                     AIDS Daily Summary 
                      January 12, 1995

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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"AIDS Virus Shown by Research to Be Relentless in Reproducing"
"End Is Sought to Blood Test that Barred Many Donors"
"Anti-Gay Measure Is Defeated"
"Contest to Give Hindi Name to AIDS"
"Broder Bids Adieu on a High Note"
"AmFAR's ART Against AIDS Japan Show Opens in Soho"
"Early Predictors of Outcome for HIV Patients with Neurological 
Failure"
"Judge: HIV Test Results Aren't Admissible"
"When to Use Fluconazole"
"AIDS Caregivers Struggling with Assisted Suicide"
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"AIDS Virus Shown by Research to Be Relentless in Reproducing"
Washington Post (01/12/95) P. A3;  Brown, David
     New research has shown that the immune system of an AIDS patient 
is in a state of all-out war against a relentlessly multiplying 
virus.  HIV can develop resistance to new drugs in as little as 
one month after the patient begins taking them, which reinforces 
the tremendous difficulty of developing drugs to keep the 
infection in check.  The immune system's ability to survive years
of infection, however, suggests that it may retain an extremely 
strong capacity for regeneration even late in the disease, if a 
way to stop the viral reproduction can be found.  The two studies
estimate that about half of the HIV particles in the bloodstream 
are killed off every two day, only to be replaced by new 
microbes.  Two research teams gave AIDS patients potent 
anti-viral drugs.  The drugs either stopped viral production or 
stopped the virus from infecting additional cells.  In either 
instance, the body gained the opportunity to clear itself of the 
virus and to replenish its destroyed CD4 cells.  Both teams 
measured a decline in virus particles in the blood, as well as an
increase of CD4 cells.  The daily "turnover" of CD4 cells was 
estimated to be between 1.8 billion and 2 billion cells, while 
100 million to 680 million virus particles were produced each 
day.  Related Stories: New York Times (01/12) P. A1; USA Today 
(01/12) P. 1D
      
"End Is Sought to Blood Test that Barred Many Donors"
New York Times (01/12/95) P. B9;  Altman, Lawrence K.
     A federal panel on Wednesday recommended that blood banks stop 
performing a screening test that has permanently excluded 
approximately 1 million potential blood donors in the United 
States, even though they are healthy.  While the recommendations 
of the panel on infectious disease testing for blood 
transfusions, convened by the National Institutes of Health, are 
not binding on health groups in such cases, they are generally 
followed after review.  The test, which is an indirect way of 
detecting  hepatitis C, is obsolete and ineffective, said the 
panel.  A lack of standardized interpretation of test results has
contributed to inconsistent rules on the exclusion of donors and 
has led to the needless disposal of 200,000 units of blood each 
year.  The elimination of the test would not reduce the safety of
the blood supply because other tests now detect various forms of 
hepatitis and HIV.  Because it will take time to review the 
recommendation, the decision is not expected to relieve the acute
blood shortage that exists in much of the country.
      
"Anti-Gay Measure Is Defeated"
New York Times (01/12/95) P. A15;  Dunlap, David W.
     In a special election on Tuesday, voters in West Palm Beach, 
Fla., upheld an anti-discrimination ordinance.  The voters 
defeated a proposal that would have removed "sexual orientation" 
as a classification under which people are protected against bias
in employment, housing, and public accommodations.  Opponents of 
the proposal claimed it would legalize discrimination.  "Why are 
we passing laws that promote and validate a life style that 
causes untold deaths and costs," asked Sarah Brack Nuckles--a 
member of the City Commission who voted against the ordinance 
when it was enacted last September--referring to the toll taken 
by AIDS.  David Canton, director of the American Family 
Association of Florida, alleged that the city had circumvented 
due process to force a special election, limiting voter turnout 
to those with the most at stake.
      
"Contest to Give Hindi Name to AIDS"
Reuters (01/12/95)
     India's National AIDS Control Organization (NACO) is offering a 
10,000 rupee ($330) prize for the best entry in a contest to give
a Hindi name to AIDS.  So far, the responses have included names 
such as Black Cobra, Untimely Cremation Ritual, and The Doctors 
Cannot Save Him Now.  According to NACO, there are 1,017 cases of
full-blown AIDS and 17,124 confirmed cases of HIV infection in 
India.  The Indian Institute of Economic Growth, however, 
estimates that the actual number of AIDS patients in India could 
be as high as 10,000, with up to 1.5 million HIV-infected 
Indians.
      
"Broder Bids Adieu on a High Note"
Boston Globe (01/11/95) P. 12;  Foreman, Judy;  Bass, Alison
     Contrary to the usual press releases and conferences that occur 
when there is a major development, news of the short-term decline
in breast cancer mortality was first announced during Dr. Samuel 
Broder's farewell address to the National Cancer Advisory Board. 
Broder is leaving the National Cancer Institute in April to work 
at a Miami pharmaceutical firm, IVAX Corp.  During the early days
of the AIDS epidemic, Broder came to national attention when he 
pioneered the use of AZT to slow disease progression.  Broder 
said that his resignation in part stems from his frustration with
the view that government impedes progress.
      
"AmFAR's ART Against AIDS Japan Show Opens in Soho"
PR Newswire (01/11/95)
     Art Against AIDS Japan, a four-week show at the Thread Waxing 
Space, opens today in Soho, New York.  The show features two 
exhibitions entitled "The Artist's Camera" and "Tradition and 
Invention: Contemporary Artists Interpret The Japanese Garden."  
Actress Tatum O'Neal will host the show, which includes the sale 
of works by such leading contemporary artists as Roy 
Lichtenstein, William Wegman, and Jenny Holzer.  Proceeds will 
benefit the American Foundation for AIDS Research (AmFAR).
      
"Early Predictors of Outcome for HIV Patients with Neurological 
Failure"
Journal of the American Medical Association (01/04/95) Vol. 273, 
No. 1, P. 35;  Bedos, Jean-Pierre;  Chastang, Claude;  Lucet, 
Jean-Christophe et al
      As part of a descriptive study of HIV, researchers studied 84 
consecutive HIV-infected patients who were admitted to an 
infectious disease intensive care unit (ICU) for neurological 
failure.  They were also trying to determine the parameters on 
admission that are predictive of death within three months.  
Within 48 hours of admission, each patient received a thorough 
clinical, laboratory, and brain computed tomography (CT) scan 
workup.  Eighty percent of the cases, or 67 patients, required 
mechanical ventilation within 48 hours of admission.  The brain 
CT showed that 51 patients had abscesses, which in 47 patients 
were attributed to probable toxoplasmosis.  There was a 
three-month survival rate of 32 percent.  Factors predictive of 
death within three months admission to the ICU include a Glasgow 
Coma Scale score less than 7, signs of brain stem involvement, 
and the need for mechanical ventilation in the 48 hours after 
admission.  No initial HIV-specific parameters were identified as
predictive of death.  The prognostic factors found only reflect 
the severity of neurological involvement in the various 
etiologies.
      
"Judge: HIV Test Results Aren't Admissible"
Washington Blade (01/06/95) Vol. 26, No. 1, P. 18;  Chibbaro Jr.,
Lou
     A Mississippi judge ruled last month that the results of HIV 
antibody tests of two homosexual men who were murdered in October
should not be admitted into court unless evidence in the pending 
trial warrants it.  The ruling was considered a setback 
for16-year-old Marvin McClendon, who has been charged with the 
shooting deaths of Robert Walters and Joseph Shoemake.  The 
defendant's attorney sparked fury in the AIDS activist community 
when he asked for posthumous HIV antibody tests on blood samples 
taken from the men.  He argued that the results were needed to 
reinforce his client's assertion that he shot the men in 
self-defense.  The request was approved, but the judge ordered 
the results to be sealed while he studied the question of whether
the information should be admitted into court.  McClendon told 
authorities he killed the two men after they attempted to rape 
him in their car.  The judge's decision to hold off on whether to
admit the test results came after the Lambda Legal Defense and 
Education Fund submitted a memorandum citing legal arguments 
opposing release of the HIV status of the victims.
      
"When to Use Fluconazole"
Lancet (01/07/95) Vol. 345, No. 8941, P. 6;  Mangino, Julie E.;  
Moser, Stephen A.;  Waites, Ken B.
     The significant increase in the incidence of invasive fungal 
infections among patients admitted to hospitals during the past 
decade is due in part to the increased use of broad-spectrum 
antimicrobial agents, long-term immunosuppressive therapy, and 
AIDS.  Comparative studies of fluconazole--an oral and parenteral
triazole--have found that it seems to be as effective as or 
better than other antifungal agents for the treatment of patients
with mucosal candidosis.  Amphotericin B and fluconazole are both
effective initial therapies for cryptococcal meningitis in AIDS 
patients.  Still, Amphotericin B is the preferred choice for 
induction because of its faster sterilization of the 
cerebrospinal fluid and lower mortality.  Lifelong suppressive 
therapy with fluconazole in this population has proven to be 
better, and also better tolerated than Amphotericin B.  Questions
about optimum fluconazole therapy include whether intermittent or
continuous suppressive therapy is indicated for patients with 
AIDS and recurrent mucosal candidosis.  Although the drug is well
tolerated and has few side effects, clinicians should be aware of
potential problems regarding resistance, drug interactions, and 
cost.
      
"AIDS Caregivers Struggling with Assisted Suicide"
AIDS Alert (01/95) Vol. 10, No. 1, P. 12
     "Rational suicide" is a phrase often used by those who advocate 
for the right of dying patients to determine the circumstances of
their own deaths.  For example, Tony Winik, a bisexual who had 
had AIDS for two years, appears to have committed "rational 
suicide" last summer.  As Texas does not have an assisted suicide
law, Winik relied on the best-selling manual, "Final Exit," for 
technical advice.  His wife says only that "we had help" in 
addition to the book.  She says that while her husband was not in
severe pain, he had spent much of the summer in the hospital and 
was frightened of a prolonged and agonizing death.  Susan B. 
Dunshee, of the Seattle-based Compassion in Dying, says that 
about half of the calls to the group are from AIDS patients.  The
group provides support and advice to dying patients who want to 
hasten their deaths, but does not write prescriptions or supply 
medication.  Dunshee also says that, despite laws prohibiting 
physicians from assisting, suicide among AIDS patients is more 
common than death certificates indicate.  The debate over 
assisted suicide focuses on how rational the suicides have been. 
Compassion in Dying insists that those who apply for help in 
dying comply with a lengthy procedure.
      
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