From: bigoldberg@igc.apc.org (Billi Goldberg)
Newsgroups: sci.med.aids
Subject: CDC Summary 9/28/92
Date: 28 Sep 92 15:18:20 GMT
Organization: unspecified
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6235


                         AIDS Daily Summary
                         September 28, 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 
************************************************************************
 "Magic Johnson Quits Panel on AIDS" New York Times (09/26/92), P. 5  
(Hilts, Philip J.)
     Magic Johnson announced his resignation on Friday from the  
National Commission on AIDS, arguing in a letter to President  Bush that 
the administration had "utterly ignored" the  commission's advice on how 
to deal with the AIDS epidemic.   Johnson, who announced his HIV-
positive status last November, was appointed to the commission by Bush 
later that month.  Since his  appointment, he has become increasingly 
disappointed with the  administration's reluctance to take an active 
stance on the  epidemic and heed the recommendations of the group.  The  
commission recommended a single national plan of attack,  increased drug 
abuse treatment, needle-exchange programs,  eliminating the immigration 
ban against foreign AIDS patients,  and a more candid discussion of 
sexual matters and safe sex in  AIDS education programs.  President Bush 
made no public comment  on Johnson's resignation.  But White House 
deputy press secretary Judy smith, traveling with Bush on a campaign 
trip to Illinois,  said, "We regret the decision by Magic Johnson to 
resign.  The  Administration and Mr. Johnson, are both committed to 
ridding  this nation of AIDS."  In addition, Secretary of Health and 
Human Services, Dr. Louis W. Sullivan, said that Johnson's resignation  
had been accepted with regret.  He disagreed with Johnson's  allegations 
of the administration's anti-AIDS efforts.  "During  the four years of 
the Bush administration, the federal government has supported increased 
efforts in research, new therapies for  those with HIV, and extensive 
health-care services," said  Sullivan.  Johnson is expected to continue 
working on AIDS  education without the commission. 

"Bolling Backs Condom Measure" Boston Globe (09/25/92), P. 19  
(Rezendes, Michael)
     Boston's Councilor at Large Bruce C. Bolling announced Thursday  
that he will vote to override Mayor Raymond Flynn's veto of a law that 
would mandate most restaurants and bars to install condom  vending 
machines.  "I see this ordinance as one more arrow in the quiver to 
combat the spread of sexually transmitted diseases,  including AIDS.  I 
will vote for the override."  Last month the  ordinance was passed by an 
8-4 vote, but supporters were one vote shy of the nine necessary to 
override a veto.  Bolling's position on the legislation could make the 
outcome possible.  Robert  Greenwald, an attorney for the AIDS Action 
Committee, said, "This epidemic has taken far too many lives for us to 
allow an elected  official's personal and moral beliefs to obstruct 
sound public  health policy.  If the mayor is not going to offer 
leadership,  then he should at least stand aside and let the City 
Council do  its job."  The legislation calls for all city establishments 
with entertainment licenses to be required to install a condom vending 
machine with a sticker listing local organizations that provide  
information about AIDS and other sexually transmitted diseases.   The 
proposal was rejected by Flynn because he believed it would  be wrong to 
enlist the government in an attempt to combat the  spread of HIV by 
requiring the sale of condoms.  Albert W.  Wallis, corporation counsel, 
said that only the mayor had the  authority over entertainment 
licensing, not the council. 

"A Room for Heroin and HIV" Los Angeles Times--Washington Edition 
(09/28/92), P. A1 (Bearak, Barry)
     For heroin addicts, shooting galleries are a classic location for 
the transmission of HIV.  This is where many drug addicts engage  in a 
type of microbiological roulette--sharing the contaminated  needles.  
The United States has a projected 1 million IV-drug  users, and in 
recent years they have not only been responsible  for 34 percent of all 
newly reported AIDS cases, but have also  been the main cause of the 
disease's spread to the heterosexual  population.  Dr. T. Stephen Jones, 
assistant director for  substance abuse and HIV prevention at the 
Centers for Disease  Control, said, "We've made it real hard for these 
people to  survive.  There's too much of a feeling that drug addicts are  
excrement and we'd do well to be rid of them."  The priority of  the 
government has been the War on Drugs and not emergency public health 
measures to convert addicts to safer needle practices.   There is a 
reluctance to do anything that might encourage drug  use.  As money has 
been allotted for police work and prisons,  money for treatment has been 
lacking.  Approximately 335,000  IV-drug users are believed to be HIV-
positive.  It is predicted  that they have transmitted HIV to 50,000 to 
75,000 non-injectors, mostly through unprotected sex, though also 
perinatally, mother  to unborn child.  These sexual transmissions are 
mostly male to  female.  Also, about two-thirds of American-born 
heterosexual  AIDS patients have reported sexual contact with an IV-drug 
user. 

"Panel Recommends AIDS Infection Drug" Journal of Commerce (09/28/92), 
P. 6A
     A Food and Drug Administration advisory committee has recommended 
approval of the first drug to prevent a possibly fatal  opportunistic 
infection in AIDS patients called Mycobacterium  avium complex (MAC).  
The MAC bacteria is prevalent in the  environment and commonly infects 
persons who are immunosuppressed by AIDS.  The infection rarely affects 
healthy people. 

"Virucides May Help in Fight Against AIDS" Journal of Commerce 
(09/28/92), P. 6A
     Virucides that kill sexually transmitted diseases might also be  
useful in preventing HIV infection, according to a report in the  
current issue of Ms. Magazine.  The Vaginal Contraceptive Film,  now 
being marketed as a contraceptive, is a small, thin square  with a 28 
percent concentration of nonoxynol-9 that is inserted  into the vagina.  
The contraceptive remains active for about two  hours and is washed away 
with body fluids.  Nonoxynol-9's  effectiveness against HIV has been 
shown in laboratory tests  conducted on monkeys infected with the simian 
immunodeficiency  virus, the magazine reported.

"Poll: Second Coming of Christ in 21st Century" United Press 
International (09/28/92)
     New York--The majority of Americans plan on seeing the second  
coming of Jesus Christ, a female president, cures for AIDS and  cancer, 
and more environmental disasters in the 21st century.   The survey 
involved 800 adult Americans and was conducted by  Yankelovich Clancy 
Shulman on July 22 and 23.  After the year  2000, 76 percent of those 
polled expected researchers to find a  cure for AIDS, while 80 percent 
expected a cure for cancer, and  only 39 percent expected a cure for the 
common cold. 

"Doctor Treats HIV Inmates With Respect" United Press International 
(09/27/92)
     Madison, Wis.--A total of 43 inmates in Wisconsin are  HIV-
positive.  While they are shunned by many of the inmates, one physician 
treats them like any other patient.  Frank M. Graziano, a physician at 
the University of Wisconsin Hospital and Clinics,  has been commended 
for his frankness and for caring.  Graziano  said, "To me these are 
human beings.  I've never felt threatened  by them.  I try to treat them 
with as much respect as I do any  other patient."  Graziano is one of a 
projected 12-20 doctors in  the state who treat HIV-positive patients.  
He treats the inmates with HIV because his hospital treats all seriously 
ill inmates.   Graziano began treating HIV-positive patients in the mid-
1980s.   The total number of cases then was 20.  It has escalated to  
400--making his clinic, which also treats patients who aren't  inmates, 
one of the largest of its kind in the state.  The 43  inmates with HIV 
infection consist of 40 men and three women.   Several discovered their 
infection when, upon admission to the  clinic, they voluntarily were 
tested for HIV.  More than 70  percent of new inmates take the test.  
According to Graziano, the state Department of Corrections rarely 
questions the necessity of tests for prisoners.  The state paid an 
average of $5,823 per  prisoner with AIDS or HIV last year. 

"Coronary Lesions in Young HIV-Positive Subjects at Necropsy" Lancet 
(09/19/92) Vol. 340, No. 8821, P. 730  (Tabib, Alain et al.)
     The presence of striking coronary lesions in HIV-positive men  
suggests that this complication may be frequent, write Alain  Tabib et 
al. of the Hopital Louis Pradel in Lyon, France.   Necropsies were 
conducted on eight young HIV-positive subjects  found dead in 
unexplained situations.  They fell between the ages of 23 and 32, and 
all had significant coronary lesions.   Information from the family or 
the attending physician was  obtained from all eight of the HIV-positive 
subjects, and no  history of familial coronary disease or predisposing 
factors were detected.  Coronary disease has been linked with 
cytomegalovirus  (CMV) infection, which was present in 2 of the cases, 
and with  cocaine abuse, but in an older population.  The lesions 
consisted of eccentric deposits similar to those found in older 
patients,  and quite distinct from the concentric pattern of the 
accelerated forms of coronary disease.  All of the subjects were male, 
four  were homosexual or bisexual, and the other four were IV-drug  
users.  A total of five had clinical AIDS.  Mechanisms of the  induction 
of coronary disease in young, HIV-positive subjects  could include 
atherogenesis by virus-infected  monocyte-macrophages, possibly through 
altered adhesion, or  injury to or stimulation of endothelial cells 
after infection or  interaction with infected cells.  The relation of 
the coronary  lesions to HIV infection is strongly suggested by the fact 
that  all coronary lesions found at necropsy of subjects in the same  
age-range were associated with well-known familial risk factors  that 
did not occur in the eight HIV-positive subjects, the  researchers 
conclude. 

"Apolipoprotein AII in HIV-1 Infection" Lancet (09/19/92) Vol. 340, No. 
8821, P. 730  (Gervais, A. et al.)
     Apolipoproteins (Apo) AI and AII decrease during acute infections 
and particularly so in AIDS, write A. Gervais et al. of the  Hopital de 
la Salpetriere in Paris, France.  The researchers  measured serum and 
cerebrospinal fluid (CSF) Apo AI, AII, B, and  H by 
electroimmunodiffusion, Apo AII and E by ELISA, and Apo (a)  by 
radioimmunoassay in 30 HIV-1 patients.  The researchers  compared 
findings with those from 79 other neurological patients, including 41 
with multiple sclerosis.  In the HIV-1 group, serum  Apo AI, AII, B, and 
H were substantially decreased.  Apo AII was  under the lower normal 
limit in 20 to 30 patients.  Cholesterol  and phospholipids were 
decreased and triglycerides were all  substantially increased compared 
with controls.  The frequency of Apo AII intrathecal synthesis, which is 
rare, was significant.   These nine occurrences of intrathecal synthesis 
were observed in  five patients with AIDS dementia complex, two with  
cytomegalovirus, one with progressive multifocal  leucoencephalopathy, 
and one without neurological symptoms.  The  increased AI/AII ratio in 
the HIV-1 group is because Apo AII  decreased.  The reason is that there 
could be progressive  tissue-wasting linked to opportunistic infections 
and/or nutrient malabsorption.  But serum albumin and prealbumin were 
not  substantially different in the 20 seropositive patients with a  
very low serum Apo AII, and were normal in the other seropositive 
patients.  Another reason could be that Apo AII may be implicated in a 
reduction of cell death induced by HIV-1 linked to the  amphipathic 
helix of this protein, similar to Apo AI. 

"Disseminated Mycobacterium Avium Intracellulare Infection  Without 
Predisposing Conditions" Lancet (09/19/92) Vol. 340, No. 8821, P. 731  
(Couderc, L.J.)
     One case of Mycobacterium avium intracellular (MAI) had no  
evidence of HIV infection but acted much the same as that in AIDS 
patients, write L. J. Couderc et al. of the Hopital Foch, in  Suresnes, 
France.  A 32-year-old woman was found to have anal  condylomas in 1986.  
She experienced recurrent buccal herpes in  1987.  In April, 1990, she 
developed cervical papillomavirus  infection, and in October of that 
year she complained of malaise, fever, and weight loss.  She never had 
the severely low CD4 cell  count common in AIDS patients with 
disseminated MAI infection.   She was started on a regimen of isoniazid, 
rifampicin, and  ethambutol.  Culture of bone-marrow was positive for 
MAI although repeated sputum samples, bronchoalveolar lavage, and blood  
cultures were negative for MAI.  In 1980 the woman had undergone  a 
blood transfusion and denied using IV-drugs and sexual contact  with a 
drug user or with a known bisexual man.  She had been  repeatedly 
negative for HIV-1 and HIV-2 by ELISA and western  blot.  In June 1981 
she deteriorated with persistent fever,  severe weight loss, and an 
increase in pulmonary interstitial  infiltrate.  In September 1991 an 
open lung biopsy was consistent with pulmonary alveolar proteinosis.  
She died in October 1991.   Necropsy did not reveal any hematological 
malignant disease or  carcinoma.  In HIV-negative patients, disseminated 
MAI infection  occurs mainly in the immunocompromised, or it may precede 
the  onset of a neoplasia.  The infections in the woman indicate an  
immunodeficiency that predominantly affected cell-mediated  immunity.  
The researchers could not detect any acquired illness  or primary 
immunodeficiency that might explain this immunologial defect. 

"Trouble in Paradise" Advocate (09/22/92) No. 612, P. 52  (Mirken, 
Bruce)
     In the Netherlands, which is believed by much of the world to  have 
exemplary AIDS prevention programs, there is still room for  
improvement, according to Dutch activists.  The activists argue  that 
the government's programs for helping drug users are not  completely 
satisfactory because not everyone is given access to  them.  A 
methadone-maintenance program in Amsterdam and about 60  clean needle 
exchange programs exclude nonresidents and prison  inmates.  However, 
Ada Wildenkamp, Amsterdam alderwoman for  social affairs and health 
care, said, "despite an increased use  of the syringe-exchange program 
in the course of the years, there has been no rise in the number of 
intravenous users."  In  addition, Health ministry spokesman Hans 
Moerkerk supports the  policy of excluding foreign nationals as 
necessary to prevent the country from becoming a world drug mecca.  
Moreover, an amendment repealing the current prohibition on prostitution 
is expected to  be enacted on Jan. 1, 1994, and many cities are already 
devising  schemes for brothel licensing and regulation.  Wildenkamp said  
this approach makes it easier to reach brothel workers with  condoms and 
information, thus reducing the spread of HIV.  Yet  one ACT-UP member 
says the Netherlands is not as tolerant as  government public relations 
materials suggest because laws  against street prostitution are strictly 
enforced.  Activists  have chastised the government for failing to 
distribute condoms  not only to street prostitutes but to gay men as 
well.