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Patients Over 45 Are Often the Forgotten AIDS Victim *
Los Angeles Times (06/20/93), P. A14
Neergaard, Laura

It has taken 12 years of the AIDS epidemic for the nation to
begin to recognize that the malady is affecting older Americans
and the even older relatives who care for them. Judy Fink of
the American Association of Retired Persons, which is
implementing an AIDS education effort for its members, said,
"It's a multi-generational crisis and we've been slow to
realize that." Among the 289,320 AIDS cases reported by April,
18 percent were among people aged 45 or older, and the disease
is growing fastest among that population. However, support
groups, education programs, and other social services targeted
at older AIDS patients are uncommon, and even doctors neglect
to question or test older patients for HIV, according to
experts. Dr. Christopher Allers, an Atlanta gerontologist,
said, "They've been largely ignored, and that means they're
suffering more and probably spreading the virus more." Although
new cases among young people have steadily declined in the last
three years, those among older people are rising between 8
percent and 10 percent annually, said Dr. William Adler of the
National Institutes of Health. Also, medical advances that
extend AIDS patients' lives are pushing up the median age of
AIDS patients every year, said Adler. Since the nation's
primary AIDS caregivers are often the patients' parents, the
older the patient is, the older and sicker the parent can be,
said Dr. Allers. Dr. Wayne McCormick of the University of
Washington said many nursing homes refuse AIDS patients.
Because of this, the next step to take is to ensure that
general practitioners avoid the myth that the elderly are
immune from AIDS, said Drs. McCormick and Allers.


BioChem Sees Profit in Multi-Drug AIDS Approach *
Toronto Globe and Mail (Canada) (06/18/93), P. B6
Gibbon, Ann

BioChem Pharma Inc. of Montreal, Canada, announced that the
research revealed at the Ninth International Conference on AIDS
in Berlin, which stated that combination therapy is the best
approach to treat AIDS, will benefit its own product, 3TC.
BioChem President and CEO Francesco Bellini said that the
company is in the final stages of developing 3TC and the
results from the conference indicate a larger potential market
for the drug. The consensus reached at the AIDS conference was
that a multi-drug approach was the most effective way to treat
AIDS. But it was undisclosed whether it is the optimal
technique for treating asymptomatic HIV-positive patients.
Therefore, BioChem's Phase II/III clinical trials on 820
patients involve administering 3TC alone and in combination
with other drugs to patients with no symptoms. But for AIDS
patients, 3TC is being tested only in combination with other
drugs. The drug has shown an apparent ability to reverse AZT
resistance in tests, so "we think 3TC will be an ideal
candidate" for combination therapy, said Gervais Dionne,
president of the company's BioChem Therapeutic Inc. unit. Other
benefits to combination therapy were noted by the company.
Adverse effects of a particular drug used in a mix of therapies
might be lessened because of the smaller doses likely to be
used, said Dionne. BioChem expects to conclude its clinical
trials of 3TC for AIDS by the end of the year and submit the
findings to regulatory authorities, including U.S. and Canadian
governments.


Late-Starter Vietnam Hopes to Beat AIDS Threat *
Reuters (06/20/93)
Rogers, John

(Hanoi, Vietnam) Although Vietnam is experiencing an emergence
of AIDS cases, experts say that the country still has a chance
of curbing the disease's spread, although it may require a
change in attitude. The growth in confirmed cases of HIV has
health-care workers in Vietnam remembering the beginnings of
Thailand's epidemic, which started just five years ago.
However, they say that a strict approach by authorities could
worsen things. Police are gathering people seen as the chief
cause of the epidemic--primarily drug addicts and also
prostitutes--and treating them in rehabilitation centers. This
action, as well as official calls for mandatory HIV tests of
foreign residents and a ban on HIV-positive people marrying,
has disturbed AIDS organizations. They feel that putting blame
for the disease on people in the margins of society will do
nothing to cease its spread. Vietnam's national AIDS committee
and the United Nations Development Program said in a recent
report, "HIV infection is not and should not be considered a
criminal offense." Vietnam had only 12 confirmed HIV-positive
cases at the start of this year, but now has 490, along with
nine cases of full-blown AIDS. But foreign AIDS experts claim
that cases should be multiplied by 300 for a more realistic
estimate of 147,000 HIV-positive people living in Vietnam. The
numbers of cases have escalated because random HIV testing has
been replaced by target testing of IV-drug users. Foreign
experts, however, feel that Vietnam still has time to fight
AIDS by making people more aware of the disease and how it
spreads.


Chinese Medicine Can Help Some AIDS Patients *
United Press International (06/20/93)
Wasowicz, Lidia

(San Francisco) A Chinese treatment may provide relief to some
AIDS patients, according to reports released by researchers
attending HIV, AIDS and Chinese Medicine: A First International
Conference at San Francisco State University. The researchers
said that as more and more people become infected with HIV, and
there is no cure or vaccine in sight, AIDS patients are seeking
alternatives. Many are resorting to traditional Chinese
medicine because it appears to be especially effective in
maintaining health during the early stages of HIV infection.
Dr. Nancy Harris, aJSan Francisco General Hospital AIDS
specialist and research director of Quan-Yin Healing Center in
San Francisco, said that Chinese medicine can minimize the
effects of opportunistic infections and reduce the adverse
effects of western drugs. Harris said, "... I have seen it
tremendously reduce the side effects of such conventional
medications as AZT--nausea, vomiting, anemia--and
constitutional symptoms that can devastate the quality of life-
-feeling lousy, night sweats, diarrhea, listlessness, fatigue,
the wasting syndrome, sleep problems." Among the 125 AIDS
patients seeking relief at the American College of Traditional
Chinese Medicine in San Francisco, nearly all are also
receiving western medical care, said clinical research director
Howard Moffet. The clinic has had good results with treating
chronic diarrhea with a mix of herbs and acupuncture, he said.
Harris said that by adding more drugs to fight AIDS, Chinese
medicine can make AIDS a chronic rather than terminal illness.


Polydex Announces Filing of Patent for Potential
New AIDS Drug *
Business Wire (06/18/93)

(Boynton Beach, FL) Polydex Pharmaceuticals Ltd. revealed on
Friday that it filed a patent for a potential new AIDS drug in
the United States, which will be followed by a similar filing
in Canada. The new drug involves the conjugation of dextran or
dextran sulphate with AZT. Independent laboratory findings
confirm that the new complex of AZT and dextran performs in
vitro at a comparable level with AZT against HIV cells. In
addition, it is believed that a significant reduction in
toxicity occurs because dextran/dextran sulphate serves as a
slow release mechanism for AZT, a factor that may reduce the
side effects of AZT. More tests are being conducted and results
are expected within the next four weeks.


Indonesia Steps Up Campaign Against AIDS *
Reuters (06/18/93)

(Jakarta, Indonesia) A new anti-AIDS campaign in Indonesia will
require blood donors to undergo HIV testing before giving
blood, and people considered at high risk for the virus will be
encouraged to be tested, the Jakarta Post reported on Friday.
Health Minister Suyudi was quoted as telling a House of
Representatives Commission on health that the government would
also establish a national body to coordinate its renewed anti-
AIDS efforts. Only 140 cases of full-blown AIDS or HIV
infection have been reported in Indonesia. However, health
officials say the country's large sex industry and prevalent
opposition to condom use could make the real number of cases as
high as 20,000, out of a population of 183 million.
Approximately 150,000 people considered at high risk, including
prostitutes, gay men, night-club and massage parlor hostesses,
prison inmates, truck drivers, and sailors, would be urged to
be tested under the new measures, said Suyudi. Also, about
700,000 regular blood donors will be tested. The World Bank
commended Indonesia for its quick response to the epidemic in
its annual report but added that the country appeared ready to
enter the epidemic's growth phase. It said more money should be
spent on prevention and changing attitudes towards the disease.


Grief Re-Examined: The AIDS Epidemic Is Confounding
the Normal Work of Bereavement *
U.S. News & World Report (06/14/93) Vol. 114, No. 23, P. 81
Horn, Miriam

Survivors of the AIDS epidemic are inventing new rituals and
renewing old ones to honor the dead, and psychiatrists are
finding that social activism may be the best way to heal from
the loss. The Ackerman Institute in New York has discovered
that bereaved family members frequently mourn in secrecy. Grief
counselor Mardi Fritz said that for those who live in a world
dominated by HIV, "by the time you close the circle of grief
for one person, four others or 10 others have died."
Conventional individual counseling is of little help in the
wake of such devastation. Therefore, those dealing with
multiple losses are turning to a far older human response to
loss--the ritual of the tribe. Due to the various subcultures
in the United States, rituals long abandoned are now being
reclaimed by those touched by AIDS. Peter Lynch, professor of
death and dying at the University of Connecticut, said, "Death
brings a sort of chaos. People don't know what to do or say or
wear. Rituals restore order, provide a script for those who
have lost the ground below their feet." But even more
therapeutic is transforming the grief into social and political
action. A recent study of gay men in the American Journal of
Psychiatry found that while there was vast evidence of profound
yearning and attachment, there was little of the kind of
paralyzing depression shown earlier in the epidemic.

Poland: HIV Testing for Inpatients? *
Lancet (Great Britain)
(06/12/93) Vol. 341, No. 8859, P. 1527
Rich, Vera

Polish physicians and medical ethicists met last month to
discuss whether or not to introduce mandatory HIV testing for
all hospital patients. Medical pay-scales in Poland allow for a
bonus for staff working with HIV-positive patients, but the
staff cannot demand an HIV test. Ministry of Health
plenipotenitary on AIDS, Dr. Krzysztof Dziubinski, said some
hospitals offer voluntary tests, and some have made testing
obligatory by refusing to operate on patients who decline an
HIV test. But controversy has surrounded the mandatory testing
issue because the bonus system suggests that the names of known
HIV patients have to be passed on to hospital administrative
staff. The predominant argument over compulsory testing is that
of cost. Prof. Andrzej Stapinski of the Warsaw Institute of
Venerology said the exorbitant amount of money required to test
every inpatient would be unnecessary because the risk of
contracting HIV during an operation is so low that it cannot be
reduced much more. However, several doctors in Poland do not
agree. There is a significant degree of misunderstanding, even
in medical professions, about the risks of HIV. A survey
recently conducted in the town of Sosnowiec, in southern
Poland, found that 40 percent of doctors are unaware than HIV
is not spread by mosquito bites, or else are doubtful about the
answer; 30 percent believed that casual contact with HIV
carriers poses a risk; and 33 percent favored isolating all
carriers.


India: HIV-Positive Blood Donors *
Lancet (Great Britain) (06/12/93) Vol. 341, NO. 8859, P. 1527
Mangla, Bhupesh

The Indian government is reconsidering its current blood
donation policy of discarding HIV-positive blood while not
informing the respective donors about their HIV status. Some
feel that the policy should be kept intact because it promotes
confidentiality, avoids the stigmatization of people with the
disease, and because of the lack of counseling facilities. But
critics of the policy contend that HIV-positive blood donors
should be notified so that they can take the necessary
precautions of preventing its spread and obtain appropriate
medical assistance. Dr. Badri Nath Tandon, former professor of
gastroenterology at the All India Institute of Medical Sciences
and a prominent health planner, believes that the shortage of
counselors is a poor excuse. "India has a large number of
doctors and social workers who can serve as counselors. Why are
we shying away from building up a counseling network with blood
banks?" he asked. But Dr. Jai Narain, team leader of the World
Health Organization's Global Program on AIDS at the regional
office in New Delhi, feels that the purpose of blood banks is
to  guarantee blood safety and not offer counseling or
intervention.  He is fearful that if people practicing high-
risk behavior were  to use blood banks to learn their HIV
status, the resulting  increase in the number of donors in the
latency period would  endanger blood safety. The Indian Council
of Medical Research  (ICMR) surveillance program in 1985 had
screened 1,730,878 people  by May, 1993. Among the 12,066 who
were found to be  HIV-positive, 15 percent were blood donors--
the second largest  HIV-positive group after the
"heterosexually promiscuous" group,  who accounted for 43
percent of the HIV-positive population.


June 22, 1993

Gays Honour AIDS Victims: Toronto Has Largest Number
of Cases of the Fatal Illness in Canada *
Toronto Globe and Mail (Canada)
(06/21/93), P. A8
Kyvrikosaios, Deborah

On Saturday, the homosexual community in Toronto revealed an
AIDS memorial to honor people who have died of the disease. "No
one wanted to admit that people were dying of AIDS; the names
of the people were never heard," said Robert Lavery, organizer
for the AIDS Memorial Committee. "The memorial will break the
silence and make people more aware of how many there have
been," he added. Of the eight concrete pillars now standing in
Cawthra Park, five bear the inscription of 1,012 names of some
of the AIDS patients in Canada and the United States who have
died. The other pillars remain empty, but names continue to be
submitted to the committee from family and friends. Toronto has
the highest rate of AIDS cases in Canada, and over the past
year there has been a steady rate of new cases in the city,
according to the chairman of the provincial advisory committee
on AIDS, Dr. Alex Klein. Between 1982 and May of this year,
there have been 1,661 men, 19 women, four boys, and one girl
diagnosed with AIDS in Toronto. Dr. Klein said Sunday that it
is a constant struggle to find physicians who will treat AIDS
patients. He said he has witnessed a new wave of the disease
recently affecting younger gay men. "We had this blinkered view
that this was happening in San Francisco and New York, but it
wasn't until we saw the staggering numbers in the community
that we realized the extent of it." Dr. Klein added that he is
surprised because it is the young whom should be receiving
messages of AIDS awareness from the educational system.


Critical Care Specialists Determine Decreased Need for Blood
Transfusions in High Risk Patients *
Business Wire (06/21/93)

(Anaheim, CA) Blood transfusions for high-risk cardiac patients
may not be needed as frequently as was thought in the past,
according to a study conducted by a team of Yale University
School of Medicine researchers. Allowing the blood count to
decrease to a low level without transfusing increases the
strain on the heart. However, in recent years, patients and
doctors have been very concerned about the potential overuse of
blood transfusions, primarily as a result of the risks
associated with HIV and hepatitis. The study is published in
the June 1993 issues of "Critical Care Medicine," which is the
official scientific journal of the Society of Critical Care
Medicine (SCCM). It states that the traditional threshold blood
level which prompts the need for blood transfusion after
surgery is a hematocrit (the percentage of red cells in the
blood) of 30 percent and that this level is likely higher than
necessary. After researching a sample of high-risk cardiac
patients, scientists concluded that a hematocrit of 28 percent
is probably sufficient. While the risk of contracting HIV
through a transfusion is probably less than one case per
100,000 units of transfused blood, several patients fear
receiving a transfusion. The study indicates that more
efficient use of transfusions will lessen the risk of
transmission of HIV and hepatitis, in addition to lowering the
cost of health care.


Free Brochure on Infection Control Offered to Ohio Consumers *
PR Newswire (06/21/93)

(Columbus, OH) The Ohio Dental Association (ODA) has been
aggressively educating the public on the safety of dental
offices throughout the state for the past several years. The
Ohio State Dental Board was the first health care board in the
country to require its licensees to follow extensive infection
control policies that require dental health-care workers to
wear disposable gloves when placing fingers into the mouth of a
patient. If dental workers fail to comply with the rules, they
can lose their licenses. Also, heat sterilization or
disinfection is required for all instruments. "These infection
control techniques practiced by Ohio dentists are endorsed by
the Centers for Disease Control as the best way to prevent
exposure to infectious diseases, including hepatitis B and HIV-
-the AIDS virus," said ODA President R.E. "Jim" Snelson. The
infection control regulations are now also part of the
Bloodborne Pathogens Standard enforced nationwide by the
Occupational Safety and Health Administration (OSHA). The CDC
states that universal precautions mean treating each patient as
if there were a possibility of transmitting an infectious
disease. Snelson said to consumers, "No one in this state is
more concerned about the safety of dental offices than your
dentist and members of the dental team. Let your dentist know
your concerns and give him or her the opportunity to inform you
of the infection control procedures practiced in their office."
The ODA encourages concerned consumers to call the association
to receive a free brochure entitled, "Facts About: AIDS and
Infection Control."


U.S. Urged to Help States Treat Haitians With HIV *
Reuters (06/18/93)

(Washington, DC) A total of 23 members of the House of
Representatives introduced a bill on Friday that would require
$1.8 million from the federal government to be given to New
York, Florida, and Massachusetts in order to treat the HIV-
positive Haitians recently flown there. A federal judge ordered
the government to admit 158 HIV-positive Haitian refugees held
at the U.S. Naval base at Guantanamo Bay, Cuba, into the United
States. The Clinton administration subsequently decided not to
appeal the ruling. The emergency appropriations bill would
provide Florida with $1.1 million, New York with $457,500, and
Massachusetts with $274,500.


Rural AIDS *
Associated Press (06/18/93)
Davis, Amanda M.

(Kansas City, MO) A three day AIDS conference that began
Thursday addressed the issues of prevention and care of AIDS
patients in rural areas and small cities. The Third Annual
Hidden Epidemic Conference, sponsored by the Rural AIDS Network
and the U.S. Public Health Service, involved about 200 people
from 18 states. The panelists said that outside of big cities,
people dealing with AIDS or HIV have less access to everything,
from doctors to money. Workshops conducted at the conference
addressed building health care teams in rural areas, rural
housing, benefit and investment counseling, and targeting
sexually active gay men in small towns. "Finding medical care
providers is our first big obstacle. Sometimes it's their
personal values, or they say their staff would balk, or they
don't take Medicaid," said Liz Hager-Mace, a planner with the
Missouri Bureau of AIDS Prevention. "I try to meet face-to-face
with physicians," said Mary Gray coordinator for Partners in
Care, an AIDS program administered form the University of New
Mexico in Albuquerque. "At least that way I'm not an anonymous
voice on the phone," she added. Although AIDS advocates have
attempted to improve the situation, rural AIDS patients often
are compelled to travel long distances for treatment, said
Hager-Mace. "They often spend more on transportation and hotel
costs ... than what the actual procedure costs."


CDC--TB *
Associated Press (06/17/93)
Neergaard, Lauran

(Atlanta, GA) All tuberculosis patients should be monitored to
ensure that they take their medication, according to new
federal guidelines targeted at fighting the spread of deadly
drug-resistant TB. When a patient doesn't complete a regimen of
treatment, multi-drug resistant strains of TB develop. Such
strains have spread to every region of the United States. The
Centers for Disease Control said that the monitoring strategy
appears to work in New York City, and could save hundreds of
thousands of health-care dollars nationwide. Dr. John Jereb, a
CDC epidemiologist, said treating someone who completes the
regimen costs about $2,000, whereas treating someone who
develops multi-drug resistance can cost $200,000. Jereb
suggested that a doctor or clinic keep the medicine so patients
have to visit, or that the local health department send someone
to patients' homes. Sue Klein of the New York State Health
Department said patients can visit a clinic a few times a week,
have their office nurse observe them, or meet a city-hired
observer on the way to work. In addition, social workers or
observers go to homeless shelters and soup kitchens. She said
that no one has to pay extra for the observation, because
Medicaid covers it and if private insurers refuse payment,
clinics throughout the city provide the service free of charge.


Detection of HIV DNA in Cervical and Vaginal Secretions *
Journal of the American Medical Association (06/09/93)
Vol. 269, No. 22, P. 2860
Clemetson, David B. A.

The presence of HIV DNA in cervical secretions was
significantly associated with oral contraceptive pill use,
cervical ectopy, and pregnancy, write David B.A. Clemetson et
al. of the University of Washington in Seattle. The researchers
studied 97 HIV-positive women attending a sexually transmitted
disease (STD) clinic in Nairobi, Kenya, who completed a
questionnaire and underwent a physical examination and an
evaluation for STDs. HIV DNA was detected by polymerase chain
reaction in 28 (33 percent) of 84 cervical samples and 13 (17
percent) of 77 vaginal samples. The rate of HIV was higher in
specimens from the endocervix than the vaginal wall, and there
was no correlation between presence of virus at the two sites.
The researchers found that cervical HIV shedding was
independently linked with oral contraceptive pill use, cervical
mucopus, and pregnancy. The presence of HIV was found in one
third of cervical samples and one sixth of vaginal samples. In
conclusion, cervical ectopy, OCP use, and pregnancy were all
significantly connected with detection of HIV DNA in cervical
secretions. There was a marginally significant association with
cervical mucopus. The ability to detect factors that increase
the infectivity of women indicates potential anti-HIV
strategies to take for reducing heterosexual transmission of
the virus.


Cardiac Morbidity and Related Mortality
in Children With HIV Infection *
Journal of the American Medical Association (06/09/93)
Vol. 269, No. 22, P. 2869
Luginbuhl, Lynn M. et al.

The presence of encephalopathy or Epstein Barr Virus (EBV)
coinfection appears to identify a subset of HIV infected
children at especially high risk for adverse cardiac outcomes,
write Lynn Luginbuhl et al. of the Children's Hospital in
Boston, Mass. A total of 81 HIV-positive children who had one
or more cardiac evaluations between 1984 and 1991 form the
study cohort that the researchers used. The first cardiac
evaluation occurred at a median age of 1.5 years, and children
were followed up to a median age of 3.6 years. The study found
that hemodynamic abnormalities and dysrhythmias occurred
frequently. Eight unexpected cardiorespiratory arrests occurred
in seven children (9 percent). Chronic congestive heart failure
was detected in 10 percent of patients. A total of 30 children
died, 10 with significant cardiac dysfunction. As HIV-positive
children progress from AIDS-related complex to AIDS,
significant cardiac problems were more likely to transpire.
Both nonneurologic AIDS and encephalopathy were strongly
associated with most severe cardiac outcomes. But
encephalopathy was the strongest correlate of cardiorespiratory
arrest. In addition, EBV coinfection was the strongest
correlate of chronic congestive heart failure. Cardiac
morbidity and related mortality became more common with
advanced HIV infection. The subset of HIV-positive children
that experience encephalopathy of EBV coinfection should
warrant close monitoring, the researchers conclude.


Absence of True Seroreversion of HIV-1 Antibody
in Seroreactive Individuals *
Journal of the American Medical Association (06/09/93)
Vol. 269,
No. 22, P. 2876
Roy, Michael J. et al.

There is no evidence that an individual who has been confirmed
to be seroreactive to HIV-1 infection by two separate samples
can subsequently become nonreactive, write Michael J. Roy et
al. of the Walter Reed Army Medical Center in Washington, D.C.
The researchers used a retrospective cohort study reviewing the
results of 5,446,161 HIV-1 antibody tests performed on
2,580,974 people from 1985 through 1992. A total of 4,911 were
found to be reactive on two independent samples. Among the
4,911, only six were potential seroreverters. Review of the six
cases revealed that five actually were HIV-seroreactive
patients who had samples from nonreactive individuals
mistakenly attributed to them, while the sixth had a testing
error proven by retesting the discrepant specimen. Errors in
the testing process were found or suspected in another 26
individuals who had not had independent confirmation of
reactivity by a second sample. Another group of 31 uninfected
infants appeared to serorevert as a result of loss of antibody
acquired from their HIV-1-infected mothers. The study provides
powerful evidence to dispel the myth that HIV-infected
individuals may lose antibodies to HIV-1, the researchers
conclude.


June 23, 1993


Canada Watch: Hemophilia Group Demands Action *
Toronto Globe and Mail (Canada) (06/22/93), P. A9

Nearly 30 people protested before the Ontario legislature on
Monday, calling for financial compensation for Canadian
hemophiliacs who contracted HIV from tainted blood products.
Health Minister Ruth Grier subsequently told the group that a
compensation package was expected to be discussed at a meeting
of deputy health ministers on Tuesday in Ottawa.


Canada Watch: New Trial Ordered in HIV Case *
Toronto Globe and Mail (Canada) (06/22/93), P. A

The case of the HIV-positive Canadian woman who contracted the
virus through artificial insemination will be heard in a new
trial. Kobe ter Neuzen, of Victoria, was awarded $883,000 in
medical malpractice damages in 1991 against Vancouver
gynecologist Dr. Gerald Korn. The British Columbia Appeal Court
decided that Dr. Korn's level of care at the time did not
deviate from the norm in his profession. The appeal judges came
close to reversing the jury verdict, but did not overturn it.


Discrimination Said to Be Hindering Fight Against AIDS *
United Press International (06/22/93)

(Geneva) Discrimination against people with HIV or AIDS is
"impeding efforts to slow the spread of the disease," according
to the World Health Organization. Dr. Dorothy Blake, deputy
director of WHO's Global Program on AIDS, said in a statement
that discrimination against people with the disease is
equivalent to "an epidemic of prejudice." She added,
"Worldwide, the human rights of HIV-infected people or people
with AIDS are routinely abused by governments and individuals
alike." Dr. Blake noted that discrimination comes in the form
of quarantines, housing discrimination, inadequate access to
health care, workplace discrimination, interference with the
right to education, restrictions on freedom of movement, and
mandatory HIV testing. Such discriminatory measures "also
undermine public health efforts to control the disease, because
stigmatization can drive those people who would benefit from
counseling and medical care underground," said Dr. Blake. "The
human rights of people with HIV must be respected as this is
one of the best means of safeguarding the health of all people
in each and every country," she said.


AIDS Disclosure *
Associated Press (06/21/93)
Fleeman, Michael

(Los Angeles, CA) An HIV-positive woman was not at fault for
neglecting to disclose her infected status to doctors before
surgery, according to a ruling by a Superior Court judge. Judge
David Horowitz said Jan Lustig had "no duty" to reveal her
medical condition and that government policy allows HIV-
infected people to "maintain their confidentiality of their
medical condition." Lustig, a clinical psychologist from
Vancouver, Wash., was sued by a medical technician who
accidentally pricked herself with a blood-covered scalpel while
treating Lustig after a biopsy and breast-reduction surgery in
1991. Lustig did not tell The Breast Center in Van Nuys,
Calif., before surgery that she had tested positive for HIV.
She signed papers that stated she had no medical problems and
wasn't being treated or observed for any illness, the lawsuit
said. But after the technician's finger was cut during the
removal of stitches, Lustig disclosed she was HIV-positive.
Lustig said she refused to previously reveal her condition for
fear that the center would deny her care. Although the
technician has tested negative for HIV, she says she still
lives in fear of becoming infected. Last February, a jury ruled
that Lustig committed fraud and negligence and intentional
inflictions of emotional distress. It awarded the technician
$120,000 in compensatory and punitive damages. Lustig requested
a new trial or a reduction in the award, but Horowitz refused
to reduce the award and upheld jury verdicts of fraud and
intentional infliction of emotional distress.


Africa--AIDS *
Associated Press (06/21/93)

(Washington, DC) The World Bank revealed on Monday its largest
loan ever provided to fight AIDS and other sexually transmitted
diseases (STDs) in Africa. The bank will give $64.5 million to
Zimbabwe. The effort's first goal is to purchase a sufficient
amount of condoms, which will cost more than $12 million. The
bank has given similar loans to India and Brazil. However, in
Africa, the largest loan previously allotted to fight STDs was
$10 million to Tanzania in 1990. The World Bank predicts that
by the middle of last year, 7 million African adults were
infected with HIV. Also, the World Health Organization claims
that in some large cities of east and central Africa, between
one-quarter and one-third of individuals aged 15-49 are HIV-
positive. In addition to the World Bank's loan, Britain's
Overseas Development Association will lend $11.8 million, and
$8 million will be provided by the Zimbabwe government,
resulting in a total of $87.3 million to fight AIDS and other
STDs in Zimbabwe. Also, more than $36 million will go to treat
HIV-related diseases such as tuberculosis. The project's funds
will be used establish a government program on STDs, help treat
patients most at risk, safeguard the blood supply, contribute
to HIV testing and diagnosis, and protect health-care workers.


Monkey Virus May Lead to Anti-HIV Insights *
Science News (06/12/93) Vol. 143, No. 24, P. 374
Pendick, D.

By using computers to obtain structural information on the
monkey version of HIV, scientists may soon be able to discover
what could inhibit the spread of HIV infection. At a recent
meeting of researchers in Washington, D.C., two teams of
investigators revealed that they have found the structure of a
key protein manufactured by the simian immunodeficiency virus
(SIV), which causes an AIDS-like illness in monkeys. The
protein SIV protease allows the virus to replicate, which then
infects other cells. Robert M. Stroud of the University of
California--San Francisco (UCSF) and Sherin Abdel-Meguid of
SmithKline Beecham Pharmaceuticals in King of Prussia, Pa.,
exhibited three-dimensional, computer-generated portraits of
SIV protease showing the exact locations of its constituent
atoms. Each researcher represented a large group of
collaborators that independently solved the structure. In HIV
infection, a nearly identical enzyme--HIV protease--enables
infected cells to assemble new virus particles. However, no one
has yet shown that disarming HIV protease can cease the
proliferation of the virus that leads inevitably to AIDS.
Structural information on SIV might help resolve whether
disabling the HIV replication protein is a viable therapeutic
approach. Charles S. Craik, a UCSF biochemist who has worked
extensively with HIV protease, said, "Knowing the structure of
SIV gives us a way to develop drugs faster that can then be
tested in monkeys." Also, because SIV and HIV are so similar,
finding a nontoxic drug that stops SIV from reproducing in
monkeys could establish the feasibility of using protease
blocking drugs to combat HIV infection in humans, added Craik.


Risk for Perinatal HIV-1 Transmission According to Maternal
Immunologic, Virologic, and Placental Factors *
Journal of the American Medical Association (06/09/93)
Vol. 269, No. 22, P. 2853
St. Louis, Michael E.

The effectiveness of different interventions in preventing
perinatal HIV-1 transmission may vary according to the stage of
maternal HIV infection at the time of pregnancy, write Michael
E. St. Louis et al. of the Centers for Disease Control in
Atlanta, Ga. The researchers studied 324 HIV-1 infected women
at delivery, with 254 HIV-negative women followed up as
controls in order to evaluate how maternal and obstetric
factors interact to influence mother-to-child HIV transmission.
The highest transmission risk (TR) was linked with maternal p24
antigenemia and maternal CD8 lymphocyte counts of at least
1,800/uL. Of women with CD8 lymphocyte counts of less than
1,800, CD4 lymphocyte counts of less than 600 were a risk
factor. In women with neither high CD8 nor low CD4 lymphocyte
counts, placental membrane inflammation was linked with
perinatal transmission. In women with neither p24 antigenemia,
high CD8 or low CD4 lymphocyte counts, nor placental membrane
inflammation, the transmission risk was only 7 percent. Further
correlates of transmission included maternal anemia and fever,
but not maternal sexually transmitted diseases. The researchers
also found that if the pathogenic agents of placental membrane
inflammation in HIV-positive women can be identified,
antimicrobial prophylaxis for chorioamnionitis might be
considered as a potential strategy to prevent HIV transmission.
This could be more effective during the intervening years when
HIV viremia is less common and placental barrier defects are
more prominent, conclude St. Louis et al.


HIV Provides Tools for Gene Therapy *
Science News (06/12/93) Vol. 143, No. 24, P. 372
Pennisi, E.

Two preliminary trials involving the transfer of genes in AIDS
patients have been recently supported by the National
Institutes of Health (NIH) Recombinant DNA Advisory Committee.
The first protocol will determine the safety of transferring
DNA that will cause the recipients' cells to make HIV proteins-
-in particular, a viral envelope protein. These proteins should
help incite the body's immune response and slow the progression
of disease. Researchers from the University of California--Los
Angeles will inoculate five asymptomatic HIV-positive patients
once a month for three months with a disabled mouse virus that
contains genes for HIV proteins. Five more people will get
injections without the virus and the genes. The researchers
will monitor the number of killer T cells in each volunteer but
will not know which patients received the genes until the study
is completed. If the transferred genes increase the number of T
cells without causing adverse effects or other safety problems,
five additional participants will receive a higher dose of the
genes. The second gene therapy trial will involve about 12 AIDS
patients who are taking AZT. Researchers from the University of
Michigan Medical Center in Ann Arbor will separate and grow T
cells from each patient's blood. The scientists will
genetically alter some cells to produce a mutated form of an
HIV protein called rev. This protein prevents viral
replications and is expected to prolong the life of altered
cells. Other cells will receive an inactivated form of the same
gene, thus making no rev protein. The researchers will then
return the cells to each participant and compare the survival
of the two groups of cells to determine rev's protective
effects.


Drug Therapy: Therapy for Human Immunodeficiency
Virus Infection *
New England Journal of Medicine (06/10/93)
Vol. 328, No. 23, P. 1686
Hirsch, Martin S. and D'Aquila, Richard T.

Many drugs have been made that disrupt several of the stages in
HIV replication, including inhibitors of reverse transcriptase,
protease, and a regulatory protein. Reverse transcriptase
inhibitors can stop the spread of the contagious virus to new
cells but doesn't interfere with the replication of HIV
genomes. Two of the most encouraging substances fight later
phases of replication and influence acute or chronic
infections. However, scientists have had little success in
bringing positive discoveries to clinical practice. Drugs such
as zidovudine, (AZT) didanosine (ddI), and zalcitabine (ddC)
postpone the clinical progression of HIV-1 infection while
others, such as stavudine(d4T), affect surrogate markers of
progression. Several clinical tests have established the
effectiveness and toxicity of AZT in several HIV-1 illnesses.
Beginning zidovudine treatment at the onset of AIDS postpones
the progression of disease as shown by the delayed onset of
opportunistic infections. DdI improves weight, cutaneous
hypersensitivity responses, CD4 lymphocyte counts, and p24
anti-genemia.


June 24, 1993


Lawsuit Could Decide Price of AIDS Drug *
Baltimore Sun (06/24/93), P. 22A

The price of the AIDS drug AZT could be contingent upon the
outcome of a patent infringement case that goes to court next
week and will decide whether generic drug makers are allowed to
make less expensive versions of the medication. AZT's
manufacturer, Burroughs Wellcome Co., is trying to prevent any
violation of its exclusive patent rights to produce the drug,
which it sells as Retrovir. The company argues that its
researchers developed AZT and that the patents provide the firm
with a monopoly on it until the year 2005. Generic drug
companies claim that federal staff and funds made up a large
part of the development of AZT and that no one company should
have exclusive rights to it. The National Institutes of Health
is backing the generic drug producers.

Related Stories: Los Angeles Times--Washington Edition (06/24)
P. B2; Investor's Business Daily (06/24) P. 9.


Guidelines on AZT Use Could Face Revisions *
Los Angeles Times--Washington Edition (06/24/93), P. A4
Cimons, Marlene

New federal guidelines for the AIDS drug AZT could be imposed
as a result of a recent European study that casts doubt on
whether the drug prolongs life, according to AIDS researchers
who met Wednesday to discuss the issue. A federal advisory
panel for the National Institute of Allergy and Infectious
Diseases, expected to continue hearings through Friday, could
release new recommendations as early as this summer that would
change the way the drug is used. Currently, AZT is recommended
for AIDS patients whose CD4 cells have fallen to 500 or below.
Several significant studies have demonstrated that taking AZT
after infection but before the onset of AIDS postpones
development of the disease. But a major new study known as
Concorde, which was conducted in France and Great Britain,
calls into question the long-term benefits of AZT. Regardless
of the study's findings, several AIDS experts supported the use
of AZT in early HIV infection. Dr. Paul Volberding, chief of
the AIDS program at San Francisco General Hospital and the lead
researcher on the original AZT studies that led to the current
recommendations, supports early AZT use. He said he is likely
to continue recommending the drug for his HIV-positive
asymptomatic patients, but only after informing them fully
about the drug, including the results of the Concorde study.
"We obviously cannot ignore Concorde. The data speak for
themselves. However, the results are not inconsistent with what
our recommendations have been since 1989.... We have clearly
seen that AZT prolongs the time to overt disease progression,
although it doesn't prolong survival."

Related Story: USA Today (06/24) P. 1D.


Mouse Provides Key Clue in AIDS Research *
United Press International (06/23/93)

(Los Angeles, CA) The depletion of the immune system can be
studied much more rapidly by using mice to reveal the hidden
secrets of AIDS, according to a study conducted by researchers
from the University of California--Los Angeles. The researchers
recorded for the first time a rapid and near complete depletion
of a human immune system implanted in mice within a few weeks
of HIV infection. The researchers implanted human fetal liver
and thymus tissue in to the mouse. Consequently, a combined
human thymus-liver organ developed, providing key elements of
the human disease-fighting immune system. They later inoculated
HIV into the implanted tissue of 16 mice and used a second
group of 13 mice with implanted tissue as a control group. The
researchers discovered that most immature immune cells were
depleted within the first three weeks. By six weeks, nearly all
mature cells from the human tissue were depleted in the
infected mice. In mice infected with lower levels of the virus,
the rate of immune system depletion was slower. The level of
HIV genetic material in the implanted tissue increased rapidly
within two to three weeks after infection, showing that the
mice had developed characteristics of AIDS. The finding is
significant because the immunodeficient nature of the animal
allows transplantation of human tissue without rejection. Dr.
Jerome Zack, principal investigator at the UCLA AIDS Institute
and assistant professor at UCLA School of Medicine, said such
animal research can be conducted quickly and inexpensively to
concentrate on the causes of and possible therapies for AIDS.


Chief Health Officer Apologizes to Miss America *
United Press International (06/23/93)

(Tallahassee, FL) A letter of apology has been sent to Miss
America from Florida's chief public health official, who
criticized school officials who asked her not to mention AIDS
or discuss sex when she visited three elementary schools. Dr.
Charles Mahan, health director for the Florida Department of
Health and Rehabilitative Services, said information on a
deadly disease must not withheld. "The fact that a couple of
Florida school boards felt compelled to limit the subject areas
of your presentation is appalling afd!embarrassing to myself
and my colleagues in public health," said Mahan in the letter
to Leanza Cornett, who has been encouraging AIDS awareness
while serving as Miss America. Mahan said children in America
are subjected to sexually oriented material every day in
magazine advertisements and on television. "We should be
educating them to deal with such messages and their own
sexuality. Withholding knowledge in the face of a killer
disease is, to me, a huge sin," he wrote.


Alleged Rapist Has HIV, Charged With Attempted Murder *
United Press International (06/23/93)

(Miami, FL) A man accused of raping three young boys while
knowing he was infected with HIV has been charged with
attempted murder. Investigators said Ignacio A. Perea Jr. was
aware of his infection at the time of the alleged assaults. At
the time of his arrest, a doctor's receipt was found that
showed he underwent T-cell testing, court records show.
Prosecutors did not disclose whether any of the three boys had
contracted the virus. Perea also faces charges of sexual
battery, kidnapping, and lewd assault on each of the three
alleged incidents. In three attacks in September and November
1991, he is accused of abducting the boys, blindfolding them,
and driving them to a warehouse or home where they were
assaulted. Two of the boys were 11 years old and the other was
13. Perea's lawyer, Jay D. Levine, has requested that Dade
County Circuit Judge Michael Chavies try the attempted murder
charges separately from the other charges, and to prevent the
jury in the sexual battery trial from being told that Perea is
HIV-positive. "Like leprosy, AIDS carries a stigma so corrosive
that a jury confronted with evidence of one's infliction might
well be inclined to return a verdict for that reason alone to
insure one's isolation and removal from society at large," said
Levine. The judge is scheduled to rule on the request on
Thursday.


AIDS Battle Reports *
Advocate (06/15/93) No. 631, P. 16

Significant new findings on HIV and AIDS were revealed recently
worldwide. Researchers from the Netherlands detected a super-
virulent HIV strain they say may hasten the onset of full-blown
AIDS. A person with this strain is six or seven times more
likely to develop full-blown AIDS within 30 months than someone
with a weaker strain of HIV, reported the researchers in the
May 1 issue of the Annals of Internal Medicine. AIDS researcher
Roel Coutinho said there is some indication that AZT is less
effective against the stronger strain. In a separate study at
Northwestern University in Chicago, researchers said that in
AIDS patients, the number of cells infected with HIV is much
higher than was previously believed. "Prospects for a
therapeutic vaccine are now less promising," said AIDS
researcher Steven Wolinsky. "But it shows we should redouble
our efforts for a preventive vaccine." Researchers had
questioned whether HIV was solely responsible for the
devastation of AIDS, said researcher Neil Graham, but the
Northwestern study "shows once and for all there is enough
virus in the cells to explain the massive immune destruction."
Another study, conducted at the Los Angeles Oncologic
Institute, found that three of five patients benefited from a
new Kaposi's sarcoma treatment. The researchers reported in the
Lancet that they used microscopic drug-packed fat capsules to
speed medicine directly to infected cells. Fewer bouts of
vomiting were experienced by the patients receiving the new
drug than when receiving chemotherapy, and 15 of the 24
patients who could be evaluated exhibited complete or partial
tumor remission.


Please Don't Drink the Water *
Advocate (06/15/93) No. 631, P. 44
Osborne, Duncan

The Milwaukee outbreak of illness caused by the cryptosporidium
parasite has drawn attention to a federal report indicating the
organism could live in New York's water supplies as well. The
report, by a federal panel convened by the Environmental
Protection Agency, indicates that the parasite could live at
high enough levels in the city's drinking water to harm people
with AIDS. According to Dr. Daniel Okun, who chaired the
report, there is a risk that the organism is in the water
supply. "It's a fairly high risk. If you take that and
recognize the impact on the immune-suppressed population, it is
a fatal risk" for those with AIDS, Okun said. Cryptosporidium
is transmitted through contact with infected feces or
contaminated water, and in humans causes flu-like symptoms
including diarrhea and nausea. Doug Nelson of the Milwaukee
AIDS Project says 65 percent of the project's clients have
shown severe conditions linked to the cryptosporidium outbreak,
and he believes the deaths of six of the clients in the period
of the outbreak were quickened by exposure to the organism.
Nelson strongly feels that those in the AIDS community must
reconsider how they look at water safety. The EPA panel report
showed cryptosporidium exists in fairly small amounts in 16
percent of water samples taken from city reservoirs. City and
state officials, however, contend that the city's water meets
necessary standards, "and would not cause problems for anyone,"
said New York State Department of Health spokesman William
Fagel.


Why Johnny Can't Be Safe *
Advocate (06/16/93) No. 631, P. 46
Galagher, John

All states now have policies concerning AIDS education in
public schools, although the policies don't guarantee that all
students are receiving sufficient AIDS education. The religious
right, say experts, are the severest foes of the education
programs, which are already jeopardized by incomplete
information and insufficiently trained teachers. A report by
the Centers for Disease Control and Prevention (CDC) that seeks
an increase in AIDS education in schools is prompting debate
nationwide. Conservatives, however, say they should reserve the
right to teach their children about sex and AIDS, and want to
encourage the teaching of abstinence. However, Brenda Greene,
manager of HIV and AIDS education for the National School
Boards Association, noted, "I don't know any health educator
across the country not saying that abstinence is the only way
to avoid HIV." Greene adds that what is taught beyond
abstinence is frequently not enough. A Sex Information and
Education Council of the United States (SIECUS) study indicates
that only 11 states provide balanced information about safe sex
without over-emphasizing abstinence.


June 25, 1993


Nurse Named to AIDS Position *
Washington Times (06/25/93), P. A7

President Clinton is expected to announce the appointment of a
former Washington state health official to the federal AIDS
czar position today, according to administration sources.
Kristine Gebbie, a former nursing professor, served as the
Washington state secretary of health until leaving the post
this spring. She is currently working on a doctorate at the
University of Michigan school of public health. Gebbie also
served for a year on the National Commission on AIDS during the
Reagan administration. She is the third person nominated for
the AIDS czar position since President Clinton has taken
office. All of the others turned down the job, which would
entail coordinating government efforts to combat AIDS. Gebbie's
appointment would come several days before the National
Commission on AIDS is planning to issue its final report, which
is expected to be highly critical of the Clinton
administration.

Related Story: Washington Post (06/25) P. A23; New York Times
(06/25) P. A17.


Wellcome Faces Court Challenge to Keep AIDS Drug Monopoly *
Journal of Commerce (06/25/93), P. 7A
Hirschler, Ben

British pharmaceutical leader Wellcome PLC will undergo a
bitter court battle in the United States next week to retain
its monopoly on the controversial anti-AIDS drug AZT. The
exclusive right that Wellcome holds to make and market AZT is
being challenged by two generic drug manufacturers, Barr
Laboratories and Novopharm. If the two companies win the case,
they will be able to start selling inexpensive copies of AZT in
the profitable U.S. market. According to Barr, a generic
version of AZT could cut by as much as 50 percent the drug's
annual cost of $2,500. Global sales for AZT were worth $317.2
million last year, with the U.S. market accounting for around
half that total. The trial will begin Monday before a jury in
Raleigh, N.C., and is expected to last four to six weeks. The
dispute surrounds the question of who first thought of using
AZT to treat AIDS patients. Barr and Novopharm contend that
Wellcome's U.S. patents--which expire in the year 2002--are
invalid because the company neglected to acknowledge that two
researchers from the U.S. National Institutes of Health (NIH)
were co-inventors of the therapy. The NIH has expressed support
for the claim by announcing that it will grant non-exclusive
licenses on the drug if the challengers are successful. Barr
will argue that because Wellcome has no competition in the
market, it has generated more than $1 billion in revenue at the
expense of AIDS patients who need access to the life-extending
drug. Regardless of which side loses, the case is expected to
be taken to the court of appeal, possibly prolonging the
dispute for at least another year.


China Puts HIV Cases at 1,000 *
Financial Times (Great Britain) (06/25/93), P. 4

More than 1,000 people in China have been found to be infected
with HIV, according to reports by state radio. By the end of
May, China had recorded 1,106 cases of HIV-positive people; 189
of the cases were among foreigners. A total of 14 people have
developed full-blown AIDS, and 10 of those have died. Although
most of those infected were drug addicts, health officials are
concerned about an increase in the number of individuals who
have contracted HIV while traveling abroad as tourists or
workers.


Hauser Awarded New Project From the National Cancer Institute
for a Compound With Possible Anti-HIV Activity *
PR Newswire (06/24/93)

(Boulder, CO) Hauser Chemical Research Inc. has announced a new
agreement with the National Cancer Institute (NCI) for the
"Isolation and Purification of Michellamine B from Crude
Extracts of Ancistrocladus sp. Novum." NCI will be researching
the anti-HIV activity of the agent. NCI has agreed with Hauser
to prepare enough of the compound to allow preclinical
evaluation of the drug's efficacy and usefulness before
recommending it for clinical trials. Hauser will prepare the
pure compound, michellamine B, from crude extract provided by
NCI. Hauser will also use its proprietary technologies to
improve the isolation and purification of michellamine B in
anticipation of larger scale production in the future. In tests
conducted by NCI, michellamine B has demonstrated "in vitro"
activity against various strains of HIV. In 1991, the compound
was first identified by NCI. The plant from which the compound
is extracted has been named Acistrocladus korupensis after the
national park in Cameroon where it was first found. NCI and
scientists at the University of Yaunde in Cameroon are
researching cultivation of the plant for future supply.


Vietnam Can Combat AIDS if It Acts Now--Study *
Reuters (06/24/93)

(Hanoi, Vietnam) A potential explosion of AIDS cases could be
contained by Vietnam if it moves now to alter people's risky
behavior, the aid agency Care International said Friday. Care
issued a report, "The Risk of AIDS in Vietnam," that gave the
most detailed survey ever of sexual behavior and attitudes in
the Communist-ruled nation. "Vietnam has vanquished many
powerful enemies in the past. But HIV/AIDS is a new kind of
enemy. War cannot be waged on HIV/AIDS, because it is
inextricably connected to people's private lives and intimate
behavior," said Care. Despite the fact that prostitution is
prohibited, Vietnam's sex industry is booming and the risks of
HIV infection are real, said Care. In addition, the report said
the situation was much like Thailand's in 1988, when an AIDS
epidemic began with an explosion in HIV infection among IV-drug
users in Bangkok and spread among prostitutes. Care said it
took three years for HIV to spread from IV-drug users and
prostitutes to the general population. The study recommended
that Vietnam consider legalizing prostitution, which the
government recently promised to eliminate. Vietnam has about
500 people, mostly IV-drug users in Ho Chi Minh city, who are
infected with HIV, while AIDS is known to have killed seven
people in the country since the epidemic emerged.


Opportunistic Infections and CD4 Lymphocytopenia With
Interferon Treatment in HIV-1 Infected Patients *
Lancet (06/19/93) Vol. 341, No. 8860, P. 1597
Pesce, A. et al.

The CD4 cell count and HLA haplotypes should be considered when
administering interferon (IFN) to AIDS patients who have used
intravenous drugs, write A. Pesce et al. of the University of
Nice-Sofia Antipolis in Nice, France. Dr. Vento and colleagues
reported in the April 10 issue of the Lancet of a decline of
CD4 cells after IFN treatment in HIV-1 infection. But Pesce et
al. observed two cases of such cytopenia complicated by
opportunistic infection. Case 1 involved a female IV-drug user,
and who was seropositive since 1987. IFN was begun in August
1992 for chronic hepatitis C. Alanine aminotransferase (ALT)
was 69 IU/L, CD4 cells 310/uL, and serum p24 antigen was
negative. Three months later, the patient had fever and
headache which led to the diagnosis of cerebral toxoplasmosis
with multiple cerebral abscesses. CD4 cells were 130/uL and
serum p24 antigen was strongly positive. ALT was normal and IFN
treatment was stopped. The patient is currently doing well and
taking AZT, with a CD4 count of 90. The second case was a male
IV-drug user and seropositive since 1986. IFN was started in
February 1993, for chronic viral hepatitis C. ALT was 180 IU/L,
CD4 cells 600/uL, and serum p24 antigen was negative. Six weeks
later, the patient was febrile, with perineal pain and oral
candidosis. CD4 cells were 134/uL and serum p24 antigen was
negative. ALT was 72 IU/L. The patient is now well and taking
four anti-tuberculosis drugs and AZT. Although not one of Vento
et al.'s patients developed AIDS during IFN therapy, two cases
of opportunistic infections occurred three months and six
weeks, respectively, after IFN was given to HIV-positive IV-
drug users, the researchers conclude.


HIV Infection as Leading Cause of Death Among Young Adults
in US Cities and States *
Journal of the American Medical Association (06/16/93)
Vol. 269, No. 23, P. 2991
Selik, Richard M. et al.

HIV infection has been found to be the leading cause of death
among young men and women in several U.S. communities, which
has lead to a large proportion of deaths in this age group,
write Richard M. Selik et al. of the Centers for Disease
Control in Atlanta, Ga. The researchers used data prepared by
the National Center for Health Statistics in Hyattsville, Md.,
to analyze national vital statistics for 1990, the latest year
for which the data was available that permitted a comparison of
rankings of HIV infection with other causes of death by city or
state. Nationally, in 1990, HIV was the second leading cause of
death among men aged 25 to 44 years and the sixth among women
in this age group. In five states, HIV infection was the
leading cause of death among young men, causing 29 percent of
their deaths in New York, 28 percent in New Jersey, 24 percent
in California and Florida, and 16 percent in Massachusetts. But
among young black and Hispanic women, HIV was the third leading
cause of death in the nation, but was the ninth leading cause
of death among young white women. Among young men, HIV
infection was the leading cause of death in 64 cities, with the
proportion of deaths due to HIV ranging from 16 percent in
Bridgeport, Conn., to 61 percent in San Francisco, Calif. HIV
infection was the leading cause of death in nine cities among
young women, with the proportion of deaths due to HIV ranging
from 15 percent in Baltimore, MD., to 43 percent in Newark,
N.J. This study emphasizes the severity of the AIDS epidemic
among young people living in U.S. cities and states, the
researchers conclude.



NOTE:  Compilation by Michael Tidmus : AIDSwire. All rights
reserved. Permission is granted to republish on electronic
media for which no fee is charged, provided the complete text
of this notice is attached to any republished portion or
portions.

* From the AIDS Daily Summary. The Centers for Disease Control
and Prevention (CDC) National AIDS Clearinghouse has made this
information available 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. Copyright
1993, Information, Inc., Bethesda, MD.

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