From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 9/15/92
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6187
Organization: unspecified
Date: Tue, 15 Sep 92 08:42:56 PDT

                         AIDS Daily Summary
                         September 15, 1992 
 The Centers for Disease Control (CDC) National AIDS Clearinghouse makes 
available the following information as a public service only.  Providing this 
information does not constitute endorsement by the CDC, the CDC Clearinghouse, 
or any other organization.  Reproduction  of this text is encouraged; however, 
copies may not be sold.  Copyright 1992, Information, Inc., Bethesda, MD 
******************************************************************************
"Awakenings...UV Light and HIV Gene Activation" Science (08/28/92) Vol. 257, 
No. 5074, P. 1211  (Wallace, Brigid  M. and Lasker, Jill S.)
     Ultraviolet (UV) radiation may be the culprit in what makes HIV  latency 
stage progress to an active immune-depleting stage,  according to recent 
research that may concern those who are  routinely exposed to UV radiation.  
Virologist John Morrey of  Utah State University--Logan found that PUVA 
therapy--which is  used for treating psoriasis and certain other skin diseases 
by  combining UV with a light sensitive drug--activates HIV genes in  an 
animal model.  This suggests that it might also activate the  latent viral HIV 
in humans, though it is undetermined whether  HIV-positive people should avoid 
excessive exposures to sunlight  and PUVA therapy.  Also, researchers are 
beginning to reveal the  molecular mechanisms by which UV light activates 
latent HIV,  information that  may assist in the eventual development of drugs 
that prevent or slow the viral re-awakening.  Morrey's study  shows that UV 
radiation also induces HIV gene activation in a  living animal.  Genetically 
altered mice used by Morrey and  colleagues,created by introducing into the 
animals a gene  construct made by linking the HIV LTR to a reporter gene 
encoding either betagalactosidase or firefly luciferease.  Exposure of  these 
transgenic mice to either UVB radiation alone or to UVA  light combined with a 
light-sensitive, DNA-binding psoralen  compound--the PUVA therapy--incited a 
significant increase in  reporter gene activity in the animals' skin cells, 
according to Morrey. 

 "AIDS Awareness on the T" Boston Globe (09/14/92), P. 14
     Boston Mayor Raymond Flynn's reluctance to support condom  distribution 
programs in city schools set the standard for the  Massachusetts Bay 
Transportation Authority's (MBTA) resistance to initiate an AIDS awareness ad 
campaign, write the editors of the  Boston Globe.  The controversy over the ad 
occurred when MBTA  officials refused to use three of seven condom posters 
submitted  by the AIDS Action Committee.  The ads, which all showed condoms, 
offered tasteful messages to promote condom use.  However, some  MBTA 
officials were fearful that the messages conveyed by some  posters would have 
an adverse effect on ridership.  After all of  the controversy, the MBTA 
agreed to use the ads.  But the  reluctance of some MBTA officials over the 
ads reflects the  similarly illogical concerns expressed by Mayor Flynn.  The 
mayor has said that distributing condoms to young people would condone  sexual 
activity.  Earlier this summer both Flynn and School  Superintendent Lois 
Harrison-Jones appeared at ease with a   proposal that would permit health 
officials to distribute condoms in school-based clinics operated by the 
Department of Health and  Hospitals.  But progress on the proposal has been 
slow.  After the debate over the transit ads ended, Larry Kessler, director of 
the AIDS Action Committee, again asked the mayor, the superintendent, and the 
School Committee to adopt an AIDS awareness curriculum  and to provide condoms 
for students.  Kessler knows that even the most successful advertising effort 
will not be enough to thwart  the spread of HIV, the editors conclude. 

"Laughing Till it Hurts" Washington Post (09/15/92), P. B1  (Span, Paula)
     Playwright Scott McPherson modeled his newest production "Marvin's  Room" 
on the plight of AIDS, without ever mentioning the disease. In the black 
comedy, a woman who devotes herself to caring for  two ailing, elderly and 
slightly loony relatives, realizes that  she also is seriously ill.  Offstage, 
McPherson had been  overwhelmed with caring for his lover who was dying of 
AIDS.   Subsequently, McPherson was also hospitalized for AIDS.  When  
"Marvin's Room" opened in New York, McPherson was so sick he  didn't think he 
could attend the play.  But it was his lover,  Danny--Daniel Sotomayor, 
cartoonist and activist--who insisted  they make the trip.  When McPherson 
wrote the play he had to  consider how obvious he wanted to be about the 
play's tie to the  AIDS epidemic.  "Marvin's Room" was written when McPherson 
was  HIV-positive but healthy, and the disease is part of the backdrop against 
which the play was created.  McPherson believed the  similarities to "Marvin's 
Room" were evident, but was surprised  to learn that "when the Chicago papers 
reviewed it, no one made  that connection."  McPherson wrote in the playbill 
for the  Harford Stage Company about his experience with AIDS, and did not 
regret his decision to designate the production as an "AIDS play."

"Doctor Dies of AIDS" United Press International (09/14/92) 
     Shoreview, Minn.--A doctor who evoked controversy two years ago  for 
practicing medicine after being diagnosed with AIDS died of  the disease on 
Sunday.  Dr. Phillip Benson died at his suburban  Minneapolis home.  His wife, 
Michelle, was by his side upon his  death.  Hundreds of his patients were 
screened for HIV infection  but none tested positive.  Some patients were 
fearful that Benson was treating patients when he had open lesions on his 
hands, even though Benson followed infection control procedures to prevent  
casual transmission of HIV. 

"How AIDS Sufferer Can Get the Most Out of IRA" Los Angeles Times (09/13/92), 
P. D4  (Lazzareschi, Carla)
     Any AIDS patient meeting the federal government's definition of  disabled 
is eligible to take funds from his or her individual  retirement account 
(IRA), Keogh and/or 401(k) while being exempt  from paying the 10 percent 
penalty for withdrawal before turning  age 59 and a half.  ordinary income 
taxes must still be paid on  any portion of those withdrawals not already 
taxed.  However,AIDS alone  may not actually be enough to qualify as a 
disability.  In order to use tax sheltered savings accounts without paying a  
penalty, one must be both sick and unable to work.  A physician's 
certification is usually required to satisfy the authorities.  If an AIDS 
patient meets the exemption criteria and proceeds with  the withdrawal, that 
person should inform the financial  institution handling the account that he 
or she is not subject to  the 10 percent penalty because of the disability.  
Also,  disability status qualifies AIDS patients to receive disability  
payments from the Social Security Administration. 

"1-800-AIDS-NIH" Science (08/28/92) Vol. 257, No. 5074, P. 1207
     The mysterious AIDS-like condition which lacks HIV  infection,reported at 
the Eighth International Conference on AIDS in Amsterdam in July, has prompted 
the National Institutes of  Health and the Centers for Disease Control to take 
action.  Both  agencies are looking to resolve the mystery quickly and are  
pooling their resources to investigate it.  The NIH and CDC have  established 
a toll-free number (1-800-AIDS-NIH) for physicians to call if they have come 
in contact with such cases in order to  help collect clinical information and 
blood samples from these  patients.  Dr. Anthony Fauci, director of AIDS 
research at NIH,  said these reports "are not cause for panic.  But it is 
important that we investigate the cases thoroughly and expeditiously." 

"Risk of Human Immunodeficiency Virus Type 1 Transmission Through 
Breastfeeding" Lancet (09/05/92) Vol. 340, No.8819, P. 585  (Dunn, D.T. et 
al.)
     Although there is a risk of HIV transmission through  breastfeeding, it 
is still recommended since it protects against  infant deaths from infections 
diseases, write D.T. Dunn et al. of the Institute of Child Health in London, 
U.K.  Detection of HIV-1 in breast milk by culture and polymerase chain 
reaction (PCR)  does not necessarily mean that breastfeeding is a route of  
transmission, even though evidence from several case-reports  indicates this 
to be true.  The researchers found that the  estimated risk of HIV 
transmission through breastfeeding is 29  percent, based on four studies that 
involve mothers that acquired the infection postnatally.  Analysis of five 
studies demonstrated that with prenatal maternal infection, the additional 
risk of  transmission through breastfeeding, over and above transmission  in 
utero or during delivery , is 14 percent.  If safe  alternatives to 
breastfeeding are available, universal named  testing of pregnant women would 
allow more infected women to be  advised not to breastfeed and might therefore 
decrease the number of vertically infected children, the researchers conclude.

"Still a Mystery but 'Not Likely' a Virus" Journal of the American Medical 
Association (09/09/92) Vol. 268,  No. 10, P. 1235  (Goldsmith, Marsha F.)
     Researchers attending the Centers for Disease Control's meeting  in 
Atlanta less than a month after reports of the mysterious  "AIDS-like 
condition" were unconvinced that the condition  involves a virus.  Researchers 
at the CDC listened to reports of  cases that met the CDC definition of 
"idiopathic CD4  T-lymphocytopenia (ICL)"--anyone who has a T-cell level of 
under  300 u/l or a CD4 percentage of under 20 percent on at least two  
samples taken on separate occasions and is HIV-negative.  Also at the meeting, 
several clinical investigators reported patients who had a similar 
constellation of signs and symptoms.  Dr. Anthony  Fauci, director, NIH Office 
of AIDS Research said, "No one here  has been able to give us any information 
that would make us  believe that we're dealing with a transmissible agent 
that's  causing the disease."  Dr. David Ho, director of the Aaron  Diamond 
AIDS Research Center, reported 17 cases of ICL.  In  cultures from two of 
them, his team found "some activity that  might be called reverse 
transcriptase-like."  But the expert  electron microscopic examination did not 
show any retrovirus or  virus.  Dr. Howard Temin, Rusch and Steenbock 
Professor, McArdle  Laboratory for Cancer Research at the University of  
Wisconsin--Madison, said, "finding the true reverse transcriptase would not 
necessarily tell us anything about new virus  infectivity or relationship to 
disease."  He and several others  stressed that researchers make sure that 
what they discover is  not a mycoplasma. 

"Costs of HIV/AIDS Rise, Care Disparities Increase" Journal of the American 
Medical Association (09/09/92) Vol. 268,  No. 10, P. 1246  (Goldsmith, Marsha 
F.)
     The lack of money for AIDS prevention and treatment options is  
frustrating to those involved in the struggle to fight AIDS.  At  the Eighth 
International AIDS Conference in Amsterdam in July,  Dr. Daniel Tarantola of 
the Global AIDS Policy Coalition at the  Harvard School of Public Health in 
Boston, Mass., presented  figures of how much AIDS will cost the world .  He 
and his  colleague Charles Cameron predict it now costs the world between  
$2.6 billion and $3.5 billion a year to treat AIDS patients.  The average 
spent on each AIDS patient in the United States is  $32,000 and in Western 
Europe, $22,390. The average spent in  Central America and South America is 
$2,000.  In sub-Saharan  Africa the outlay is $393.  More than half of 
worldwide AIDS  cases are in Africa, but less than 2 percent of the money 
spent  on the disease globally is allotted there.  Dr. Fred Hellinger of the 
U.S. Agency for Health Care Policy and Research said that  health-care 
expenses are on the rise in the U.S.  The cumulative  cost of treating 
everyone in the country with HIV infection is  projected to increase 48 
percent between 1992 and 1995, from  $10.3 billion annually to $15.2 billion 
annually.  He said the  increase is due to the greater use of services by more 
people with HIV/AIDS.  He also noted that the average cost of treating each  
person's HIV infection, without AIDS, almost doubled from $5,100  to $10,000. 

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