                     AIDS Daily Summary 
                       March 16, 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 1995, Information, Inc., Bethesda, MD


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"Storing One's Own Blood for Surgery Strains Medical Resources, 
Study Says"
"Mandatory Disclosure Would Create False Security"
"Women Who Are Pregnant Should Be Routinely Tested"
"AIDS Project Swaps 75,000 New Syringes"
"Three Drugs Found Effective Against AIDS Infection"
"Biocontrol Hyperthermia Treatment Succeeds"
"Bars, Liquor Stores Closed Down in Djibouti"
"NIH Research Agenda"
"HIV in the Elderly: Not Just from Transfusion"
"Has AIDS Won?"
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"Storing One's Own Blood for Surgery Strains Medical Resources, 
Study Says"
Wall Street Journal (03/16/95) P. B6;  Rundle, Rhonda L.
     The increasingly popular practice of autologous donation--or 
banking one's own blood for possible use during surgery--is 
expensive, strains medical resources, and offers little benefit 
to society, a new study concludes.  The study, published in this 
week's New England Journal of Medicine, analyzes a medical 
procedure that many blood banks and physicians began to promote 
in the early 1980s after stories spread about people who became 
infected with HIV through a blood transfusion.  In light of the 
improvements in the safety of the blood supply over the past 
decade, however, autologous blood may be a poor use of scarce 
medical resources, according to Dr. Jeff Etchason, the study's 
lead author, a staff physician at the West Los Angeles Veterans 
Affairs Medical Center.  An editorial that accompanies the study,
however, says that "the peace of mind that comes from having 
control over the risk of AIDS and other potentially harmful 
effects of transfusion is immeasurable."  The study concludes 
that the incremental cost-effectiveness of autologous blood, 
expressed as dollars per quality-adjusted year of life saved, 
ranged from $235,000 to more than $23 million.
      
"Mandatory Disclosure Would Create False Security"
Philadelphia Inquirer (03/15/95) P. A13;  Patrick, Al;  Gold, 
Marla
     When it comes to celebrities with AIDS, the medical facts are 
often a sidebar to the main story about how they contracted HIV, 
write Al Patrick and Marla Gold in the Philadelphia Inquirer.  
The best way to protect oneself from the disease is to act as if 
everyone else is potentially infected.  Mandatory disclosure for 
people with AIDS would be the worst way to fight the disease, 
contend Patrick and Gold.  If all people who knew they were 
HIV-positive disclosed their status, they write, it would only 
promote a false sense of security.  Many people do not know they 
are infected, which leads to the issue of mandatory testing.  
Greg Louganis, for example, pushed the bounds of human resilience
when he completed the dive during the Olympics after having hit 
his head on the diving board, and won another gold medal, despite
the incredible pressure of the competition and his HIV infection.
The thought of losing another athlete--another human being--to 
AIDS is overwhelming, but the thought of continued discrimination
and irresponsibility despite the 400,000 Americans with AIDS and 
the thousands more who have HIV is enraging, conclude the 
authors.
      
"Women Who Are Pregnant Should Be Routinely Tested"
Philadelphia Inquirer (03/15/95) P. A13;  Caplan, Art
     There are three compelling reasons for the mandatory HIV testing 
of pregnant women, writes Art Caplan in the Philadelphia 
Inquirer.  Studies have shown that AZT, when taken early during a
pregnancy, can reduce by two-thirds the number of HIV-infected 
newborns.  Quick treatment with AZT just after birth may prevent 
transmission.  Another route through which a mother, who does not
know she is HIV-positive, can transmit HIV to her child is by 
breastfeeding.  About 4 million women give birth in the United 
States each year.  Testing each of them for HIV would cost about 
$100 million, but the cost of caring for one baby with HIV is, 
conservatively, $35,000 per year.  As those children live an 
average of 10 years, each child born with HIV represents $350,000
in health-care costs.  It, therefore, makes sense to spend the 
money mandatory testing would require.  The antidote for the fear
and the stigma associated with HIV and AIDS, and the way to be 
sure that lives are saved, is to require that every pregnant 
woman receive HIV testing and counseling, concludes Caplan.
      
"AIDS Project Swaps 75,000 New Syringes"
Milwaukee Sentinel (03/14/95) P. 5A;  Manning, Joe
     Seventy-five thousand used syringes were exchanged for clean ones
during the first year of Lifepoint, the Milwaukee AIDS Project's 
needle exchange program, according to figures released by the 
organization on Monday.  Lifepoint had expected to exchange only 
about 41,000 needles by this point, said Doug Nelson, executive 
director of the AIDS Project.  Nelson said the program tries to 
get intravenous drug users into treatment for their addictions.  
Until they decide to seek treatment, however, Lifepoint attempts 
to keep the addicts from becoming infected with HIV.  Two 
full-time needle exchange workers reached more than 4,000 users 
during the first year, Nelson said.  The majority of the 
participants in the program are from Milwaukee, but intravenous 
drug users from other cities and rural areas of Wisconsin are 
also exchanging needles.  The program has also helped drug 
addicts learn about HIV, how drug use increases the risk of 
becoming infected, and how they can avoid the risks of 
contracting the disease and transmitting it to others.
      
"Three Drugs Found Effective Against AIDS Infection"
Reuters (03/15/95)
     In a recent study, Dr. Samuel Bozzette and colleagues at the 
University of California at San Diego found that dapsone, 
aerosolized pentamidine, and a combination of trimethoprim and 
sulphamethoxazole were each effective against AIDS-related 
pneumonia.  The study, which was co-authored by Dr. William 
Powderly of Washington University, is published in Thursday's New
England Journal of Medicine.  Powderly conducted a second trial 
comparing fluconazole and clotrimazole lozenges.  He found that 
fluconazole was three times more effective against AIDS-related 
fungal infections than the clotrimazole.
      
"Biocontrol Hyperthermia Treatment Succeeds"
Reuters (03/15/95)
     On Wednesday, Biocontrol Technology Inc. announced that its IDT 
Inc. subsidiary, in conjunction with HemoCleanse Inc., had 
successfully treated 10 people with AIDS in its second Food and 
Drug Administration (FDA)-approved clinical trial of a whole-body
extracorporeal hyperthermia treatment.  Each patient received two
treatments within four days, which, according to the company, was
the first time that two hyperthermia treatments had been 
administered on a single patient in so short a time span.  
Biocontrol said that all 10 patients did remarkably well during 
and immediately after the treatments.  HemoCleanse's BioLogic-HT 
system, which is used to monitor and regulate body chemistries 
during the procedure, performed above expectations.  In a total 
of 30 treatments, the BioLogic-HT system had eliminated the side 
effects.  Biocontrol said it intends to apply to the FDA, under 
the agency's expedited review process for AIDS, to market the 
BioLogic-HT system, which is made by HemoCleanse.
      
"Bars, Liquor Stores Closed Down in Djibouti"
Reuters (03/15/95)
     In a drive against alcoholism, drugs, and AIDS, approximately 85 
bars and shops selling alcohol in Djibouti closed on Wednesday 
under government orders.  The government ordered the stores to 
close after allowing a six-week reprieve at the request of their 
Ethiopian owners to give them more time to enter other 
businesses.  Interior Ministry Secretary-General Ali Mallow said 
the move was an attempt to protect young people from alcoholism, 
drugs, and AIDS, as well as to curb prostitution, which was 
banned in 1979.
      
"NIH Research Agenda"
American Medical News (03/06/95) Vol. 38, No. 9, P. 12
     As one step toward a major re-examination of AIDS research 
priorities, William E. Paul--the director of the Office of AIDS 
Research (OAR) at the National Institutes of Health--in February 
appointed molecular biologist and cancer researcher Dr. Arnold 
Levine to head a panel of scientists who will develop a new 
research agenda.  At last summer's International Conference on 
AIDS, Paul said that while a great deal of money had gone into 
clinical trials, not enough had been spent on basic research.  
"The OAR is committed to a strategy that allows both a 
rededication to fundamental research on HIV and AIDS, and the 
maintenance of efficient efforts in the spheres of drug 
discovery, clinical trials, vaccine development, and behavior 
modification," Paul wrote recently in Science magazine.
      
"HIV in the Elderly: Not Just from Transfusion"
AIDS Clinical Care (03/95) Vol. 7, No. 3, P. 25
     Two small studies add to the data known about the small, but 
growing population of HIV-infected people who are aged 60 or 
older.  The first study analyzed the charts of 27 men and 5 women
ages 60 to 83 at an inner-city Atlanta hospital.  In 15 of the 20
cases where the source was known, HIV was transmitted through sex
or injection drug use.  Transfusion was the cause in only three 
cases.  Diagnosis was frequently delayed because the patients 
were not considered to be at risk for HIV.  The second study 
looked at serum samples taken from 170 elderly patients who died 
between 1992 and 1993 at Harlem Hospital in New York.  The 
researchers found evidence of HIV infection in 6 percent of the 
men and 9 percent of the women.  Once again, most or all of the 
cases were unsuspected, and many of the patients had no known 
risk factors.  Clinicians should be aware of the potential for 
HIV in the elderly and should take a sexual history regardless of
age.  There is evidence that older sexually active 
people--including those with HIV risk factors--have much lower 
rates of condom use than younger people.
      
"Has AIDS Won?"
New York (02/20/95) Vol 28, No. 8, P. 31;  Horowitz, Craig
     There is increasing dissatisfaction among those in the AIDS 
activist and scientific communities.  "I've essentially had it," 
said Peter Staley, one of the country's leading AIDS activists.  
"I get no gratification or inspiration from this work anymore.  
Every month it's a new battle, and the battles now are usually 
intra-community."   And although there have been AIDS-related 
medical advances, there has been an amazing lack of progress.  A 
vaccine is believed to be years away.  The four drugs approved by
the Food and Drug Administration for treatment are all toxic and 
none works particularly well.  "Here's one little virus that has 
had over a billion dollars a year spent on it for years by the 
government and who knows how much by the pharmaceutical industry.
So there is the sense that we should be farther along," said 
Nobel laureate Dr. David Baltimore of MIT.  Some $1.3 billion of 
the National Institutes of Health's (NIH) $11 billion budget is 
devoted to AIDS research.  Many people, however, have 
questioned--in both practical and philosophical terms--the way 
the money is spent.  Dr. William Paul, director of NIH's Office 
of AIDS Research, recently called for a "re-examination of the 
entire NIH AIDS research endeavor," and said he was forming a 
commission that over the next year will rethink AIDS research.
      
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