be proven for one class of drugs.  If AZT were tested, for 
example, it would also be accepted for showing the effect of ddI 
or ddC, but a new trial would be required to prove that HIV RNA 
also works with protease inhibitors.
      
"Update: HIV Prevention and Children"
American Medical News (10/17/94) Vol. 37, No. 39, P. 14
     Grants totaling $20.7 million to benefit AIDS prevention and 
assistance programs for children and families were announced by 
U.S. Health Secretary Donna E. Shalala.  "Programs that help 
prevent kids from becoming HIV-positive--or help HIV-positive 
kids and their families to cope--deserve community and individual
support," she said.  The awards, funded under Title IV of the 
Ryan White Comprehensive AIDS Resources Emergency Act, will help 
organizations such as public health departments, universities, 
and community-based social service groups.
      
"Community Acquired Pneumonia in Adults in Addis Ababa: Etiologic
Agents and the Impact of HIV Infection"
Journal of the American Medical Association (10/26/94) Vol. 272, 
No. 16, P. 1234j
     A study was conducted during 1987 and 1989 at Black Lion Hospital
in Addis Ababa, Ethiopia, to determine the prevalence of HIV 
infection in patients with Community Acquired Pneumonia (CAP).  A
total of 8 percent of the 110 pneumonia patients were HIV-1 
seropositive, compared to the 2.4 percent of the general 
population who were seropositive for HIV-1.  The HIV-infected 
were more frequently young, male, and of urban residence.  The 
patients had fewer chills, increased bilateral and multilobar 
lung involvement, and recurrent chest infiltrate.  The 
researchers concluded that the incidence of CAP in patients with 
HIV would probably increase with the rise of HIV infection.
      
"Former Cold War Rivals Share Women's Health Challenges"
Nation's Health (10/94) Vol. 24, No. 9, P. 24;  Jones, Dorothy
     A group of 20 Russian obstetricians took a month-long tour of 
women's health facilities in the United States.  The doctors 
visited several sites including the District of Columbia General 
Hospital, the Centers for Disease Control and Prevention in 
Atlanta, and the Planned Parenthood of Santa Cruz County (Calif.)
Teen Clinic.  Issues such as HIV in pregnancy, sexually 
transmitted diseases and AIDS control and prevention, and social 
service interventions for pregnant women at risk were addressed 
during the tour.  "We share many of the same challenges, 
including disease reduction and increasing the health of mothers 
and children..." said Dina I. Zelinskaya, chief of the National 
Maternity and Child Protection Board.
      
