From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 1/22/93
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 11
Organization: unspecified
Date: Fri, 22 Jan 93 07:30:20 PST

                      AIDS Daily Summary
                       January 22, 1993 
 The Centers for Disease Control and Prevention (CDC) National AIDS  
Clearinghouse makes available the following information as a public  
service only. Providing this information does not constitute endorsement  
by the CDC, the CDC Clearinghouse, or any other organization. 
Reproduction  of this text is encouraged; however, copies may not be 
sold.  Copyright 1992, Information, Inc., Bethesda, MD 
------------------------------------------------------------------------
 "Study Finds DDC Effective by Itself Against AIDS" Los Angeles Times--
Washington Edition (01/22/93), P. A4   (Cimons, Marlene)
     A new study that is expected to be released today has found that  
DDC is as effective--and possibly more so--than DDI in AIDS  patients 
who are unable to tolerate AZT, according to sources  familiar with the 
research.  The National Institute for Allergy  and Infectious Diseases 
is scheduled to release the study, which  is the first to demonstrate 
that DDC is beneficial when used  alone.  The study involved 467 
patients and took place between  December 1990 and September 1992.  
About two-thirds of the  patients had been diagnosed as having full-
blown AIDS, said  sources.  The study was sponsored by the institute's 
Community  Programs for Clinical Research on AIDS, a research program 
based  in primary health-care settings like private doctors' practices  
and substance abuse clinics.  The researchers investigated  disease 
developments, including the onset of AIDS-related  illnesses and deaths, 
and found them almost the same among groups taking DDI or DDC.  The 
study revealed that survival time was  slightly longer among patients on 
DDC.  There were 100 deaths in  the DDI group, compared to 87 in the DDC 
group.  A memo  summarizing the research said, "DDC was found to be at 
least as  efficacious as DDI in delaying disease progression, including  
death, and may provide a survival advantage."  The findings could lead 
to a new treatment option for AIDS patients who cannot  tolerate AZT.  
Food and Drug Administration Commissioner David A. Kessler said the 
agency would examine the data and "consider  revising the [DDC] label," 
and would contemplate "urging  insurance companies to pay for single 
agent use." 
------------------------------------------------------------------------
"Doctor: 'Mystery AIDS' Defies Testing" Philadelphia Inquirer 
(01/22/93), P. A2  (Collins, Huntly)
     The mysterious AIDS-like illness found in the United States may  be 
caused by an unusual variant of HIV that is not detectable by  
conventional laboratory tests, said a leading AIDS researcher  
yesterday.  Dr. Jeffrey Laurence, head of AIDS research at  Cornell 
University, said that the number of people with this  variant appeared 
to be exceedingly small.  There is no proof that the virus is 
transmitted from one person to another through blood or sexual 
intercourse the way HIV is, he added.  Laurence, who  spoke to medical 
staff at Hahnemann University in Philadelphia,  was among a group of 
researchers who reported puzzling HIV cases  at July's International 
AIDS conference in Amsterdam.  The  researchers found patients who 
tested HIV-negative in laboratory  tests but who had AIDS-like symptoms, 
including severely  depressed immune systems.  Since the conference, the 
Centers for  Disease Control has detected 68 such cases of the AIDS-like  
illness, known as idiopathic CD4 T-lymphocytopenia.  Laurence  reported 
five cases of the condition last summer, and has found  12 additional 
ones since that time.  He said the mysterious cases may be caused by a 
virus that is similar to HIV-1.  He based his  belief on preliminary 
evidence from two patients.  Pictures of  the patients' cells, taken 
with an electron microscope, showed  virus particles like HIV-1, said 
Laurence, and research  demonstrated that the genetic makeup of the 
particles closely  resembled that of HIV.  While the virus is similar to 
HIV, it may be different enough not to be detected on conventional lab 
tests. Laurence urged that more advanced tests be developed. 
------------------------------------------------------------------------
"Boost for AIDS Drugs" Financial Times (01/22/93), P. 8  (Abrahams, 
Paul)
     Stock shares for Burroughs Wellcome rose sharply last week after  
reports of a positive trial for AZT.  The trial was conducted by  the 
National Institutes of Allergy and Infectious Diseases, which compared 
AZT with DDI in HIV-infected patients with late-stage  disease.  The 
study demonstrated that AZT was more effective in  delaying the progress 
of AIDS among patients who had not  previously used the drug.  The trial 
was conducted from October  1989 to May 1992 and involved 617 patients.  
Among the 380 AIDS  patients who had not taken AZT before, 18 percent 
developed a  new, previously undiagnosed, AIDS-related illness or died 
within  a year, compared with 31 percent taking 750 mg of DDI, and 29  
percent on a 500 mg dose.  But for those who had used AZT for  eight to 
16 weeks before, DDI proved more effective.  For this  group, 33 percent 
taking AZT developed a new AIDS-related  condition or died within a 
year, compared with 11 percent on 500  mg of DDI, and 17 percent on 750 
mg.  The study showed that the  two drugs had mixed side-effect 
profiles.  Those taking AZT were  more likely than those on DDI to 
experience lowered blood cell  counts.  Those on a 750 mg dose of DDI 
were more likely to  develop pancreatitis than those on a 500 mg dose or 
AZT.  The  trial suggests that combination therapy will play an 
increasingly important role in treating HIV-related disease. 
------------------------------------------------------------------------
"France's Fabius Wants Trial to Clear His Name" Reuters (01/20/93)
     Paris--Former French prime minister Laurent Fabius asked to be  
tried by a parliamentary High Court to vindicate himself from a  scandal 
in which 1,200 French hemophiliacs contracted HIV from  contaminated 
blood.  Fabius, who served from 1984 to 1986 and is  currently first 
secretary of the ruling Socialist Party, said he  hoped that judges 
would not decide that too much time had elapsed for a trial to be held.  
In 1985, the hemophiliacs were infected  by HIV-tainted transfusions 
before controls to screen and purify  the blood stocks were introduced.  
Last month, members of both  houses of parliament decided that Fabius 
and two other former  ministers should be tried by the High Court on 
charges of  neglecting to assist persons in danger.  A panel of judges 
will  convene today to determine whether there are grounds for a trial. 
Fabius has argued that he was not responsible for the incident  because 
scientific knowledge about AIDS was more limited at the  time.  He said 
that if a time limit is established by the judges  considering his case, 
he will return to parliament to press his  case for a trial. 
------------------------------------------------------------------------
"Chiron Diagnostics Appoints Jean-Paul Bonn Vice ..." Business Wire 
(01/20/93)
     Emeryville, Calif.--Chiron Corp. announced Wednesday that it  
appointed Jean-Paul Bonn as vice president, sales and marketing,  for 
Chiron Diagnostics.  This appointment is significant because  Bonn has 
previously coordinated European marketing and new  business development 
of AIDS and hepatitis products for Ortho  Diagnostic Systems Inc., a 
unit of Johnson + Johnson, which has a joint business in blood screening 
products for HIV and hepatitis  with Chiron.  Before joining Ortho, Bonn 
worked at E.I. Du Pont  de Nemours + Co. Inc., where he held a series of 
management  positions.  Some of his responsibilities included the 
development of new tests for HIV and HIV-1/2, clinical evaluations, 
product  registrations, and distribution agreements.  William G. Gerber,  
president of Chiron Diagnostics, said, "Jean-Paul has a strong  
technical background and is particularly familiar with the  research 
community and diagnostic market for hepatitis and AIDS  in Europe."  He 
added, "Our tests are designed to be used to  monitor therapy by 
quantifying the amount of virus present in  patients.  We have begun the 
process of establishing the utility  of these tests for hepatitis C, 
hepatitis B, and AIDS treatment  with opinion leaders.  Jean Paul is 
ideally suited to lead this  effort, and has the added advantage of 
being able to work  effectively with our colleagues at Ortho to 
coordinate these  separate but complementary businesses." 
------------------------------------------------------------------------
"Some Library Patrons Want Gay-Lesbian Magazine Removed" United Press 
International (01/21/93)
     Goshen, Ohio--The gay-lesbian magazine The Advocate has evoked  
controversy in a small Cincinnati-area community, where patrons  of a 
local library want officials to remove the publication from  library 
shelves.  Dave Macksam, director of the Clermont County  Public Library, 
said three people have filed written requests to  have library staff 
examine the magazine.  He said, "We try to  look at reading interests on 
a community basis.  It was the  opinion of the staff at the branch that 
there was a reading  audience for it."  One of the complaints about The 
Advocate was  that it was "inappropriate material" for the library.  
However,  Barbara Galik, assistant university librarian for information 
and research services at Miami University and Northern Kentucky  
University, argued, "The articles in there are quite good.  If  you want 
up-to-date information on AIDS and AIDS research that is the place to 
get it.  We've had no complaints."  Betsy Gressler,  president of 
Stonewall Cincinnati, a gay and lesbian group, said  the magazine does 
not contain sexually explicit photos or  advertisements, but does 
provide information on fashion, music,  and books, and also shows 
positive homosexual role models.  "In a lot of rural areas, having 
access to magazines such as The  Advocate is the only link to the gay 
and lesbian community that a lot of people have.  I think any attempt to 
have it removed is an attempt at censorship," said Gressler. 
------------------------------------------------------------------------
"The Geography of AIDS" Atlantic Monthly (01/93) Vol. 271, No. 1, P. 90   
(Gould, Peter and Kabel, Joseph)
     Recent technology has allowed computers to model maps of the  
progress of the AIDS epidemic, which can be helpful as a means of 
education.  In the early years of the epidemic, geographic  information 
was hard to obtain because doctors thought that  disclosing it might 
threaten the confidentiality of people's  medical records.  But now, 
AIDS cases can be reported on an  appropriate geographic basis without 
any possibility of revealing identities, and most states today publish 
data on AIDS cases by  county or by zip code.  Researchers give the 
computer the number  of AIDS cases in each county; the computer gives 
complex formulas to predict their likely distribution throughout the 
county.   Also, the colors on the AIDS map represent geometric steps, 
which can capture the great variation in incidence for each location.   
For example, a map of Ohio will show different colors for rates  of AIDS 
cases.  The prevalence of AIDS tends to intensify in  confined areas 
before more remote locales are infected.  But maps with a predictive 
capability have not yet been used in  epidemiology in any systematic 
capacity, even though the ability  to predict the course of epidemics 
could help health-care  planners in many ways.  Several hospitals and 
health-care  facilities are already overwhelmed with AIDS cases, and 
planning  new or expanded facilities requires decisions about where to  
obtain scarce medical resources.  In addition, maps can be  motivating 
when animated.  Teenagers and young adults are very  difficult to reach 
in educating  behavioral change.  Therefore,  viewing an AIDS prevalence 
map might help them understand that  the danger of AIDS is everywhere. 
------------------------------------------------------------------------
"Delayed Trial of HIV Immune Globulin to Protect Infants of  Infected 
Mothers Is Likely to Resume" Journal of the American Medical Association 
(01/06/93) Vol. 269,  No. 1, P. 17  (Cotton, Paul)
     Abbott Laboratories will no longer pursue blocking a trial of a  
product that may prevent the transmission of HIV from infected  mothers 
to their infants.  The group has dropped its demands to  be exempt from 
liability in the trials of HIV Immune Globulin  (HIVIG).  But it may 
still be a full year from when a National  Institutes of Health-
sponsored multicenter trial was supposed to  start to when the trial 
actually does commence.  Abbott sold all  rights to its HIVIG to North 
American Biologicals Inc., of Miami, Fla., "including raw materials, 
some manufacturing equipment, the know-how, everything," as of Nov. 4, 
according to Abbott  spokeswoman Traci Lance.  Mark Rosenbaum, an 
attorney with the  American Civil Liberties Union, said it was a 
"textbook case" of  promissory estoppel contract law, except that in 
this case  "thousands of infants' lives and the progress of AIDS 
research  were at stake."  He said that liability "never was the real  
reason" for blocking the trials, as the "so-called risk" was the  same 
when Abbott first proposed the study as when the company  raised the 
issue two years later.  Abbott had said that it needed complete 
indemnification because HIVIG, purified antibodies from  healthy persons 
infected with HIV, might possibly increase the  chance of a baby 
becoming infected.  Although Abbott sold  everything to North American 
Biologicals Inc., the NIH is  reviewing applications from at least one 
other producer of HIVIG, the New York Blood Center, to supply it for the 
trial.  If North  American Biologicals wins, the trial could begin in 
the spring  because phase-1 studies of the former Abbott product are  
completed. 
----------------------------------------------------------------------- 
"Cats and Toxoplasmosis Risk in HIV-Infected Adults" Journal of the 
American Medical Association (01/06/92) Vol. 269,  No. 1, P. 76  
(Wallace, Mark R. et al.)
     The presence of toxoplasmosis in an adult HIV-infected population 
is unusual and appears unrelated to cat ownership or exposure,  write 
Mark R. Wallace et al. of the U.S. Naval Hospital in San  Diego, Calif.  
Serial toxoplasma antibody results were available  for 723 patients.  A 
total of 70 patients (9.7 percent) were  positive on their initial 
screen; the seronegative patients were  tested annually for 1 to 5 years 
(mean duration of follow-up, 2.1 years).  Only 13 patients (2.0 percent) 
who were initially  seronegative acquired antibodies to Toxoplasma 
gondii.  None of  the patients who seroconverted developed clinical 
disease.  A pet history was available on 12 of 13 patients who 
seroconverted;  only one (8.3 percent) had owned or lived in a household 
with a  cat during the period of seroconversion.  The calculated  
attributable risk of cat ownership/exposure for toxoplasmosis  
seroconversion in this population is -2.9 per 100 persons  annually.  
Cat owners who are initially seronegative for  toxoplasmosis can be 
assured that their pets pose them no major  risk for seroconversion and 
possible subsequent toxoplasmic  encephalitis.  But patients who own 
cats would continue to be  advised to exercise reasonable caution while 
emptying or  otherwise working with litter boxes, as close contract with 
cat  feces is an established means of transmission in certain  settings.  
Daily emptying of litter boxes in addition to prompt  handwashing can 
serve to further prevent the risk of  toxoplasmosis in those who empty 
litter boxes, the researchers  conclude. 
------------------------------------------------------------------------
"FDA OKs New Fast-Track Blood Infection AIDS Drug" American Medical News 
(01/18/93) Vol. 36, No. 3, P. 19
     The first drug to treat a blood infection in patients with  
advanced AIDS has been approved by the Food and Drug  Administration.  
The drug, rifabutin, has been on a fast track  through the FDA since an 
advisory committee gave approval last  February.  Clinical tests have 
exhibited the efficacy of  rifabutin in blocking or delaying 
Mycobacterium avium complex, or MAC, which occurs in about 25 percent of 
patients in late stages  of AIDS.  The trials, performed on 1,100 AIDS 
patients, revealed  that the drug decreased the rate at which patients 
developed MAC  by almost half.  Its side effects include rash and  
gastrointestinal symptoms, muscle and joint aches, discolored  urine, 
and a decrease in certain white blood cells, said the FDA. 

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