From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 12/24/92
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6675
Organization: unspecified
Date: Thu, 24 Dec 92 10:58:08 PST

                        AIDS Daily Summary
                        December 24, 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 

 "FDA Approves Drug Against an Infection Often Linked to AIDS" Wall 
Street Journal (12/24/92), P. 11
     A drug to prevent mycobacterium avium complex disease (MAC) in AIDS 
patients was approved by the Food and Drug Administration. The drug, 
rifabutin, is the first drug approved to prevent the life-threatening 
disease.  Chronic debilitating symptoms of MAC infection include fever, 
night sweats, weight loss, fatigue, abdominal pain, severe anemia, and 
liver dysfunction.  Rifabutin is made by Adria Laboratories in Columbus, 
Ohio, and will be sold under the brand name Mycobutin.  Patients 
involved in clinical trails who received rifabutin were one-third to 
one-half as likely to develop MAC as were patients who received a 
placebo. The most common side effects linked with rifabutin are rash, 
gastrointestinal symptoms, muscle and joint aches, and discolored urine.  
The only serious adverse reaction found in the trials was a decrease in 
certain infection-fighting white blood cells. Rifabutin was provided in 
February under a Treatment Investigational New Drug protocol, which 
enables drug developers to provide patients with access to experimental 
drugs for serious and life-threatening conditions that have no 
satisfactory treatments.  The FDA's Antiviral Drug Products Advisory 
Committee recommended approval of rifabutin in September. Related Story: 
Washington Post (12/24) P. A5 

"Unimed Wins FDA Approval on AIDS Drug" Chicago Tribune (12/23/92), P. 
3-3  (Morris, Steven)
     The Food and Drug Administration granted approval Tuesday to the 
marketing of Marinol, a drug that fights the weight loss experienced by 
AIDS patients.  The FDA granted Unimed Inc. of Buffalo Grove, Ill., 
approval under the orphan drug provision, which allows the company to 
have exclusive marketing rights to this specific use for seven years.  
In the 1980s, the orphan drug law was passed to encourage firms to 
develop drugs for ailments suffered by small numbers of patients.  
Unimed has marketed Marinol since 1985 as a treatment for nausea and 
vomiting in chemotherapy patients.  Scott Broder, senior vice president 
of sales and marketing, said, "Sales will grow rapidly now that it's 
spread out through the growing field of AIDS."  The drug, which 
stimulates the appetite, "offers a means for AIDS patients to enhance 
the quality of their lives," he said.  The active ingredient in Marinol 
is a synthetic marijuana agent called delta-9-tetrahydrocannibinol 
(THC).  A physician must prescribe the treatment, which is taken in 
capsule form. Related Story: Journal of Commerce (12/24) P. 7A 

"Dance Club Barred From Promoting Event as AIDS Benefit" Philadelphia 
Inquirer (12/24/92), P. B3  (Cass, Julia)
     A Philadelphia night club has illegally been promoting a New Year's 
Eve event as a benefit for AIDS research, and has been asked to stop 
doing so by the state Attorney General.  Bob Gentzel, a spokesman for 
Attorney General Ernie Preate, said a nonprofit foundation used by the 
Aztec Club to sponsor the event was not registered as a charity, as 
required by Pennsylvania law. Among the four AIDS organizations listed 
as beneficiaries of the event, two have argued that their names were 
used without permission and the other two are not listed as charities in 
Pennsylvania, said Gentzel.  The event is expected to feature local and 
national celebrities at a ticket price of $150.  Rick Miller, the dance 
club's marketing director, said the club discontinued ticket sales when 
it received a letter from Preate on Tuesday.  He said that the club's 
lawyers responded by sending the Attorney General's Office the 
information it requested and were "waiting to hear from them so we can 
start selling tickets again."  Gentzel said that the club's nonprofit 
organization for the event, the New Year's AIDS Foundation, and the two 
groups that now will be beneficiaries, must register as charities with 
the Department of State.  The two groups that did not give authorization 
to use their names in the club's promotional material were Action AIDS 
in Philadelphia and the American Foundation for AIDS Research in New 
York.  The only two groups now listed as beneficiaries  are Total AIDS 
Support Service in Glenside and the Search Alliance in Los Angeles. 

"At Simon's Rock, Few Fault College in Shootings" Boston Globe 
(12/22/92), P. 31  (Roche, B.J.)
     Some outside observers have suggested that Simon's Rock College of 
Bard in Great Barrington, Mass., could have acted to prevent a Dec. 14 
shooting rampage by student Wayne Lo that left two people dead and four 
injured.  However, many Simon's Rock students and their parents contend 
that the school could have done nothing to forestall the tragedy even 
though Lo reportedly made no effort to hide violent and hateful 
attitudes towards such diverse groups as African Americans, Jews, AIDS 
patients, homosexuals, and individuals with disabilities.  The students 
say the college environment at the elite school fosters unimpeded 
freedom of thought and freedom of expression.  "The most human reaction 
is to say that someone should have known," said Saffron Kohler, the 
mother of a sophomore at the college.  "Wouldn't it be wonderful if we 
could tell that these idiots are going to go out and do these things?"  
Student Joshua Faber said, "It's hard to tell at what point something is 
intellectual and what point someone will put it into action."  Great 
Barrington Police Chief Thomas Walsh told reporters that Lo threatened 
to kill two student advisors prior to the murderous rampage on Dec. 14.  
The Associate Press has reported that Lo received a package of 200 
rounds of ammunition in the campus mail, which college officials knew 
about but failed to confiscate because he told them he planned to give 
the ammunition to his father for Christmas.  The college has issued a 
statement claiming it "acted responsibly and conscientiously in the 
events leading up to and following the incident."  Dean Bernard F. 
Rodgers Jr. said in a letter to alumni and parents, "Part of the price 
we are paying for our cooperation [in the investigation]...is that many 
of the television and print reports...are inaccurate." 

"Two Strides Toward a Workable AIDS Vaccine" Science News (12/19-26/92) 
Vol. 142, Nos. 25 + 26, P. 422 (Ezzell, C.)
     Two recent studies have made significant progress toward the 
development of an effective AIDS vaccine.  The first study used a 
vaccine made of crippled but live virus to completely protect a group of 
monkeys from simian immunodeficiency virus (SIV).  The second involved a 
research team which determined that HIV picks up bits of the cells it 
infects, perhaps as a means of improving their ability to latch onto and 
attack new cells.  Ronald C. Desrosiers and his colleagues from the New 
England Regional Primate Research Center in Southborogh, Mass., used a 
strain of SIV by removing a gene called nef, which is believed to 
regulate the virus' ability to reproduce.  They discovered that a single 
immunization with live, weakened virus allowed each of the four monkeys 
to fight infection following repeated injections of enough virulent SIV 
to infect 10 animals--even though the vaccine was administered more than 
two years previously.  The researchers claim their findings indicate 
that a similar strategy involving live HIV "may also be the most potent, 
effective vaccine for the prevention of AIDS" in humans.  Another study 
conducted by Larry O. Arthur, director of the AIDS vaccine program at 
the National Cancer Institute's Frederick Cancer Research and 
Development Center in Frederick, Md., found on the surfaces of HIV 
particles clusters of molecules that human immune system cells normally 
use to communicate with one another.  They found that both SIV and HIV 
selectively concentrate more major histocompatibility complex (MHC) 
proteins, possibly to enable them to better adhere to and infect other 
cells. 

"Expression Directed From HIV Long Terminal Repeats in the Central 
Nervous System of Transgenic Mice" Science (12/11/92) Vol. 258, No. 
5089, P. 1804 (Corboy, John R. et al.)
     Differences in the nucleotide sequence of the long terminal repeats 
(LTRs) of different HIV strains can alter the tissue-specific pattern of 
gene expression directed from their LTRs, as has been observed for other 
retroviruses, write John R. Corboy et al. of the Johns Hopkins 
University School of Medicine in Baltimore, Md.  Infection with HIV is 
often accompanied by the AIDS dementia complex (ADC).  The researchers 
constructed transgenic mice that contained the LTRs of two CNS-derived 
strains and a T cell tropic strain of HIV-1.  Only mice generated with 
CNS derived LTRs directed expression in the CNS, particularly in 
neurons.  The findings are unexpected because HIV-1 replication in the 
CNS has not been detected in neurons. But the pathogenesis of the 
neuronal cell loss seen in ADC is still uncertain.  In autopsy studies 
of the brains of individuals with ADC, macrophages and microglia are the 
cells most commonly infected with HIV-1.  Infrequently in autopsy and 
biopsy studies, other CNS cells, including endothelial cells, 
astrocytes, and oligodendrogli and neurons are found to be infected.  In 
tissues other than those of the CNS, HIV-1 primarily infects T 
lymphocytes and macrophages that express the surface molecule CD4.  But 
CD4 may not be necessary for HIV-1 infection of neural-derived primary 
or cultured cells, where the virus may use other molecules for entry 
into cells.  If these CNS-derived strains are able to enter into the 
cell, neurons can produce cellular transcription factors that interact 
with and direct expression from LTRs, the researchers conclude. 

"Men's Disclosure of HIV Test Results to Male Primary Sex Partners" 
American Journal of Public Health (12/92) Vol. 82, No. 12, P. 1675  
(Schnell, Daniel J. et al.)
     Although it is believed that undergoing HIV testing leads to 
disruption of an important relationship and may discourage men  from 
being tested, an encouraging rate of disclosure of  serostatus and a low 
rate of relationship disruption has been  found, according to Daniel J. 
Schnell et al. of the Centers for  Disease Control in Atlanta, Ga.  The 
researchers examined disclosure of HIV antibody status to a main sex 
partner and the impact on the relationship in men who have sex with men 
and who are enrolled in the AIDS Community Demonstration Projects 
cohorts.  Between 1987 and 1990, 1,684 participants had made an initial 
visit and first return visit to one of four sites: Dallas, Texas; 
Denver, Colo.; Long Beach, Calif.; and Seattle,  Wash.  It was found 
that 89 percent of both seronegative and  seropositive men disclosed the 
results to their main sex  partners.  In addition, 70 percent of the 
seronegative men and 82 percent of the seropositive men who did disclose 
their results reported that the relationship remained "as strong as 
ever" after six months.  Most men who did not reveal their test results 
to their main partner reported being "single" after six months.  The 
findings indicate that more homosexual/bisexual men may get tested since 
there was such a low rate of relationship disruption reported, conclude 
Schnell et al. 

"Fatal Hospital-Acquired Multidrug-Resistant Tuberculosis Pericarditis 
in Two Patients With AIDS" New England Journal of Medicine (12/17/92) 
Vol. 327, No. 25, P. 1816  (Horn, David L. et al.)
     Clinicians should be aware of Mycobacterium tuberculosis infections 
involving both pulmonary and extrapulmonary sites, write David L. Horn 
et al. of the Lincoln Medical and Mental Health Center in Bronx, N.Y.  
Two patients at the medical center developed tuberculosis pericarditis.  
The first patient had AIDS and was hospitalized with fever and 
hypotention.  He had had two previous hospitalizations for possible 
tuberculosis and had been treated with isoniazid, rifampin, 
pyrazinamide, ethambutol, and streptomycin but had not complied with 
therapy.  Antituberculosis therapy was reinstituted.  The patient became 
hypodic and required mechanical ventilation.  Despite a pericardiotomy, 
the patient had a cardiac arrest and died.  M. tuberculosis resistant to 
isoniazid, rifampin, ethambutol, and streptomycin but moderately 
susceptive to pyrazinamide was cultured from the sputum.  An autopsy 
showed fibrinous pericarditis and miliary TB involving the lungs, 
spleen, kidneys, thyroid, lymph nodes, and pericardial tissue.  The 
second patient also had AIDS and was hospitalized with fever and weight 
loss.  Acid-fast bacilli were found on sputum smears, and the patient 
was treated with isoniazid, rifampin, pyrazinamide, and ethambutol.  A 
pericardiotomy and biopsy were performed.  A smear of pericardial fluid 
was negative for acid-fast bacilli.  Hypotension persisted, and the 
patient died.  Microscopial examination of the pericardial tissue 
revealed acid-fast bacilli, and M. tuberculosis was isolated from bone 
marrow, sputum, blood, and pericardial fluid.  Multidrug-resistant TB 
was not detected in these patients before they died, therefore 
preventing effective therapy. 

*  The AIDS Daily Summary will not published Friday, December 25, 1992
   due to the observance of the holiday.
   Have a safe and happy holiday! 
Newsgroups: sci.med.aids