From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 7/29/92
Note: non-commercial reproduction.
Archive-Number: 5805
Organization: UCLA, Computer Science Department
Date: Wed, 29 Jul 92 18:54:34 PDT

                         AIDS Daily Summary
                           July 29, 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 
Clearinghouse, or any other organization.  Reproduction of this text is 
encouraged; however, copies may not be sold.  Copyright 1992, 
Information, Inc., Washington, DC 
************************************************************************
 "Man With HIV Seeks Damages After Entry Into Canada Denied" Toronto 
Globe and Mail (07/28/92), P. A6  (Fine, Sean)
     Craig Rowe, a Queens, N.Y. man with AIDS, is seeking $25,000 in  
damages from the Canadian government, claiming in the Federal  Court of 
Canada that border officials illegally prevented him  from attending a 
New Year's party in Montreal last year because  of "irrational, 
misguided, stereotyped prejudice about AIDS and  HIV and gay men."  He 
said that he was publicly humiliated when  he was asked in front of 
other passengers on a train whether the  drugs he was carrying were to 
treat AIDS, then taken off the  train, detained for several hours, and 
subsequently sent back on  a nine-hour bus ride at his expense.  
According to the  Immigration Department, officials can prohibit entry 
on medical  grounds if the medical condition could result in a large 
demand  on health or social services during the person's visit.  The  
department said the policy would probably not apply to AIDS.   Perrin 
Beatty, the health and welfare minister, said in April  1991 that short-
term visitors with AIDS could no longer be denied entry into Canada, 
mentioning the conclusion of his advisory  committee that during short 
visits, HIV-positive individuals are  not a threat to public health.

"In the World: French Blood Bank Must Pay in AIDS Case" Baltimore Sun 
(07/29/92), P. 6A
     A state-operated blood bank in Nice, France, was directed by a  
court to pay $400,000 in damages each to three people who  acquired HIV 
as a result of contaminated blood transfusions.  The directive came 
during national controversy over the extent to  which government 
ministers were aware of HIV-infected blood  transfusions in the mid-
1980s.  The damages paid in Nice were  provided for people who were 
given the transfusions at the time.  Since then, one of the three has 
died, so the money will go to  his family.  In addition, four former 
leading health officials  are being tried in Paris on fraud charges 
linked with the several thousand people who contracted HIV in the mid-
1980s. 

"Haitians With AIDS Await Court Ruling" United Press International 
(07/27/92)
     Miami--Haitian refugees with AIDS have been forced to temporarily 
stay at the United States Navy base in Cuba while they await  ruling on 
political asylum claims, refugee advocates say.  The  U.S. Immigration 
and Naturalization Service has kept the Haitians since they left their 
homeland and were restrained at sea by the  Coast Guard.  Though refugee 
advocates concede that Haitians are  probably receiving better food and 
medical care than they would  at home, they  maintain that the Haitians 
are being held in a  "cruel limbo."  Among the 293 Haitians remaining at 
the camp, 233 are HIV-positive and the remaining 60 are their spouses 
and  children.  The INS decided that the Haitians likely have grounds  
for pursuing political asylum claims in the U.S., but the  refugees 
cannot enter the United States because of a law  prohibiting immigrants 
with AIDS and other infectious diseases.   The INS cannot send them back 
to Haiti without further  examination of their asylum claims.  However, 
the agency cannot  continue with those examinations until the courts 
decide whether  the Haitians have the right to consult attorneys, said 
INS  spokesman Duke Austin.

"AIDS Epidemic: No End in Sight" Baltimore Sun (07/29/92), P. 15A
     While humans have subdued their large natural predators,  something 
as tiny as HIV can wipe out an even larger population,  write the 
editors of the Baltimore Sun.  The international AIDS  conference in 
Amsterdam last week brought with it some sobering  news.  Researchers 
became confused over reports of at least two  dozen people who 
experienced symptoms of AIDS but tested negative for HIV, potentially 
signalling that the virus has mutated into a different strain 
unrecognized by current testing techniques--or  that there exists an 
entirely new virus.  The uncertainty of  these questions looms as large 
as the urgency to answer them, the editors write, as  about 40 million 
people will be HIV-positive  worldwide by the year 2000, and some 
estimates go as high as 110  million.  AIDS is a heterosexual disease in 
most of the world,  and even in America the disease is losing its 
identity as  predominantly affecting gay men.  Women are becoming a 
growing  percentage of AIDS cases, especially in the Third World, a  
disheartening statistic because their roles are key to the health and 
economic well-being of the family.  Consequently, more  children will be 
born with HIV infection, the editors conclude. 

"Miss Manners: When and How to Say You Have AIDS" Washington Post 
(07/29/92), P. C5  (Martin, Judith)
     It is very important to distinguish between a warning and a  
confidence when disclosing HIV-positive or AIDS-infected status.  writes 
Judith Martin (a.k.a. Miss Manners).  A warning is  "morally obligatory" 
to anyone who might be in jeopardy of  becoming infected--a potential 
romantic partner, for example.  A  warning should be given to anyone who 
is attempting to "pick you  up," writes Martin, because it is 
essentially their "business."   A confidence is voluntary and should be 
given only to those  people whose are expected to react positively.   
With people who  are only acquaintances, one should not feel obligated 
to disclose his or her condition, even if they are likely to learn of it  
later.  However, if an AIDS patient wants to discuss the disease  for 
social, educational, or conversational reasons, and he or she  is 
prepared to receive potentially unsympathetic responses, then  it should 
be alright.  When two people first meet, it is socially acceptable for 
an AIDS patient to say, "I'm an engineer, but I'm  retired now because 
of my AIDS" or "One of my chief interests is  AIDS education, since I'm 
a victim of AIDS myself."  This allows  the other person to stay 
interested or choose to leave.   Related Story: Boston Globe (07/28) P. 
58 

"Improved Diagnosis of Pneumocystis Carinii Infection by  Polymerase 
Chain Reaction on Induced Sputum and Blood" Lancet (07/25/92) Vol. 340, 
No. 8813, P. 203  (Lipschik, Gregg Y. et al.)
     Nested polymerase chain reaction (PCR) can detect P carinii in  
induced sputum samples with greater sensitivity than standard  staining 
methods, write Gregg Y. Lipschik and colleagues of the  National 
Institutes of Health in Bethesda, Md.  Sensitivity and  specificity of 
two PCR approaches were compared with those of  conventional staining 
for detection of P carinii in induced  sputum, bronchoalveolar lavage 
fluid (BAL) and blood.  Among the  71 sputum samples, 17 were from 
patients with microbiologically  confirmed P carinii pneumonia.  A 
nested PCR technique correctly  identified the presence of P carinii in 
all 17 and found no  organisms in 50 of 54 microbiologically negative 
samples.  PCR  with a single primer pair was 71 percent sensitive and 94 
percent specific.  The sensitivity of conventional staining methods was  
substantially less (38-53 percent) than that of nested PCR.  In  BAL, 
neither PCR method was significantly better than the  conventional 
staining methods.  P carinii was found in BAL or  sputum from 10 
immunocompromised patients without microbiological proof of P carinii 
pneumonia, which indicates that symptom-free  carriers or subclinical 
infection can exist.  Nested PCR on  induced sputum provides a non-
invasive method of detecting  disseminated disease, conclude the 
researchers. 

"CD8 Lymphocytosis and Pseudotumoral Splenomegaly in HIV Infection" 
Lancet (07/25/92) Vol. 340, No. 8813, P. 207 (Oksenhendler, Eric et al.)
     The HLA haplotype A1, B8, DR3 in HIV-positive patients indicates  a 
genetically determined host immune response to infection with  the 
virus, according to Eric Oksenhendler et al. of the Hopital  St. Louis 
in Paris, France.  This haplotype is associated with  rapid progression 
to AIDS and with rapid decline of CD4 T cell  counts.  The Three 
patients with HIV infection, presented with  pseudotumoral splenomegaly, 
CD8 lymphocytosis and  hypergammaglobulinaemia, had spleen and bone 
marrow that  exhibited diffuse CD8 lymphocyte and plasma-cell 
infiltration.   Amplification of the T-cell receptor gamma chain gene 
did not  reveal any clonal T-cell population.  Phenotypic analysis  
demonstrated a predominance of CD8/CD57 suppressor T cells with  
expression of activation markers.  No cytotoxic T lymphocytes  specific 
for HIV infection could be identified.  All three  patients shared the 
HLA haplotype A1, B8, and DR3.  Preferential  direct interaction of HIV 
or some of its strains with these HLA  molecules may yield, in some of 
these patients, the amplification of a spontaneous cycle of persistent 
antigenic stimulation,  B-cell and T-cell activation, defective 
cytotoxic T-lymphocyte  functions, and lack of clearance of the 
infectious agent, the  researchers conclude. 

"A Potent Drug for Fighting AIDS" Business Week (08/03/92) No. 3277, P. 
32
     The synthesis of a drug, BHAP-E, is in the test tube more  powerful 
than AZT, DDI, and other AIDS drugs, Upjohn announced on July 22.  
Clinical trials on healthy people are scheduled for  September.  
However, Irwin Chen, an Upjohn researcher, mentioned  that the virus 
eventually becomes resistant to the new drug and  will most likely be 
used in combination with other drugs to treat AIDS, said Chen.  Merck 
and Boeringher-Ingelheim created drugs  similar to BHAP-E, Chen said, 
but they abandoned the drugs after  learning that HIV exhibited 
resistance to the treatments.  He  said it was unfortunate for those 
companies because the chances  for success increase as more drugs become 
available for combining against AIDS. 

"The Hidden Cost of AIDS: Shooting Up the Future" U.S. News + World 
Report (07/27/92) Vol. 113, No. 4, P. 55   (Black, Robert F. et al.)
     While IV-drug use is on the rise in Brazil, so are the number of  
AIDS cases that bring along tremendous health-care bills.  The  port of 
Santos, near Sao Paulo, has the highest rate of AIDS  cases in South 
America as a result of needle sharing and  prostitution.   Few 
Brazilians understand the impact of the AIDS  epidemic because they are 
more concerned with the economic  turmoil currently existing in the 
country.   A total of 22,583  people in Brazil have AIDS and an 
estimated 700,000 are  HIV-positive.  Also, the number of HIV-positive 
Brazilians will  likely increase by more than fourfold by 1995.  The 
medical costs for the increasing number of ill AIDS patients will add to 
the  government's already insufficient health sector.  The majority of 
Brazilian companies do not offer comprehensive medical insurance  and 
private insurers commonly exclude AIDS from coverage.  The  city of Sao 
Paulo needs to triple its number of available beds  for AIDS patients to 
1,000.  Hesio Corderio, dean of the  University of the State of Rio de 
Janeiro, said that hospital  bills for AIDS patients average more than 
$20,000 a year. 

"The Hidden Cost of AIDS: Harvesting a Crop of Sorrow" U.S. News + World 
Report (07/27/92) Vol. 113, No. 4, P. 57   (Black, Robert F. et al.)
     Uganda may have the most AIDS cases in the world and as a result, 
the country's crucial agricultural sector is expected to  dramatically 
dwindle.  Nearly 1.5 million people out of a total  population of 18 
million are HIV-positive--8.3 percent.  About 19 percent of the sexually 
active population is infected with HIV,  and approximately 4 million 
people will contract the virus by the year 2010, and an estimated 
870,000 will be dying of AIDS.   Uganda's work force is mostly comprised 
of the agricultural  sector, employing 86 percent of the labor force.  
Uganda's  robusta coffee bean has been declining as the epidemic has  
exacerbated decades of neglect caused by economic strife.  In  parts of 
Uganda, like Rakai, entire families have been eliminated by AIDS.  The 
disease will leave behind approximately 1 million  to 2.8 million 
Ugandan orphans in the next two decades.  Despite  the murky situation 
the country faces, it has implemented one of  the most "enlightened" 
AIDS policies in Africa.  Monies from  international donors like USAID 
and the World Health Organization are allotted to provide AIDS 
education, home health care, HIV  testing, and counseling. 

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