From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 12/17/92
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6651
Organization: unspecified
Date: Thu, 17 Dec 92 08:15:51 PST

                     AIDS Daily Summary 
                     December 17, 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 

 "San Francisco Journal: A Pharmacy for the AIDS Epidemic" New York 
Times (12/17/92), P. A24  (Gross, Jane)
     A gay-owned pharmacy, designed to serve the unusual needs of AIDS 
and HIV patients, recently opened in the Castro district in San  
Francisco.  Paul A. Morabito, a 28-year-old investment banker  with an 
expertise in health care, owns the Castro Village  Pharmacy.  He set out 
to identify what aspects of traditional  pharmacies failed to meet AIDS 
patients' needs, and then sought  to correct the problems with a 
combination of common sense and  high technology.  Morabito found one 
problem was the  unavailability of specialized AIDS drugs in small 
pharmacies,  which could not afford to stock the expensive offerings.  
Castro  Village supplies with various AIDS pills, ointments, and  
infusions.  Another problem Morabito discovered was the  requirement 
imposed by virtually all pharmacies that customers  pay up front for 
their drugs.  As a result, Morabito inked a deal with the McKesson 
Corp., a pharmaceuticals distributor,   convincing it to advance him the 
costly drugs and wait for  payment after insurance reimbursement.  
Morabito established an  array of computers, modems, fax machines, and 
automatic pill  counters to facilitate filling prescriptions.  He has 
developed a system that allows doctors to fax prescriptions and tap into 
a  computer that shows them what other medications their patients  are 
taking and how the different treatments interact.  Also,  patients can 
leave refill orders on the drug store's voice mail  system. 

"Chemical Briefs: Study Links AIDS, Failure of TB Drugs" Journal of 
Commerce (12/17/92), P. 7A
     Several AIDS patients previously believed to be co-infected with  
the drug-resistant strain of tuberculosis, may actually be unable to 
absorb the medicine, according to a study published in the New England 
Journal of Medicine.  Researchers from the National  Jewish Center for 
Immunology and Respiratory Medicine in Denver,  Colo., say they treated 
an man with AIDS whose TB reappeared  because he could not absorb the 
medicine, not because the TB had  become resistant.  Shaun E. Berning 
led the group and said that  because intestinal disease is common among 
HIV-positive patients, the patients should be tested to ensure the dose 
of the drug is  high enough for the medicine to be effective. 

"Company Markets Reputed Anti-AIDS Cream for Health-Care Workers" United 
Press International (12/16/92)
    Pompano Beach, Fla.--A hand-cream that allegedly kills HIV  
infection is being marketed despite Food and Drug Administration  
concerns.  Knight Industries Inc. has begun marketing what it  calls 
"liquid glove" intended for health-care workers.  But the  FDA said 
Wednesday that it started an investigation of "Viro  Glove" cream, which 
regulators insist needs government approval  before being marketed.  
Monica Revelle, FDA spokeswoman, said,  "At this point, it could be 
premature to say what actions we  might take.  (But) we consider (the 
product) a drug, and right  now, it is unapproved."  However, Knight 
Industries maintains  that Viro Glove is a "device," not a medicine, 
therefore no  FDA-approval is needed.  Knight Industries spokeswoman 
Colleen  McMurray said Knight had submitted all required reports on the  
cream's safety and efficacy to the FDA.  In addition, she said  that the 
product passed a 90-day waiting period without any  government 
challenge.  McMurray asserted that Viro Glove provides health-care 
workers with protection from HIV infection for four  to six hours.  It 
also helps protect against gonorrhea and  influenza.  She said, "Our 
target market is at-risk health  professionals: emergency-medical 
technicians, police, school  nurses--anybody who comes into contact with 
blood or blood  pathogens due to their occupations."  McMurray also said 
that  Viro Glove contains the spermicide Nonoxynol-9 and will sell for  
$19.95 per 8-ounce bottle. 

"National Briefs: 'Brownie Mary' Case is Dropped" Boston Globe 
(12/16/92), P. 10
    A California district attorney announced Tuesday that he would  
discontinue the prosecution of an elderly woman who attempted to  ease 
the pain of AIDS patients by providing them with  marijuana-laced 
brownies.  Mary Rathbun, nicknamed "Brownie  Mary," baked the illegal 
brownies and distributed them to AIDS  patients in San Francisco. 

"John Maddix Dies; Was Official at the Whitman-Walker Clinic" Washington 
Post (12/17/92), P. C6
    John Maddix, former director of training at the Whitman-Walker  AIDS 
Clinic in Washington, D.C., died on Dec. 15 at the age of  42.  Maddix 
had AIDS.  He joined the staff of the clinic as  director of training in 
1987.  Maddix directed the speaker's  bureau and designed an HIV-related 
community training and  volunteer program at the clinic.  In addition, 
he spearheaded  "AIDS in the Workplace" seminars that were presented to  
corporations and government agencies.  In 1991, he retired on  
disability.  Although retired, Maddix served on Whitman-Walker's  board 
of directors.  He was a key player in the creation of the  Persons With 
HIV Advisory Committee.  Moreover, the education  building at the 
Whitman-Walker Clinic was named the John Maddix  Center.   Related 
Story: Washington Times (12/17) P. B4 

"Inside the Beltway: Ho Ho Ho" Washington Times (12/17/92), P. A6
    An unwelcome Christmas greeting has been floating around  
Washington, D.C.  Five different stickers have been distributed  
depicting crying children with the following message stamped on  them, 
"Christmas is canceled this year, Santa has HIV.  If only  Reagan and 
Bush had told the truth, Santa wouldn't have to die  from AIDS."  A 
stack of the stickers were found at a Dupont  Circle record store on 
Tuesday.  An employee of the store said  all materials considered 
offensive to patrons are ultimately  removed from the premises, and as 
of yesterday there were no such stickers to be found.  The Washington 
Times said, "As for those  who still believe in Santa Claus and are 
concerned that his  health might prevent him from making his annual 
rounds next week, don't worry.  We have it on reliable authority that 
Santa is not  a member of any of the high-risk groups for AIDS." 

"Dr. Elders's Bully Point" New York Times (12/17/92), P. A34
    President-elect Bill Clinton made a wise choice in selecting Dr.  
Joycelyn Elders to be the new Surgeon General of the United  States, 
write the editors of the New York Times.  Elders has  served as director 
of the Arkansas Health Department for five  years.  She has been 
straightforward in discussing AIDS, sexual  abuse of children, the 
necessity of sex education, and easy  access to contraceptives for 
teenagers.  She is remarkably  realistic about adolescent sex, which is 
a necessity when a  quarter of sexually active teenage women under 18 
have had four  or more sexual partners.  "I really feel we must put our 
children first and I'm willing to do whatever we have to do to save the  
children," she said.  Being black and female, she helps fulfill  
Clinton's pledge of a diverse administration.  Former Surgeon  General, 
Dr. C. Everett Koop, effectively used his office by  turning it into a 
bully pulpit from which to warn of the dangers  of smoking, support sex 
education, and speak intelligently and  compassionately of AIDS.  Dr. 
Elders, whose integrity and  frankness matches Dr. Koop's, may be 
equally effective as a  leader in public health, the editors conclude. 

"Sexual Lifestyles and HIV Risk" Nature (12/03/92) Vol. 360, No. 6403, 
P. 410   (Johnson, Anne M. et al.)
     Many Britons at high risk of HIV infection have perceived this  and 
have already undergone HIV testing, but more than half remain untested, 
according to a study conducted by Anne M. Johnson et  al. of the 
University College London Medical School in London,  U.K.  The study 
involved a total of 18,876 respondents between  the ages of 16 and 59.  
It found that there is a greater tendency of younger respondents, 
particularly men, to report multiple  partners over recent time 
intervals.  The probability of  reporting two or more partners in the 
past year was significantly increased among the unmarried (including 
cohabitees); those who  reported first heterosexual intercourse before 
age 16; and those  in the two highest social classes.  The proportion 
reporting ten  or more partners is higher among those aged 25-44 than 
among  those over 45, though lower among men aged 16-24 who have become  
sexually active more recently.  Also, those of higher  socio-economic 
status were more likely to report larger numbers  of partners.  More 
than 13 percent of the sample reported they  had had an HIV test.  The 
most common reason for testing was  blood donation, but more than 4 
percent of men and nearly 3  percent of women had had a test for reasons 
other than blood  donation, pregnancy, and insurance/travel.  Among IV-
drug users,  53 percent reported ever sharing needles, and nearly half 
had  undergone HIV testing.  The researchers conclude that all these  
rates are in significant excess of those of the overall  population, 
indicating that a considerable proportion of those  with high-risk 
behaviors have chosen to undertake HIV testing. 

"Atovaquone (Mepron; 566C80) Approved for Pneumocystis" AIDS Treatment 
News (12/04/92) No. 164, P. 1  (James, John S.)
     The Food and Drug Administration approved atovaquone (brand name  
Mepron; formerly known as 566C80) on Nov. 25 for mild to moderate 
pneumocystis, as a second-line treatment for those patients who  cannot 
tolerate the existing treatment,  trimethoprim/sulfamethoxazole 
(TMP/SMX).  The drug should be  available in pharmacies nationwide by 
early December.  Atovaquone was approved for second-line, not first-
line, treatment because  of a major comparative trail which found that 
TMP/SMX worked  better for those who could tolerate it.  Although the 
two drugs  had about the same "therapeutic success", TMP/SMX had higher  
survival after eight weeks.  But 20 percent of those administered 
TMP/SMX had to discontinue its use because of side effects; now  
atovaquone is available as second-line treatment for such  patients.  
Atovaquone should be taken with meals because it is  much better 
absorbed when taken with food.  The drug's  manufacturer, Burroughs-
Wellcome, announced a price to the  wholesaler of $2.13 per 250 mg. 
tablet.  The recommended dose is  2250 mg per day for 21 days, which 
means the wholesale price to  treat one case of pneumocystis is about 
$402.  But  Burroughs-Wellcome has announced a program to cap the annual 
cost for patients without third-party coverage who use more than 411  
grams in a calendar year--about $3,500 wholesale.  The cap may  assist 
those experiencing cases of hardship, but presumably few  will reach the 
limit.

"Atovaquone: Development History, Activist Involvement" AIDS Treatment 
News (12/04/92) No. 164, P. 2  (James, John S.)
     A drug to treat pneumocystis, atovaquone, was put through human  
trials and then received Food and Drug Administration approval in a 
surprisingly short amount of time.  But during this time,  Burroughs-
Wellcome, the drug's manufacturer, conducted the  largest controlled 
trial yet of a pneumocystis treatment, at 37  locations in the U.S., 
Canada, and Europe.  Although the trials  were still in progress, the 
company provided atovaquone free of  charge to over 900 patients who had 
no other treatment option,  through a "treatment IND" approved by the 
FDA.  The speedy  approval process can be attributed to Burroughs-
Wellcome, the  FDA, and AIDS activists, who have done much to expand 
access to  this drug.  David Peck of ACT-UP/Boston said in a press 
statement released after the approval of atovaquone, "ACT-UP knocked on  
Wellcome's door 18 months ago, and asked for access to atovaquone during 
its development.  Our agenda specified drug access  guidelines, such as: 
the target patient population, 24-hour drug  delivery, an 800 number, 
etc., and Wellcome implemented this  expanded access program with FDA 
approval a year ago.  Over 900  people got atovaquone free of charge 
during the program--and  ACT-UP/Boston is proud of this accomplishment."  
He also said  that ACT-UP/Boston pressured the FDA to move the drug 
through the approval process quickly.  "As recently as last week, at our  
urging, the FDA changed the proposed labeling on atovaquone to  make its 
use more inclusive...," said Peck.  He added,  "Atovaquone proves that 
ACT-UP and drug companies, despite our  differences and our seemingly 
endless demands, can work  together." 

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