-----===[[[ A I D S w i r e  D I G E S T  07.05.93 ]]]===-----

July 5, 1993: Holiday

July 6, 1993


Attitudes About AIDS at Work *
Washington Post--Health (07/06/93), P. 5

About two-thirds of businesses with more than 2,500 employees
and almost 10 percent of businesses with fewer than 500
employees have had at least one worker with HIV or AIDS,
according to a survey conducted by Foster Higgins. A telephone
poll of 2,000 people conducted by the National Leadership
Coalition on AIDS found that 75 percent wished their employers
offered an AIDS education program, while 28 percent reported
that their employers had offered such a program within the last
year. Thirty-two percent of respondents said they believed
their employers would immediately fire, or put on disability,
any worker who exhibited HIV-related health problems.


Army May Hold Up AIDS Vaccine Trial *
Washington Post (07/06/93), P. A13
Squires, Sally

The $20-million planned trial of a therapeutic AIDS vaccine
that was recently expected to be conducted by the National
Institutes of Health has been returned to the Department of
Defense. The Army confirmed Friday that it will test the drug,
VaxSyn, only if its manufacturer, MicroGeneSys, donates enough
vaccine for the study, which is expected to involve 6,000 HIV-
positive participants. Col. Donald S. Burke, director of the
Division of Retrovirology at the Walter Reed Army Institute of
Research, said, "Right now the only thing that stands between
us and proceeding with the trial is the availability of the
vaccine for free from the company." But that is exactly what
prevented a similar trial of VaxSyn by NIH. Last fall, Congress
mandated that the DOD conduct this particular study and
allocated $20 million to pay for it, including the purchase of
the vaccine. However, the mandate provoked criticism from many
AIDS researchers and activists. NIH subsequently decided that
the trials should involve a broad representation of HIV-
positive people, not just military personnel or patients in the
Veterans Affairs system, and should be conducted by NIH.
Nevertheless, the initial legislation did not specify multi-
drug trials, and after much debate, the project was returned to
the Army. Burke said that acting secretary of the Army John W.
Shannon stressed on Friday that the trial would not proceed
unless MicroGeneSys donated the vaccine. MicroGeneSys' vice
president Robert W. Sherrer said in a letter faxed July 1 to
Burke, that the company is "not able to donate [the vaccine]
for a large-scale study," because of limited assets.


Free Condoms Are Now Just a Fact of Life at High Schools *
Los Angeles Times--Washington Edition (07/06/93), P. B3
Chu, Henry

The condom distribution program implemented last year in the
Los Angeles Unified School District has drawn little opposition
lately. Last year, the district decided to make condoms
available to its 127,000 high school students free of charge.
The decision initially outraged some parent, civic, and
religious groups. However, after 14 months, the opposition has
virtually disappeared. In addition, relatively few parents have
exercised their right to deny their children access to the
contraceptives. And while the program still receives criticism,
condoms have become an accepted--if not always well-advertised-
-aspect of student life. Josephine Jimenez, the district
administrator who oversees the program, said that since it
began in April 1992, approximately 35,000 condoms have been
distributed throughout the district. School health officials,
counselors, coaches, and teachers who are believed to have a
good rapport with teenagers hand out the condoms at each school
site upon the students' request. The condoms are provided to
the district by the Los Angeles County Department of Health
Services. A recent survey by the Los Angeles Times of more than
half of the district's 49 high schools found only a handful
with opt-out rates higher than 10 percent. Opt-out means that
parents can give "negative" consent in order to prevent their
children from obtaining condoms in schools. Moreover, a
majority of schools reported that fewer than 5 percent of
parents have denied their children access to condoms--a
statistic in line with similar programs established in
Philadelphia and San Francisco.


Britain--AIDS *
Associated Press (07/02/93)

(London) Potential brain infection as a result of toxoplasmosis
in AIDS patients may be detected early on, according to a small
preliminary French study published in the July 3 issue of the
British journal The Lancet. Dr. Jean Pierre Vendrell at the
Institute of Biology in Montpellier, France, reported that if
large studies confirm the findings, the blood test could be
used to gauge the progress of the illness or even detect the
disease months before symptoms emerge. The only way to
currently diagnose brain infection with toxoplasmosis is to
remove a tiny part of the brain and search for the organism.
AIDS patients may experience symptoms of brain disease, but not
have toxoplasmosis. Therefore, it is difficult without the
biopsy to ascertain whether infection or nerve damage is
causing the symptoms. Although toxoplasmosis can stay latent in
healthy people for years, it can flourish and lead to severe
illness and brain disease in AIDS patients. The doctors in the
study searched for antibodies against toxoplasmosis in the
white blood cells of HIV-infected patients. Earlier studies
have found that white blood cells of patients without AIDS who
do have toxoplasmosis secrete antibodies. The researchers
discovered antibodies that had been secreted in 20 of 21 AIDS
patients with known toxoplasmosis. Those patients had already
had a brain biopsy, brain imaging, or exhibited good response
to medicine. In addition, the researchers found antibodies in
19 of 103 HIV-positive patients without symptoms of
toxoplasmosis. A total of five of the 19 later suffered from a
brain infection of toxoplasmosis within three to 15 months.


Octamer Compound Circumvents AZT Resistance and Inhibits
Replication of HIV and SIV *
Business Wire (07/05/93)

(Mill Valley, CA) Significant findings on a compound's ability
to fight the monkey version of HIV and its AZT-resistant
strains were reported Monday by privately held Octamer Inc. Dr.
Ernest Kun headed the study, which was conducted by incubating
cells with relatively low amounts of 3-nitrosobenzamide (NOBA)
before infecting them with simian immunodeficiency virus (SIV),
which is the monkey version of HIV. The NOBA prevented
replication of the SIV. It was found that the DNA code for the
gag gene, an essential part of the virus, was disabled, as
determined by polymerase chain reaction, a sensitive detection
approach. The action of NOBA on SIV is consistent with its
effect on HIV as determined in previous experiments. The
findings concur with Octamer's previous discovery of a new
target site on HIV and families of drugs that act on it. This
target site is on one of the viral zinc fingers. Zinc fingers
are found in certain regulatory and viral proteins that play
key roles in the processing of genetic material. A critical
feature of this site is that it cannot be mutated. Therefore,
the virus cannot avoid the action of Octamer compounds. The
development of these new anti-AIDS drugs, targeting retroviral
zinc fingers, and not acting on reverse transcriptase,
represents a new approach to AIDS therapy.


WHO Estimates Global AIDS Cases at 2.5 Million *
Reuters (07/02/93)

(Geneva) There has been a total of 718,894 reported AIDS cases
worldwide to date, according to the World Health Organization's
member states. However, in a six-month update of its figures,
the agency's Global Program on AIDS said it predicted the
actual cumulative total was more than 2.5 million because of
under-reporting of the disease by developing countries. About
half of the cases reported to WHO are from industrialized
countries, according to the United Nations health agency. The
United States alone accounts for 40 percent of the worldwide
total, with 289,000 cases of AIDS. But about 80 percent of all
cases are believed to occur in developing countries, with most
in sub-Saharan Africa, said WHO. The agency said approximately
13 million adults have contracted HIV since the start of the
epidemic, in addition to at least one million children. Of the
total, 8 million are from sub-Saharan Africa, and more than 1.5
million HIV infections are estimated to have transpired in
south and southeast Asia. Western Europe is believed to have
had about 500,000 people contract HIV infection, while North
America has 1 million infections, and Latin America and the
Caribbean have about 1.5 million infections.


Household Bleach as Disinfectant for Use
by Injecting Drug Users *
Lancet (06/26/93) Vol. 341, No. 8861, P. 1658
Donoghoe, Martin C. and Power, Robert

IV-drug users who continue to share syringes should not be
urged to clean used equipment but to ensure a routine and
reliable source of sterile equipment, writes Martin C. Donoghoe
and Robert Power of the Charing Cross and Westminster Medical
School in London, U.K. On March 25 of this year, the National
Institute on Drug Abuse (NIDA) issued a warning about the
effectiveness of bleach for cleaning needles, syringes, and
other drug-injecting paraphernalia to prevent the transmission
of HIV and other blood-borne infections. At a meeting at the
Johns Hopkins University school of Hygiene and Public Health,
research had indicated that hypochlorite-based household bleach
does not destroy or inactivate HIV from injecting devices. At a
10 percent dilution, household bleach does not inactivate HIV
even after five minutes of exposure. This could seriously
affect measures of HIV prevention used among IV-drug users. In
the United States, some state legislation prevents syringe
provision and possession, and bleach distribution has been
commonplace as a means to thwart the spread of HIV among drug
addicts. In London, a recent survey showed that among 70 IV-
drug users interviewed, only 25 percent reported never having
shared syringes. But 57 percent reported reusing syringes in
the previous six months, using a range of cleaning agents
including household bleach. As a result of these findings and
those from NIDA, household bleach should only be recommended as
a last resort when there is a lack of sterile syringes, and
only then at full strength, concludes Donoghoe and Power.


Antibody to Specific HIV-1 Proteins in Oral Mucosal Transudates
*
Lancet (06/26/93) Vol. 341, No. 8861, P. 1659
Cheingsong-Popov, Rachanee et al.

Oral mucosal transudate (OMT) is a potential source of
specimens for the measurement of HIV antibodies to gp120, write
Rachanee Cheingsong-Popov et al. of the St. Mary's Hospital
Medical School in London, U.K. It has been suggested that HIV-1
antibodies can be detected, with a high degree of sensitivity
and specificity, in saliva and in OMT from HIV-positive
patients. Also, it has been indicated that testing for HIV-1
antibodies in these specimens is cost-effective and suitable
for screening in developing countries. The procedure for
collecting OMT is simple and non-invasive and is safer for
health-care workers than extracting blood from the vein. OMT
specimens can be kept at room temperature for many weeks
without losing antibody reactivity. Consequently, OMT specimens
may be used in future field studies of HIV vaccines in
developing countries. The researchers have investigated HIV-1-
specific antibody to gp120, p24, and the HIV-1 V3 major
neutralization epitope in OMT collected from HIV-1-infected
individuals, compared with serum specimens by specific enzyme
immunoassays (EIAs). It was found that anti-gp 120 was detected
in all OMT and sera among the 140 samples that were collected
from 50 and 90 Tanzanian participants. Also, it was discovered
that the amount of antibody in OMT is less than in serum. But
there was an excellent correlation between the specific
antibody titres in sera and in OMT. Although OMT can be used to
measure antibody to gp120, if the response to the HIV-1 major
neutralization determinant or to p24 core protein is of major
interest, then serum should be used instead, the researchers
conclude.


Government Study Finds Benefits in Needle Exchange Programs *
AIDS Alert (06/93) Vol. 8, No. 6, P. 86

Although a recent government study found that needle-exchange
programs are effective in preventing the spread of HIV, the
U.S. surgeon general must give a similar assessment before
federal funds could be provided for such programs. The study
was conducted by the U.S. General Accounting Office (GAO) in
Washington, D.C., at the request of the U.S. House of
Representatives Select Committee on Narcotics Abuse and
Control. The GAO study was released in March 1993 and was
followed by a bulletin from the National Institute on Drug
Abuse (NIDA) in Washington, D.C., citing new research that
challenges the effectiveness of bleach in cleansing dirty
needles. The bulletin mentions needle exchange programs as a
possible means of providing sterile devices, although it states
that the risks and benefits of such programs are still being
studied. The first needle exchange program was implemented in
Tacoma, Wash., in 1988, and since then, 32 U.S. cities have
implemented such programs. All but 15 of the programs are
illegal. Even though all 50 states have drug paraphernalia
and/or syringe prescription laws, Washington, Connecticut, and
New York have enacted special legislation to implement pilot
needle exchange programs to reduce HIV transmission through IV-
drug use. The authors of the GAO report said, "Based on our
expert consultant review, we found the model to be technically
sound, its assumptions and data values reasonable, and the
estimated 33 percent reduction in new HIV infections sound."
The GAO recommended that incoming U.S. Surgeon General Joycelyn
Elders evaluate the issue in order to designate funds for
future needle exchange programs.


July 7, 1993


He Fought the Law While Fighting AIDS *
Philadelphia Inquirer (07/07/93), P. A1
Collins, Huntly

The recent decision by the U.S. Social Security Administration
to extend benefits to HIV-positive people was partially
prompted by a class-action suit filed by an infected
Philadelphia man. Peter Rosetti, an electrician with AIDS,
filed a class-action suit in June of 1991 alleging that the
Social Security Administration (SSA) neglected to hold proper
public hearings on its disability rules for people with HIV or
AIDS. The suit was backed by Community Legal Services, which
represents the poor. But SSA officials argued that Rosetti had
no secondary infections and that his HIV infection appeared "to
be controlled." It took Rosetti two applications, an appeal, 15
months, and a lawsuit to finally win the benefits to which he
felt entitled after more than a decade of payroll contributions
to the Social Security system. A few months after the suit was
filed, an administrative law judge for the SSA reversed the
agency's earlier denials of Rosetti's claims. He was awarded
monthly disability benefits of about $575, and $8,000 in
retroactive benefits--the amount he would have received had his
claims been approved when he was forced to quit his job. But
Rosetti's attorneys pursued the case, seeking similar benefits
for other people like Rosetti. His lawyers are seeking back
benefits for about 1,000 HIV-positive people in Pennsylvania,
New Jersey, and Delaware. The new Social Security guidelines
released Friday make it easier for HIV-positive individuals to
qualify for Social Security disability payments, and extend
coverage to include other AIDS-specific illnesses.


Court Says No Rules Broken by Fort Wayne Company *
United Press International (07/06/93)

(Indianapolis, IN) No law was violated by a Fort Wayne, Ind.,
company that discriminated against an HIV-positive man,
according to a Tuesday ruling by the Indiana Court of Appeals.
The state court said the company's policy would be illegal now,
under the federal Americans With Disabilities Act, but was
legal at the time it was imposed. Lincoln Foodservice Products
Inc. had a self-funded medical insurance plan allowing a
lifetime benefit of up to $1 million for major medical
expenses, but a comparable benefit of $50,000 for people with
AIDS. Annual benefits for AIDS patients were limited to
$25,000. As aJresult of his condition, Lincoln denied Kenneth
Westhoven $19,750 in annual benefits. By August 1990, Westhoven
had used up about 60 percent of his benefits. He brought his
case to the Indiana Civil Rights Commission of Discrimination
Against People with AIDS. Westhoven subsequently died and his
case was pursued by his estate, by the attorney general's
office for the commission, and by Lambda Legal Defense and
Education Fund Inc., a New York-based group that fights legal
battles on gay and AIDS-related issues. The commission decided
the company was at fault, but Huntington Circuit Court and the
appeals court said the federal law at the time outweighed the
Indiana law. The court also deemed it irrelevant that the
commission's position was later adopted under the federal act.


Government Solicits Pimps to Fight AIDS *
Reuters (07/07/93)

(Jakarta, Indonesia) The Indonesian government has decided to
ask for the assistance of pimps in helping thwart the spread of
HIV infection in the world's fourth most populous nation, the
Jakarta Post daily reported on Wednesday. The newspaper quoted
director general for social rehabilitation Soesilo Soepeno as
telling parliament he thought pimps could convince prostitutes
to protect themselves and others against HIV infection. While
health officials say that HIV probably already affects several
thousand Indonesians, the government claims there are less than
200 people with HIV infection. In Indonesia, there are tens of
thousands of prostitutes, and officials say one of the hardest
things to do is to get them to use condoms. Also, the newspaper
reported that a campaign to promote the use of condoms by
giving them away in red-light districts was unsuccessful and
prostitutes complained that their customers refused to wear
them. One parliamentarian recommended that the campaign also
target the customers.


Only AIDS-Free Couples to Marry--Kenyan Vicar *
Reuters (07/07/93)

Nairobi, Kenya--Medical certificates should be required from
couples who are getting married to prove they are negative for
HIV infection, according to an Anglican vicar in Kenya. The
Rev. Stephen Njenga, who is responsible for a diocese in
Kenya's capital, Nairobi, said, "By demanding the certificates,
the church would also be discouraging sex out of wedlock." He
told the newspaper, Kenya's Standard daily, "I am tired of
presiding over weddings only to be called a few months later to
conduct funerals for the same couples that I earlier witnessed
exchange marriage vows." Njenga did not explain how the
certificates would guarantee fidelity after marriage, and it
was unclear whether he was referring to a new policy of the
Anglican Church, one of Kenya's largest.


War on AIDS Is Victim of Friendly Fire *
Washington Post (07/07/93), P. D1
Milloy, Courtland

The Washington, D.C., Commission on Public Health's Agency for
HIV/AIDS cannot continue to neglect the city's AIDS epidemic
because of problems within the office, writes Washington Post
columnist Courtland Milloy. Caitlin Ryan, the agency director
who is a lesbian and also white, was suspended three weeks ago
for allegations that she improperly steered an AIDS contract
away from a clinic directed by a leader in the Nation of Islam.
Mayor Sharon Pratt Kelly has neglected to move aggressively to
name a new leader and fix the damage done to this critical
operation. When Ryan took the job two years ago, she changed
the image of the AIDS office to her own--that of a fierce
lesbian warrior against AIDS. But in the highly conservative
black Baptist Washington, she was seen as a disaster. The Rev.
Anthony Motley, who in protest resigned as Ryan's liaison with
the city's black ministers, said, "In a city where 61 percent
of the AIDS cases are black, why is she giving blacks less than
20 percent of the money?" And while the AIDS office statistics
show that the disease is expected to sweep through the IV-drug-
using black heterosexual community, Ryan's budgets continued to
favor primarily white-operated groups that focused on gay men.
Ryan was open about her belief that the AIDS fight should be
focused primarily on the gay community. However, the problem
went beyond what straight staff members believed was her
dislike of heterosexuals. Since Ryan has failed in her mandate
to encourage a spirit of cooperation and trust, and with
statistics showing that HIV is spreading faster in Washington
than any other major U.S. city, there needs to be aggressive
action taken in the AIDS office.


Marion--Tuberculosis Drug *
Associated Press (07/01/93)

(Kansas City, MO) An application for a tuberculosis treatment
that combines three drugs has been submitted by its
manufacturer to the U.S. government. Marion Merrell Dow, a top
producer of anti-TB drugs, said Wednesday that it filed a new
drug application to the Food and Drug Administration for
Rifater, which combines the most commonly used anti-TB drugs--
rifampin, isoniazid, and pyrazinamide. The company said
standard treatment for tuberculosis requires using various
combinations of the three drugs over several months. Fred Lyons
Jr., president and chief executive officer, said, "This is an
effort to help stem the resurgence of TB." He added that even
though the number of TB cases is only at an estimated 26,000
annually in the United States, the number has been growing in
recent years. David Thompson, a company spokesman, said Rifater
is used in some European, Asian, and South American countries.
But because of the low rate of TB in the United States, it did
not offer the promise of being a commercial success. Marion
Merrell Dow decided to make an attempt to provide the drug for
humanitarian reasons, said Thompson. The company said it is a
common problem for TB patients to neglect to complete the full
regimen of drugs because they often are not in regular contact
with doctors or clinics. However, health officials believe the
once-a-day, combination drug may facilitate the completion of
the drug-taking process for TB patients, the company said.


Berlin: Concorde Trial Questions Early AZT Use--Wider
Implications *
AIDS Treatment News (06/18/93) No. 177, P. 3
James, John S.

The medical journal The Lancet issued a one-page letter on
April 2, 1993, describing the preliminary examination of the
biggest clinical testing of early treatment with AZT. The test,
called the Concorde trial, took place in the United Kingdom,
France, and Ireland. The examination called into question the
benefit of early use of AZT in people who are asymptomatic and
who have no other reason which would cause the doctor and the
patient to decide to start treatment. In these patients, the
examination discovered no long-term benefit of using AZT
immediately rather than waiting to begin treatment at a later
date. A small, short-term benefit was achieved in delaying
disease progression when using immediate treatment, but after
three years, the two health of the two groups was nearly
identical. Because AZT did increase T-helper counts, but did
not demonstrate long-term benefits in this group of patients,
Concorde researchers proposed that T-helper counts may not be a
dependable way for testing new drugs, and that "clinical
endpoints" might need to be implemented instead. The end result
of Concorde is that if AZT worked, it didn't work particularly
well, and now there is pressure to end treatment and
concentrate on prevention. American AIDS activists applaud the
Concorde because they feel the death of AZT will make way for
new advances to be explored.


Proposal: A Better Strategy for Developing AIDS Drugs *
AIDS Treatment News (06/18/93) No. 117, P. 5
James, John S.

It is widely agreed that better drugs are needed for better
AIDS treatment, and if the Concorde report does prompt a
movement against AZT and the other third-rate drugs currently
available, the success of such a movement will rely on the
success of alternative drug-development methods. Two major
paths for drug development are through better antivirals--
particularly practical treatments which curb HIV in chronically
and acutely infected cells--and immune-system treatments. Both
approaches could indirectly control the virus and repair damage
already sustained. John S. James of AIDS Treatment News
advocates beginning with antivirals because they are currently
easier to test. James says testing for antiviral activity in
humans should be made vital to HIV development instead of
peripheral to it. The antiviral activity test would also take
advantage of the gains made in viral testing that will soon
become available, like sensitive tests for HIV RNA. Researchers
should also use small, quick antiviral activity tests to
examine different kinds of antivirals. When a drug is proven
safe, and evidence indicates antiviral activity in humans, it
should be approved without having to wait for a large phase III
test to get incontrovertible evidence of clinical benefit.
Already existing viral-activity tests should be improved and
made available to doctors so that they can manipulate them to
their patient's particular needs.


July 8, 1993


C-Sections May Protect Babies From HIV *
United Press International (07/08/93)

(Washington, DC) Delivering babies from HIV-infected mothers by
way of cesarean section may reduce the risk of the virus'
transmission, according to a study published today in the
Online Journal of Clinical Trials, a scientific journal
distributed via computer. Researchers reported that babies
delivered by c-section surgery have approximately a 1 in 7
chance of becoming infected from their HIV-positive mothers,
compared with about a 1 in 5 chance in babies born vaginally.
The researchers said, "About 16 HIV-infected women must deliver
by cesarean in order to prevent one case of HIV perinatal
infection." Dr. Henry Sacks, one of the study's authors from
Mount Sinai School of Medicine in New York, said, "We're not
ready to recommend that all women with HIV infection have
cesarean sections, but there is a strong suggestion that the
risk [of transmission to babies] would be a little less if they
do." He added, "There needs to be a better study so people can
decide," suggesting that c-section delivery has risks of
surgery which--at least in some cases--might outweigh any
protection against HIV transmission. Sacks and colleagues from
the Harvard School of Public Health in Boston, Mass., examined
data from six previous studies involving more than 1,200 women
to reach their conclusion.


Detention of Carriers 'Last Resort' for HIV *
Washington Times (07/08/93), P. A1
Price, Joyce

The newly-appointed AIDS czar said yesterday that detaining
HIV-positive people who are "carelessly irresponsible" about
spreading the disease sexually is suitable as a "last resort."
Federal AIDS coordinator Kristine Gebbie said, "My personal
position is that you should only go to detention after you have
exhausted other options ... and you'd probably need a court
review." Gebbie said, "This would not be a prison issue.... It
would be more like a supervised group home ... but as a last
resort, some form of restriction on behavior, including
restriction on movement" should be considered for people
putting others at risk for HIV. She said that she is not
endorsing this as national policy, adding, "Public health laws
are state laws." However, both supporters and opponents of
Gebbie's appointment criticize her position on detaining people
who knowingly spread HIV. AIDS activist group ACT-UP, which
chastised her appointment, said her position on this issue is
one reason why she should not have been named AIDS czar. "The
ones who would be incarcerated would be gay men, prostitutes,
and IV-drug users, the same ones who have been the scapegoats
for the epidemic," said Luke Sissyfag, an ACT-UP/Seattle
member. At least 24 states have laws advocating the detention
of HIV-positive persons whose behavior is threatening to the
public, including Washington state, where Gebbie served as
health secretary.


Japanese Poster Gives Wrong Information on AIDS *
Reuters (07/08/93)

(Tokyo) A children's poster distributed in Japan that was
intended to educate students about how a person contracts HIV
infection was corrected by its publisher after it showed that
unclean people were more likely to become infected with HIV,
according to a Japanese Ministry of Education official.
"Shogaku-hoken News" (Primary School Hygiene News) printed a
poster called "AIDS and other diseases love unclean people." It
claimed that disease organisms are attracted to dust, dirt, and
unclean people, and travel through the air to enter the body
through the mouth and nose, said the ministry official. The
poster, which showed pictures of HIV and other disease
organisms with captions, was distributed to nearly 13,000
schools in Japan. The poster incited protests from school
teachers, who argued that the information was wrong because HIV
is transmitted through blood and other body fluids, but not
through the air. The ministry official said, "We believe that
the poster was inappropriate." He said the ministry has asked
the publisher to remove the posters, but that it did not know
if all the schools have actually eliminated them. He also said
that the publisher has sent a written correction to the
schools. A total of 554 people have been reported with AIDS,
2,601 people are infected with HIV, and 304 people have died of
AIDS in Japan, according to the country's health ministry
figures.


Phase I Clinical Trials of MiKasome Initiated by Vestar;
Liposomal Formulation of Antibiotic May Combat Resistant TB *
PR Newswire (07/07/93)

(San Dimas, CA) Phase I clinical trials will begin for
MiKasome, Vestar Inc.'s liposomal formulation of the antibiotic
amikacin, reported the company on Wednesday. Preliminary data
from tuberculosis and mycobacterium avium infection models
resistant to traditional chemotherapeutics have shown that
MiKasome is effective in killing infection. "Phase I trials
represent the first opportunity to explore in humans the
profile we've seen in animals, although preclinical success
does not guarantee success in humans. Our Phase I trials will
carefully analyze the safety and pharmacokinetics of MiKasome,"
said Dr. Roger J. Crossley, chairman, CEO, and president of
Vestar. Amikacin is an aminoglycoside antibiotic that is used
against several infections. Its use, however, has been limited
by a high degree of toxicity, including kidney damage and
hearing loss at effective doses. Vestar's liposomal technology
has been proven to reduce toxic side effects with other drugs,
thereby exhibiting improved efficacy without toxicity.


Grassroots Campaign to Oppose Surgeon General Pick *
Reuters (07/07/93)
Auchard, Eric

(Washington, DC) President Clinton should not appoint Dr.
Jocelyn Elders as the next surgeon general, according to
conservative women's groups who Wednesday vowed to block
Elders' nomination through a national lobbying effort. The
groups cited Elders' record as Arkansas state health department
director and her support for abortion as well as her position
endorsing AIDS prevention. In addition, they requested that the
Senate reject her nomination. The conservative organizations
include Concerned Women of America, the Christian Coalition,
the Traditional Values Coalition and the Family Research
Council. Jan Parshall, a spokeswoman for Concerned Women of
America, said that the groups collectively plan to launch a
postcard and telephone lobbying campaign, radio broadcasts, and
other media advertising in opposition to Elders. The Senate
Labor and Human Resources Committee, headed by Sen. Edward
Kennedy (D-Mass.) have scheduled Elders' confirmation hearings
for later in July. Health and Human Services Secretary Donna
Shalala supported Clinton's choice, saying, "Those who would
portray Dr. Elders as being radical or out of touch with the
desires of American people are distorting her record in an
effort to prove their claims." She added, "Dr. Elders supports
comprehensive health training for our nation's children, but
that does not mean inappropriate sex education topics for young
children, as her critics suggest."


Poland--AIDS *
Associated Press (07/06/93)
Grajewski, Marcin

(Warsaw, Poland) The Polish Education Ministry, which consists
of mostly conservative Roman Catholics, wants to prohibit an
AIDS education booklet published by the Health Ministry to
teach secondary school students how to avoid contracting HIV
infection. The booklet, "AIDS and You," uses pictures that
illustrate sexual intercourse and how to properly put on a
condom. The Health Ministry was expected to distribute about
200,000 of the booklets among secondary schools students across
Poland at a cost of $63,000. But Education Ministry spokeswoman
Krystyna Czuba said that the booklet treats "the condom as the
only solution in AIDS prevention." She added that local school
officials are able to decide whether the booklet is used, but
they ought to share the ministry's stance. Czuba criticized the
Health Ministry for not consulting the Education Ministry about
the booklet earlier. AIDS activists, however, denounced the
Education Ministry's position on the informative booklets.
Maria Dziedzic, the chairwoman of the Social AIDS Committee,
said, "The thinking of the people from the Education Ministry
is from the Middle Ages." There are a total of 2,600 people
reported to have HIV infection in Poland, 150 with full-blown
AIDS, and 81 who have died from the disease, according to
official statistics. Unofficial estimates of the rate of
infection are much higher.


HIV Immigration Ban, Travel Restrictions--Current Status *
AIDS Treatment News (06/18/93) No. 177, P. 6
James, John S.

On June 10, President Clinton signed into law a new HIV
immigration ban that he initially opposed but did not openly
speak against in Congress. Because the president could not veto
the bill without also vetoing the NIH Reauthorization Act that
Congress attached to it, the AIDS community did not press for a
rejection of the measure. When in Berlin for the International
Conference on AIDS, reporters for AIDS Treatment News learned
of the bill's passage, and one German told them he was leaving
international research because he was worried that U.S.
officials might obtain his name and ban him from the United
States, where many of his friends live. Although they told him
there are waivers available for short-term visits, there now is
much uncertainty about how the Attorney General will use her
power to continue these waivers. The new ban adds one sentence
to the previous Immigration and Nationality Act of 1990, which
banned "any alien who is determined to have a communicable
disease of public health significance." The new passage adds,
"which shall include infection with the etiologic agent for
acquired immune deficiency syndrome." HIV must now be listed by
an act of Congress, regardless of what public-health
authorities or the president decide.


Duesberg's Anti-AZT Campaign Continues *
Nature (06/24/93) Vol. 363, No. 6431, P. 660
Clayton, Julie

The controversial American molecular biologist who claims that
recreational drug use rather than HIV is the cause of AIDS has
rejected as a "fabrication" the findings of a recent study
designed to disprove his hypothesis. Michael Ascher and
colleagues of the California Department of Health Services used
data from the San Francisco Men's Health Study to demonstrate
that men who were heavy drug users but showed no evidence of
HIV infection did not contract the virus, whereas those in the
study who were either light drug users, or did not use drugs at
all, were shown to be infected with HIV. The study contradicts
Peter Duesberg's idea that AIDS is a clinical development of
long-term consumption of recreational drugs and of treatment
with AZT. But Duesberg said at a recent meeting in London
organized by a group known as the Steering Committee Against
AZT Malpractice (SCAM), that he refused to accept the group's
conclusion, and continued to insist that his own
interpretations are sound. He continued to criticize the
labeling of one table in the publication of the California
study for not indicating the category of "no drug use," and
that the paper was therefore invalid. He apparently ignored an
explanation in the text that these subjects were represented in
the table's category of "light" drug users. In addition, he
said that he refused to accept the way that the results of the
study were presented in a graph, claiming that "the curve is a
fabrication and the conclusions are flawed." Moreover, Duesberg
said that the research group's findings could be interpreted to
support the opposite conclusion and suggested that there was a
100 percent correlation between AIDS and drug use.


July 9, 1993


Suing Over Transfusions *
Wall Street Journal (07/09/93), P. B3
Moses, Jonathan M.

The Wisconsin Supreme Court has ruled that people suing health-
care providers over HIV-contaminated blood are bound by the
statute of limitations in personal injury cases, rather than by
the much shorter limits involved in medical-malpractice cases.
The decision in John Doe vs. American Red Cross continues a
recent nationwide trend reversing years of lower court rulings
which had dismissed similar cases because they were filed too
long after the transfusion occurred. The nature of AIDS means
allows it to exist in the body for years without causing any
symptoms.


Progress Reported in Developing Vaccine for HIV *
Washington Post (07/09/93), P. A13

Significant headway has been made by U.S. researchers in
developing a preventive vaccine against HIV infection,
according to a study published in the current issue of the
Lancet. The scientists have manufactured a vaccine that incites
the human body to produce antibodies that helped neutralize HIV
in laboratory tests. However, the findings do not indicate that
a vaccine against AIDS itself has been invented. David Schwartz
of Johns Hopkins University in Baltimore, Md., said, "This is
one of two or three studies that are suggesting that we may be
beginning to have a glimmer of hope." Schwartz and his
colleagues tested the vaccine on 28 HIV-negative volunteers.
The vaccine was made from the envelope that surrounds the virus
and was given to the study participants in varying doses.
Antibodies produced by the volunteers were subsequently tested
against HIV in test tubes. HIV was not administered to the
volunteers, said Schwartz. The antibodies "neutralized the
strain of HIV upon which the vaccine was based... . There were
also antibodies that neutralized another strain of HIV," he
said. The higher the dose of vaccine, the more effective it was
in prompting production of antibodies, the report said.
Moreover, the vaccine caused no notable adverse effects. The
vaccine also led to the production of memory T cells,
components of the immune system that recognize foreign proteins
and call antibodies to attack an intruder.

Related Stories: New York Times (07/09) P. D18; Washington
Times (07/09) P. A8; Baltimore Sun (07/09) P. 12A.


CDC Updates Guidelines for Dentists *
Washington Times (07/09/93), P. A6

The Centers for Disease Control released new guidelines
yesterday on the infection-control procedures used in dentistry
for the first time since it conceded that a Florida dentist
with AIDS had transmitted HIV to six of his patients. The CDC
said in a supplement to its weekly report that it was revising
the 1986 recommendations to take into consideration recent
changes in dental equipment and technology. Although the
federal agency found in 1990 that Dr. David Acer had
transmitted HIV to one of his patients and later to five
others, the CDC reported in May that there have been no
additional cases. The agency tested nearly 20,000 patients of
other infected dentists to come to its conclusion. In
implementing the guidelines, the CDC acknowledged that the Acer
cases had prompted concern, but said the precautions were also
designed to reduce transmission of other diseases, such as
hepatitis, that are much more likely to be spread during dental
procedures. "These new guidelines are not in response to the
Florida case. We are just restating the procedures for
universal precautions taking into account new technology," said
Dr. Jennifer Cleveland, a dentist and CDC epidemiologist. The
new infection control rules include recommendations on devices
like laser probes, tiny dental camcorders, and ultrasonic
dental devices, most of which did not exist at the time of the
previous recommendations.


AIDS Group Blasts State for Handling of AIDS-Infected Inmate *
United Press International (07/08/93)

(San Francisco, CA) An inmate who was dying of AIDS should have
been allowed to spend his final days at home, according to an
AIDS activist group that criticized California prison
officials. Lawrence Wilson of ACT-UP/Golden Gate said it was
"inhumane" to keep convicted burglar Stanley Young incarcerated
until his death of AIDS at the California Medical Facility in
Vacaville. For nearly a year, Young's mother, Frieda Kubas,
fought a battle in the state court system in an effort to win
her dying 28-year-old son an early release. When she believed
her son's case was being ignored, she engaged in a hunger
strike on the state capitol steps. Director of Corrections
James A. Gomez examined the case and requested that Monterey
County Superior Court Judge Hark Joon Paik revoke the
prisoner's sentence. Paik rejected the request Wednesday,
claiming that he was concerned that the inmate would commit
another crime after his release. Young died the same day.


Haitian With AIDS Slams Treatment at Guantanamo *
Reuters (07/08/93)

(Washington, DC) An HIV-positive Haitian woman who was recently
detained at the U.S. naval base in Guantanamo Bay, Cuba, told
the Amnesty International newsconference Thursday that she was
mistreated while at the base. Defense Department officials,
however, said refugees held at the base were treated "far
better" there than at home in Haiti. A woman known only as
Yolande Jean said she had been given experimental drugs for her
condition that made her and other refugees ill. "They were
experimenting with us with new treatments for HIV," she said.
The woman said one drug she was administered for AIDS was Depo-
provera. However, a spokesman for the Upjohn Co., the drug's
manufacturer, said the product was an injectable contraceptive,
not an AIDS treatment. U.S. Atlantic Command spokesman Capt.
Jeff Zakem admitted, "Some people were given Depo-provera." He
added, "No drug was forced on anybody. There were complaints
about side effects and those who complained were taken off the
drug." The woman who spoke to the conference also said she had
been kept in small quarters and given spoiled food. But Zakem
countered that Haitian detainees at Guantanamo Bay were given
the same food that U.S. military personnel receive at the base,
and the housing there was spacious.


Man Convicted of Rape Used a Condom *
United Press International (07/08/93)

(Mineola, NY) A man from Hewlett, N.Y., was indicted Thursday
for raping a woman who convinced him to wear a condom. A Nassau
County Court jury also convicted 27-year-old Ivan Jiminez of
sodomy and burglary after six hours of deliberation. Jiminez
faces up to 25 years in prison once sentenced on Aug. 3. Nassau
County District Attorney Denis Dillon said Jiminez raped and
sodomized a 22-year-old woman at her apartment on June 10,
1992. Dillon said the victim begged the defendant to use a
condom and he complied.


Third Victim of Florida Dentist Buried *
United Press International (07/08/93)

(Akron, OH) A man from Akron, Ohio, who contracted HIV from the
Florida dentist with AIDS was buried Thursday after dying from
the disease. John Yecs Jr., 36, was the third patient of Dr.
David Acer, a dentist from Stuart, Fla., to die from AIDS.
There are three remaining patients who contracted HIV from Acer
do not yet have full-blown AIDS. They are Sherry Johnson, 18,
of Jensen Beach, Fla.; Barbara Webb, a school teacher in Palm
City, Fla.; and Lisa Shoemaker, 36, of Birmingham, Mich., who
had been treated by Acer while living in Florida. Yecs
underwent a root canal in 1988 that was performed by Acer, but
did not discover he was infected with HIV until he attempted to
donate blood in 1990. Yecs, who was divorced and had a 2-year-
old son, said he had never had a homosexual encounter nor used
IV-drugs. Health investigators determined from genetic tests
that Yecs' strain of HIV almost certainly came from Acer. A
spokesman for the Summit County coroner's office said Yecs died
of AIDS-related pneumonia.


Dentist Fined for Turning Away AIDS Patient *
United Press International (07/08/93)

(New York, NY) A dentist from New York City has been ordered to
pay $7,500 in compensatory damages to the estate of an AIDS
patient whom he refused to treat, an action that caused the
defendant emotional distress, the city Human Rights Commission
announced Thursday. Dennis deLeon, commission chairman, said
Dr. William Hurwitz had been ordered by Administrative Court
Judge Rosemarie Maldonado to pay damages for discriminatory
treatment of John Campanella in 1987. The case was prosecuted
by the commission as well as the Lambda Legal Defense and
Education Fund. Campanella, who died of AIDS in 1988, said that
after he told Hurwitz he had AIDS, the dentist sent him a
letter stating he would not treat him because of the "nature"
of his illness and returned Campanella's payment and X-rays. In
a 1991 decision, Maldonado ruled that Hurwitz's practice was a
public accommodation as defined in the city's Human Rights Law,
which strengthened the prosecution of the case. She decided
that denying Campanella dental treatment "zapped Campanella's
energy at a time of particular vulnerability." The commission
has required Hurwitz to file reports with the Law Enforcement
Bureau for a period of two years concerning any patient he
refuses to treat, said deLeon. Evan Wolfson, senior attorney
for the Lambda Fund, said, "This decision comes too late for
John Campanella but should help others who unlawfully and
unethically are denied needed care by their doctor or dentist."


HIV Induces Thymus Depletion In Vivo *
Nature (06/24/93) Vol. 363, No. 6431, P. 728
Bonyhadi, Mark et al.

Because the thymus probably serves as a site of T-cell
differentiation and maturation throughout life, the elimination
of thymopoiesis may represent a key pathogenic mechanism in all
HIV-positive patients, write Mark L. Bonyhadi et al. of
Systemix Inc. in Palo Alto, Calif. HIV is typified by declining
CD4 T-cell counts in the peripheral circulation, a loss which
may be secondary to accelerated destruction, to suppressed
differentiation, and/or to sequestration of circulating cells
into tissue spaces. In order to obtain a better description of
HIV pathogenesis in vivo, the researchers implanted human
hematolymphoid organis into the immunodeficient SCID mouse to
create the SCID-hu mouse. The researchers report that human
thymopoiesis is suppressed by HIV infection, thereby precluding
regeneration of the peripheral T-cell compartment. The
scientists found that HIV-1 infection of Thy/Liv implants in
SCID-hu mice is associated with a rapid depletion of CD4, CD8
thymocytes, and an inversion of the CD4:CD8 ratio. The loss of
CD4 cells seems to be mediated at least in part by programmed
cell death, an otherwise physiological function of the thymus.
Because of the vast differences that exist between HIV
infection in the SCID-hu system and in humans, it is still not
clear how relevant the findings are to pathophysiological
mechanisms of HIV. But the SCID-hu mouse model may provide
valuable insights into mechanisms associated with HIV-induced
thymocyte depletion and other aspects of HIV pathogenesis in
vivo, the researchers conclude.


The SCID-hu Mouse as a Model for HIV-1 Infection *
Nature (06/24/93) Vol. 363, No. 6431, P. 732
Aldrovandl, Grace M. et al.

HIV-1 infection of the SCID-hu mouse reproduces key aspects of
HIV-1 pathology in humans and may be an important small animal
model to study HIV-1-induced pathogenesis in vivo, write Grace
M. Aldrovandl et al. of the University of California--Los
Angeles Medical Center. The researchers used a SCID-hu mouse as
a model to find the effect of virus infection on human tissue.
The mouse is homozygous for the severe combined
immunodeficiency (SCID) defect. The model was constructed by
implanting human fetal liver and thymus under the mouse kidney
capsule. A conjoint human organ develops, which allows normal
maturation of human thymocytes. After direct inoculation of
HIV-1 into these implants, the researchers observed severe
depletion of human CD4-bearing cells within a few weeks of
infection. This correlated with increasing virus load in the
implants. The researchers were unable to demonstrate killing on
this scale of CD4 cells or in pediatric thymocytes following
HIV infection in vitro. Therefore, the SCID-hu mouse system
does not merely reproduce in vitro phenomena, allows infection
of primary cells to be studied in a more appropriate
environment. This model may prove to be important for examining
how HIV-1 infection interferes with the ontogeny of the human
immune system, 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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