From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 12/15/92
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6634
Organization: unspecified
Date: Tue, 15 Dec 92 07:18:26 PST

                    AIDS Daily Summary
                     December 15, 1992 
 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 
************************************************************************
 "Hemophilia Drug Gains Government Approval" Journal of Commerce 
(12/15/92), P. 7A
     The federal government last week granted approval of Genetics  
Institute Inc.'s genetically engineered drug to treat hemophilia. The 
drug, called Factor VIII, is the blood-clotting protein that  is absent 
in 15,000 to 17,000 hemophiliacs in the United States  with an equal 
number in Europe and slightly fewer in Asia.   Gabriel Schmergel, 
Genetics Institute president, said, "It has  taken us 11.5 years and 
$200 million to reach this day." 

"Somatogen to Continue Blood Substitute Trials" Journal of Commerce 
(12/15/92), P. 7A
     The second part of Somatogen Inc.'s Phase I trials for its  blood 
substitute product will continue into next year, instead of  ending this 
year as planned.  The pharmaceutical company from  Boulder, Colo., did 
not indicate any reason for the extension.   Currently, Somatogen is 
developing a genetically engineered blood substitute called rHb1.  In 
addition, the company revealed that  it plans to introduce a simplified 
commercial manufacturing  process that will increase yields and quality 
of the product. 

"In the Nation: Experts Put AIDS Cost at $15 Billion by '95" Baltimore 
Sun (12/15/92), P. 8A
     The cost of treating HIV-positive Americans could increase about  
48 percent, to $15.2 billion a year, by 1995, health experts told a 
Senate panel yesterday.  Fred Hellinger, a financing specialist with the 
U.S. Public Health Service, said, "The widespread use of expensive drugs 
has contributed to the high costs of treating  persons with HIV."  
Approximately a million Americans are  infected with HIV and 250,000 
have been diagnosed with AIDS.   Among those AIDS patients, 160,000 have 
died.  Hellinger said  that the number of newly diagnosed AIDS patients 
could reach  97,000 by 1995. 

"AIDS Stigma Still a Problem, Magic's Doctor Says" Los Angeles Times--
Washington Edition (12/15/92), P. A8   (Almond, Elliott)
     Magic Johnson's second retirement from the National Basketball  
Association on Nov. 4 illustrates that discrimination against  HIV-
positive people is a reality among professional athletes,  according to 
Johnson's physician Michael Mellman.  He said, "I  guess we just didn't 
to a good enough job, or we weren't  convincing enough or we got our 
facts messed up.  It's so hard to know what is wrong."  Mellman's 
frustration stems from the fact  that Johnson played in last February's 
NBA All-Star game and last summer's Olympic Games without the 
controversy that came a week  before this NBA season began.  Once 
Johnson announced he would  play regular-season games, fears arose among 
players and  officials.  Johnson said the pressures of being an HIV-
positive  athlete were too much to bear once he was introduced to the 
world of AIDS discrimination.  Mellman said, "In spite of our attempts  
to educate, the message is: "Watch out.  There will be some form  of 
discrimination that will occur."  Although experts said there  is an 
infinitesimal chance of transmission among players, it did  not allay 
fears of some players who were worried that Johnson's  infected blood 
could mix with theirs in an open wound if they  collided.  Mellman said 
the only area where similar HIV  transmission has been documented is in 
the health-care setting.   Health-care workers usually deal with 
patients who are sick and  thus have high levels of the virus in their 
blood.  But competing athletes would more likely be healthy, and 
carrying low levels of the virus.  Therefore, the chances of 
transmission are much  lower. 

"School Kept AIDS Secret for 5 Years" St. Louis Post-Dispatch 
(12/14/92), P. 1  (Tuft, Carolyn)
     A St. Louis, Mo.-area school averted the potential for  
discrimination and controversy by keeping a five-year secret that a 
child with HIV infection was attending classes.  The parents of the HIV-
positive child revealed the child's status to the  Hillsboro School 
Board in 1987.  The school officials, the  child's teachers, and the 
school nurse in the Jefferson County  district were the only ones who 
knew the child was infected.  But last month the secret was disclosed.  
Parents, including some new board members, discovered the secret from a 
television news  report, although they still don't know who the child is 
or what  class the child is in.  Consequently, the district held a 
hearing for parents two weeks ago.  Many parents said they were more  
uneasy with the fact that they were kept in the dark about the  child's 
condition than they were about the student's presence in  classrooms.  
School board member Sam Rauls said, "We can't keep  this locked up in 
the closet: We have to protect the rights and  privacy of this child, 
but we also have to respect the rights of  the district's other 3,300 
children and their families."   Hillsboro School Superintendent John 
Sucharski said the Hillsboro district had decided to keep the AIDS case 
secret basically  because federal law had permitted the child to attend 
regular  classes and required his identity kept confidential.  According  
to Sucharski, the community was handling the news in a positive  manner 
because of increased AIDS awareness and understanding.  In addition, 
school officials said the HIV-positive child would have no impact on 
operations because precautions were already in  effect.

"Labor Letter: Employer AIDS Policies..." Wall Street Journal 
(12/15/92), P. A1  (Karr, Albert R.)
     A recent survey of 536 companies by Wyatt Co. found that 36  
percent have some kind of policy for dealing with AIDS.  Most  cover any 
catastrophic illness while ten percent cover only AIDS. Some companies, 
including Levi Strauss and Smith Corona, have  recently instituted 
employee education programs.  Federated  Departments Stores now has a 
manager-training program to work on  the problem of AIDS discrimination. 
Other companies, such as  Xerox and Liz Claiborne, believe their general 
policies already  cover AIDS; ITT says that AIDS patients are protected 
under  disability law.

"Britain--AIDS Virus" Associated Press (12/11/92)  (Epstein, Randi 
Hutter)
     London--HIV can hide inside pre-ejaculatory fluid in men, as  well 
as infecting semen, according to two studies of HIV-positive men  
published in the Dec. 12 Lancet.  Dr. Peter Schlegel, co-author  of one 
of the studies and associate professor of urology at New  York Hospital-
Cornell Medical Center, said, "Many men believe  oral sex without 
ejaculation is completely safe.  That is clearly not the case based on 
the potential infectivity of this fluid."   The second study was 
conducted by researchers at Harvard Medical  School and Boston 
University's School of Public Health.  Both  studies do not suggest the 
risk of contracting HIV by contact  with pre-ejaculatory fluid.  But 
author of the second study Dr.  Jeffrey Pudney of Harvard urged 
additional research.   Pre-ejaculatory fluid "is produced during sexual 
stimulation  before intercourse, so placing a condom on the penis 
earlier may  be important to prevent contact with this fluid, not just 
at the  time of intercourse," said Schlegel.  He added, "We're not  
talking about a lot of fluid, but a small amount of it may be  
important."  The Cornell researchers investigated pre-ejaculatory fluid 
from 14 men with AIDS and two men without the virus.  They  discovered 
HIV and white blood cells in the fluid of six of the  14 men with AIDS.  
Neither was present in the two HIV-negative  men.  Pudney examined 12 
samples of pre-ejaculatory fluid from  nine men with HIV and 11 samples 
from six uninfected men.  His  team discovered HIV in pre-ejaculatory 
fluid from six of nine  infected men but not in any samples from the 
uninfected men used  as controls. 

"Clinical Manifestations and Predictors of Disease Progression in Drug 
Users with Human Immunodeficiency Virus Infection" New England Journal 
of Medicine (12/10/92) Vol. 327, No. 24,  P. 1697  (Selwyn, Peter A. et 
al.)
     HIV-positive IV-drug users have similar progression to AIDS as  
those of other HIV-infected groups.  However, they have a  significant 
pre-AIDS morbidity and mortality, particularly from  bacterial 
infections, which also appear to predict disease  progression, write 
Peter A. Selwyn et al. of the Albert Einstein  College of Medicine in 
Bronx, N.Y.  A prospective study of a  cohort of patients in a 
methadone-treatment program was conducted in New York City from July 
1985 through December 1990.  The  patients underwent standardized 
evaluations at base line and  semiannually thereafter and received on-
site primary medical  care.  Among the 318 HIV-positive patients who did 
not yet have  AIDS (171 men and 147 women), 90 were black, 179 were 
Hispanic,  and 49 were white.  Over a median of 3.0 years of follow-up, 
55  (17 percent) received a diagnosis of AIDS.  Major outcomes before 
the development of AIDS included oral candidiasis, pyogenic  bacterial 
infections including pneumonia and sepsis, pulmonary  tuberculosis, 
multiple constitutional symptoms, and herpes  zoster.  There were 41 
deaths from AIDS, and 13 asymptomatic  HIV-positive patients died of 
bacterial infections, as compared  with only 1 of 411 HIV-negative 
patients examined.  The  prevalence of AIDS was 62 percent lower among 
those who took  zidovudine than among those who did not.  There was no 
concrete  relationship between progression to disease and the continued 
use of IV-drugs, the researchers conclude. 

"Anti-Fungals Get HIV Labeling" Drug Store News for the Pharmacist 
(11/23/92) Vol. 2, No. 11,  P. 35
     Vaginal anti-fungal product cartons and patent leaflets will  soon 
include new labeling regarding the link between frequent yeast  
infections and HIV infection, according to the Food and Drug  
Administration.  Joseph Winfield, a medical officer in the  division of 
anti-infective drug products, said, "It's been  something that we 
thought should have been included for a long  time and we have been 
working on it for about a year."  Winfield  said the FDA received 
requests from several special interest  groups that felt stronger 
wording was needed on the products  since studies have demonstrated that 
women infected with HIV tend to have a higher prevalence of yeast 
infections.  In January, the California Pharmacist Association's 
HIV/AIDS Advisory Task Force  encouraged the FDA to mandate more 
detailed wording.  Elizabeth  Johnson, vice president of education at 
the association, said she was happy with the FDA's decision to implement 
the new labeling. 

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