                     AIDS Daily Summary 
                      February 5, 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 Clearinghouse, or any other organization. Reproduction
of this text is encouraged; however, copies may not be sold, and the CDC
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Copyright 1996, Information, Inc., Bethesda, MD


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"Drugs too Pricey for Patients?"
"Can Post-Traumatic Stress Arise From Office Battles?"
"Repeal Sought of HIV Provision in Defense Bill"
"U.S. Experts Warn of Honduras AIDS Risk to Women"
"Congress Takes Steps to Speed FDA Approval of New Medicine"
"Healing a Wound Over AIDS"
"Case Contends AIDS Infection by Dental Tools"
"Toward an Understanding of the Correlates of Protective Immunity
to HIV Infection"
"Was HIV Present in 1959?"
"Antibiotic-Resistant Bacteria Take Hold in California"
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"Drugs too Pricey for Patients?"
Philadelphia Inquirer (02/05/96) P. A1;  Collins, Huntly
     While new, more powerful AIDS drugs are expected to be approved 
for marketing in the United States in a few months, they may be 
too expensive for the tens of thousands of uninsured AIDS 
patients who rely on special state funds.  Gary Rose, an official 
at the AIDS Action Council, said the high cost of these new drugs
may create a two-tiered system, separating those who can afford 
private insurance and those who cannot.  The Clinton 
Administration has said it will try to increase federal funding 
for AIDS drugs, but has not yet received support from Congress.  
Last week, scientists reported positive results for new drugs 
classified as protease inhibitors.  The first of this new class 
costs about $5,800 a year, and the new studies show that a 
combination of such drugs is most effective against the virus.  
Patients may have to take these medications for many years.  The 
federal Agency for Health Care Policy estimates that the average 
lifetime cost of treating an AIDS patient is more than $119,000.
      
"Can Post-Traumatic Stress Arise From Office Battles?"
Wall Street Journal (02/05/96) P. B1;  McMorris, Frances A.
     Post-traumatic stress disorder is most commonly associated with 
combat flashbacks experienced by Vietnam veterans.  It is now 
being raised in job discrimination cases, medical malpractice and
other liability claims.  One example of the condition is in the 
case of Raymond Machesney, a former priest who learned his doctor
had wrongly identified him as HIV-positive after seven years of 
having undergone treatment for the disease.  In his 
medical-malpractice suit, Machesney sought damages for 
post-traumatic stress disorder.  The doctor's lawyer argued, 
however, that the disorder could have been caused by other 
factors, such as leaving the priesthood.  A federal jury in 
Washington, D.C., awarded Machesney $4.1 million last year, 
although a judge later reduced the amount to $2 million.
      
"Repeal Sought of HIV Provision in Defense Bill"
Baltimore Sun (02/03/96) P. 5A
     A bipartisan coalition of U.S. lawmakers is seeking to repeal a 
provision in the Defense authorization bill to force the 
discharge of all military members with HIV.  Rep. Peter 
Torkildsen (R-Mass.) said he has filed a bill to repeal the ban, 
on which lawmakers would need act within six months, at which 
time the discharges would go into effect.  Rep. Robert Dornan 
(R-Calif.) sponsored the discharge provision, saying that people 
in the military with HIV cannot be sent abroad or to combat, and 
should not be allowed to serve.  On Friday, Dornan said that as 
many as half the service members with HIV are former drug 
addicts.
      
"U.S. Experts Warn of Honduras AIDS Risk to Women"
Reuters (02/03/96)
     Honduras has been the Central American nation hardest hit by the 
AIDS epidemic, and U.S. researchers say that the country may be 
suffering from a particularly potent strain of HIV that is 
especially dangerous to women.  The Health Ministry said that 
7,664 Hondurans have been infected with HIV since 1985, and 995 
have died.  That represents 60 percent of the total number of 
people with HIV in all of Central America.  The rate of women 
infected is unusually high at 36 percent.  Researchers from 
Harvard University and the World Health Organization have been 
taking blood samples, especially from HIV-infected women, said 
Winslow Klaslala, a professor at the University of Miami.  The 
scientists will look for HIV sub-type B, which is known to be 
highly aggressive and adaptable.
      
"Congress Takes Steps to Speed FDA Approval of New Medicine"
Washington Times (02/05/96) P. A6
     Hearings on an FDA reform bill sponsored by Sen. Nancy Kassebaum 
(R-Kan.) are slated for February.  The new bill would require the
FDA to shorten review times, tell pharmaceutical companies 
exactly how to test new medicines, and farm out its work to 
private drug-review companies if it cannot meet the new approval 
deadlines of four months for "priority" therapies for fatal or 
untreatable diseases and six months for other products.  The bill
also permits some therapies approved for sale in certain foreign 
countries to be marketed in the United States before receiving 
official FDA approval.  Under this provision, drug firms could 
petition for automatic sale if the FDA has not reviewed a therapy
within six months.
      
"Healing a Wound Over AIDS"
Miami Herald (02/02/96) P. 1B;  Jacobs, Sandra
     Haitian and American doctors addressed the controversial AIDS 
stigma attached to Haitians in the early 1980s at a conference on
Thursday.  Thirteen years ago, U.S. researchers held meetings 
with Haitian doctors who felt their country was being stigmatized
as a source of the AIDS epidemic, before enough about the disease
was known.  Now that scientists know how HIV is spread, theories 
about genetic disposition and geography have been debunked as 
explanation of early cases of AIDS among Haitians.  In the early 
1980s, Haitians were identified in the United States as a 
high-risk group and they were banned from donating blood.  The 
Haitian risk category was removed in 1984, but the federal 
government was criticized for temporarily banning 200 
HIV-positive Haitian refugees from entering the U.S.  Many 
Haitians also felt they never received an apology from the U.S. 
government or their medical colleagues.
      
"Case Contends AIDS Infection by Dental Tools"
Boston Globe (02/02/96) P. 19;  Roche, B.J.
     James Sharpe, a convenience store owner in Massachusetts who 
learned he was HIV-positive six years ago, is bringing a medical 
malpractice suit against his dentist, alleging that he was 
infected by contaminated dental equipment.  The lawsuit says that
the dentist had ignored recommendations by dental associations 
and the federal government to heat-sterilize, or autoclave, his 
instruments between patients.  Sharpe's lawyer says he will 
present research that shows the virus can survive in the 
lubricants used in the equipment, if it is not sterilized by 
heat.  Richard H. Price, a spokesman for the American Dental 
Association, warned that such findings can cause an undue panic 
in the public.  He says that a 1995 survey found that 92.5 
percent of  dentists heat-sterilize their instruments between 
patients.
      
"Toward an Understanding of the Correlates of Protective Immunity
to HIV Infection"
Science (01/19/96) Vol.271, No.5247, P. 324;  Haynes, Barton F.; 
Pantaleo, Giuseppe;  Fauci, Anthony S.
     Three patterns have been found in people with HIV.  About 10 
percent, called "rapid progressors," develop AIDS within 2 years 
to 3 years after infection.  About 5 percent to 10 percent are 
"nonprogressors," and are asymptomatic after 7 years to 10 years.
The remaining HIV-infected population consists of "typical 
progressors," who are expected to develop AIDS within about 10 
years of infection.  Nonprogressors show an immune response to 
HIV that is quantitatively and qualitatively better than the 
immune response in rapid progressors.  Recent studies have shown 
that the viral load established early in the infection predicts 
how the disease will develop and that a small viral load predicts
long survival.  Still unknown is whether a small viral load in 
nonprogressors is associated with an HIV strain that has low 
pathogenicity, or an especially effective immune response, or 
both.  Another issue the authors say merits further study is the 
role of a person's genetic background in determining the rate of 
progression of AIDS.
      
"Was HIV Present in 1959?"
Lancet (01/20/96) Vol.347, No.8995, P. 189;  Bailey, Andrew S.;  
Corbitt, Gerald
     In a letter to the editor of the journal Lancet, Andrew Bailey 
and Gerald Corbitt, virologists at the Manchester Royal 
Infirmary, respond to an article by T. Zhu and D. Ho in the 
journal Nature which questioned whether HIV was actually found in
a man who died in 1959 with AIDS-like symptoms, as Bailey and 
Corbitt published in the Lancet in 1990.  They agree that the 
virus found was modern and that the tissue was probably 
contaminated in their lab, but they take issue with how Ho dealt 
with the problem.  Bailey and Corbitt say they were surprised 
when Ho suggested that the tissue samples they provided to him 
were taken from two different people.  Further tests of their 
original samples and of new samples taken from the body, Bailey 
and Corbitt say, have not substantiated this claim.  They do 
conclude that Ho's research agrees with their own finding that 
the virus is modern and was a result of contamination.  However, 
they say that the patient's symptoms at his death would today "be
regarded as strongly indicative of underlying HIV infection. If 
this was not the case, what was the underlying cause of this 
man's disease and subsequent death?"
      
"Antibiotic-Resistant Bacteria Take Hold in California"
American Medical News (01/15/96) Vol.39, No.3, P. 18
     A bacterium that is resistant to antibiotics that has killed 
people in hospitals on the East Coast seems to be taking hold in 
California and is responsible for one death.  
Vancomycin-resistant enterococcus (VRE) is not a problem for 
people in good health, but can cause life-threatening infections 
in people with weakened immune systems, like AIDS patients.  
There are no drugs to treat the bacteria.  "We're going back to 
the preantibiotic era," said Dr. David Stevens, chief of 
infection control at Santa Clara Valley Medical Center.  Overuse 
of antibiotics in the past 50 years has been blamed for the 
ability of some strains of organisms to develop resistance to 
them.  VRE spreads through direct contact, and could spread 
easily in a hospital or nursing home if care-givers are not aware
of it.  Soap kills the bacteria, so health care providers are 
taking more care to wash their hands to combat infection.
      
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