From: Billi Goldberg <bigoldberg@igc.apc.org>
Subject: CDC Summary 12/30/92
Note: Copyright 1992, Dan R. Greening. Non-commercial reproduction allowed.
Archive-Number: 6692
Organization: unspecified
Date: Wed, 30 Dec 92 08:48:03 PST

                          AIDS Daily Summary
                          December 30, 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 

 "U.S. Patents Are Granted for 3 Laboratory Mice" Washington Post 
(12/30/92), P. A4
     The federal government granted three patents yesterday to strains 
of genetically altered mice.  Researchers consider the patents critical 
for biotechnology.  They are the first since 1988 to recognize ownership 
of a genetically altered animal species.  The U.S. Patent and Trademark 
Office (PTO) notified its Official  Gazette that it was issuing patents 
for laboratory mouse strains  to Harvard University, GenPharm 
International of Mountain View,  Calif., and Ohio University.  GenPharm 
was granted a patent for a mouse strain that has been altered so that it 
naturally fails to  develop a fully functional immune system.  The 
GenPharm mouse was genetically altered by the addition of aJgene that 
prevents the  rodent from developing fully mature lymphocytes.  The new 
mouse  will be used in the study of immune-system diseases such as AIDS, 
or in research on autoimmune diseases, said Jonathan MacQuitty,  chief 
operations officer of GenPharm. 

"AIDS Groups Refine Strategies as Many Court Same Donors" Wall Street 
Journal (12/30/92), P. 1  (Sebastian, Pamela)
     More and more AIDS groups are searching for a better fund-raising 
foothold as the epidemic moves into its second decade.  "Heart Strings," 
a Broadway-style touring musical produced by New York's Design 
Industries Foundation for AIDS (DIFFA), has been popular in the past but 
may be rewritten.  When "Heart Strings" played in New York, it was 
received warmly, but didn't even raise a third of the $989,000 generated 
in Houston.  The road show fared poorly in Washington, San Francisco, 
and Chicago.  "Heart Strings has been touring since 1990, each year with 
a different theme.   Approximately 400 private grant-making foundations 
give money to  AIDS and more than 18,000 programs offer a range of 
medical and  personal services for AIDS patients.  Therefore, it is 
inevitable that disputes about priorities emerge as some AIDS fund-
raising  groups mature, new ones form, and there is more concentration 
on  the efforts of the incoming Clinton administration.   Consequently, 
DIFFA is considering taking a scaled-down  production of "Heart Strings" 
to high-school and college  campuses, stressing its educational benefits 
and de-emphasizing  the fund raising for the time being.  This would 
allow DIFFA to  work on a new version of the show to go on the road, 
raising  money for AIDS, in 1995. 

"Teacher With AIDS Virus Invited to Clinton Inaugural" United Press 
International (12/29/92)
     Worcester, Mass.--An HIV-positive teacher will speak about  
compassion for AIDS patients at President-elect Bill Clinton's  
inauguration on Jan. 18.  Michael Quercio, a teacher at the  Worcester 
Academy in Massachusetts, was selected to join 53  Americans in offering 
their personal experiences at an inaugural  event entitled, "Faces of 
Hope."  Quercio met Clinton in October  at a fund-raiser and said that 
Clinton showed understanding and  compassion for people affected by the 
disease.  At the academy,  Quercio works to educate high school students 
about AIDS.  He  tells them to "leave their brains at the door and bring 
their  hearts to class."  Quercio will discuss what it is like to live  
with HIV infection at the inaugural event.  "I want to bring more 
anecdotal experience of friends I've lost and people I know  living with 
AIDS."  Quercio said he will not talk about  government policy or 
statistics, but will focus on people and  life.  "People need to stop 
the judgment of people living with  AIDS," he said.  "To be considered 
as a 'face of hope' in this  country is a tremendous honor and a feeling 
of tremendous  responsibility.  All I want to do is bring home the 
message of  people living with it," Quercio added.

"AIDS Prevention" Associated Press (12/30/92)  (Dixon, Jennifer)
     Washington--Despite the spread of the AIDS epidemic, local and  
state health departments nationwide may have to cut back their  AIDS 
prevention and education programs.  Last month, state  officials were 
told to expect cuts in the amount of federal funds available to finance 
state and local health department programs  for AIDS prevention, 
education, counseling, and testing.  Kent  Taylor, spokesman for the 
Centers for Disease Control, said that  every dollar spent on AIDS 
prevention equals $30 saved in health  care costs.  He said the agency 
will actually grant the same  amount of money to states for prevention 
programs in fiscal 1993  as in 1992--$143.7 million.  However, states 
will have less money left over from 1992 to use this fiscal year than 
they had left  from 1991.  He said the amount of so-called carryover 
money has  dropped from $20.8 million in 1991 to $15.8 million in 1992 
to  about $9.7 million in 1993.  Taylor said states have less money  to 
carry over because they are using their grants more  effectively.  
Congress established overall funding for AIDS  prevention and 
surveillance in fiscal 1993 at $498 million, an  increase from $477 
million in fiscal 1992.  But Congress also  designated $27.7 million of 
the 1993 total to be used for  community-based minority programs, for 
people with hemophilia,  for HIV and multidrug-resistant tuberculosis 
prevention, and for  programs addressing HIV among women.  This forced 
the CDC to take $7 million out of other AIDS programs to make up the 
difference,  said Taylor. 

"Advantage Life Products Inc. and Nestle Corp." Business Wire (12/30/92)
     Laguna Hills, Ca.--Advantage Life Products Inc. of Laguna Hills, 
Ca., said Wednesday that it will provide its BE SAFE program free of 
charge to separate high-school assemblies in Portland, Ore.,  and 
Atlanta, Ga., as part of its continuing partnership with  Nestle Corp.  
The two companies are working together to bring  necessary information 
about HIV and AIDS to students.   Advantage's education program 
encourages AIDS awareness and  prevention through the distribution of BE 
SAFE, the company's  book and audio cassette program, at school 
assemblies.  The  assemblies involve students, professional athletes, 
and medical  experts who discuss the implications of HIV in the 1990s.  
The BE SAFE program aims to enable parents, teens, and couples to freely 
communicate the facts about HIV infection and help establish  strong 
communication skills and self-esteem to prevent the spread of the virus.  
Among those attending some of the assemblies will  be National 
Basketball Association stars, including Kiki  Vandeweghe, Clyde Drexler 
and Dominique Wilkins.  The Johns  Hopkins School of Public Health will 
receive a portion of the  proceeds from BE SAFE for its continuing HIV 
education and  research efforts. 

"Cryptosporidial Disease in the Adult HIV-Infected Patient" Journal of 
the Association of Nurses in AIDS Care (10-12/92)  Vol. 3, No. 4, P. 11  
(Fegan, Christine)
     Caring for AIDS patients with cryptosporidial disease is a tough 
challenge nurses must face because as the disease weakens and  
transforms the body, independence is lost, writes Christine  Fegan, RN, 
BSN, et al. of the University of California--San  Diego. Cryptosporidial 
diarrhea is considered an AIDS-defining  diagnosis if there is also a 
history of four weeks of chronic  diarrhea.  The condition is generally 
experienced in individuals  with a CD4 cell count below 200.  It is an 
illness that affects  15 percent of HIV-positive patients in the United 
States.  The  disease is a protozoan parasite that can infect any 
vertebrate.   Cryptosporidiosis is a self-limiting illness in the  
immunocompetent host, usually lasting 5 to 21 days.  However, in  HIV-
positive patients, the onset may be more gradual, but the  symptoms 
worsen as immune functions deteriorate.  The organism  infects the 
epithelial cells that line the digestive tract.   Symptoms of 
cryptosporidium in HIV-positive patients may vary  from asymptomatic 
carriage to voluminous life-threatening  diarrhea.  The main complaint 
of most patients is profuse watery  diarrhea, from 5-20 stools per day.  
A fluid loss ranging from  1-17 liters per day may result.  Other 
symptoms include nausea,  vomiting, abdominal pain and cramping, weight 
loss, anorexia, and low-grade fever.  The oocysts shed in the stool are 
highly and  immediately infectious.  Most likely, transmission will 
occur via fecal-oral route, and can be spread from animal to person as 
well as person to person.  Cryptosporidium can also be transmitted  from 
contaminated food and water, concludes Fegan. 

"Moving Home to Live: Migration of HIV-Infected Persons to Rural  
States" Journal of the Association of Nurses in AIDS Care (10-12/92) 
Vol. 3, No. 4, P. 42  (Davis, Kristine A. et al.)
     Rural nurses need to be prepared to treat both indigenous and 
returning AIDS patients and their families, and to provide  professional 
and community education, write Kristine A. Davis,  RN, MA, et al. of the 
University of Iowa in Iowa City.  Migration of HIV-positive persons into 
rural areas may present challenges  to both health-care workers and 
patients.  A cross-sectional  survey was administered to a convenience 
sample of 54 rural  HIV-clinic patients in Iowa to determine the 
percentage of  patients who had moved back to the state after 
contracting HIV  and the problems they experienced after moving.  The 
authors  found that 46 percent of their patients reported moving to or  
back to Iowa from a different state.  About 61 percent of the 54  
patients said they had lived outside Iowa during the past 10  years.  
Also, 21 percent of patients described problems after  moving.   Among 
the patients moving back, 61 percent had not been tested for HIV and 52 
percent were not experiencing symptoms.   The percentage of patients who 
reported moving with an AIDS  diagnosis (27 percent) was higher than 
determined using their  physician-reported data (17 percent).  The 
researchers conclude  that many HIV-positive patients who move from 
urban to rural  areas are not terminally ill. 

"Mobile HIV Testing Attracts Clients--Even in Bars" AIDS Alert (12/92) 
Vol. 7, No. 12, P. 186
     A mobile HIV testing and counseling program was begun in New York 
State to address high-risk populations who would otherwise shun  the 
services found at the sexually transmitted diseases clinic  (STD).  
Sondra Pruden, RN, is team leader for the New York State  Health 
Department's outreach program on HIV, STDs, and  tuberculosis.  The 
program is a mobile education, counseling, and testing effort that takes 
its services to homeless and battered  women's shelters, alcohol and 
drug rehabilitation centers, and  gay bars.  Since the beginning of the 
program in May 1990, Pruden and her team of four public health 
representatives have educated  about 3,000 people in Broome County, a 
community of 200,000 in  south-central New York.  Among those 3,000, 
about 1,050 agreed to be tested for HIV infection, and approximately 25 
tested  positive--a 2 percent rate in a county where only one in every  
1,000 pregnant mothers tests positive for HIV.  The program is  funded 
by the Centers for Disease Control's grant of $28,000.  It pays for five 
part-time positions, a public health nurse for two  days a week, a 
public health representative at half time, and  three additional public 
health representatives with varying  hours.  Pruden's team visits about 
12 agencies on a regular basis during a given year.  The team 
establishes itself just about  anywhere it's invited, provided members 
have access to a room  large enough for a general presentation and 
smaller rooms for  counseling and testing.  A visit usually entails a 
90-minute  educational talk on HIV infection and private counseling 
sessions that last about 20 minutes.  During the sessions, counselors  
assess the client's risk of infection. 

"A Controlled Trial of Aerosolized Pentamidine or  Trimethoprim-
Sulfamethoxazole as Primary Prophylaxis Against  Pneumocystis Carinii 
Pneumonia in Patients with Human  Immunodeficiency Virus Infection" New 
England Journal of Medicine (12/24/92) Vol. 327, No. 26, P.  1836  
(Schneider, Margriet M.E. et al.)
     For primary prophylaxis against pneumocystis carinii pneumonia  
(PCP), trimethoprim-sulfamethoxazole is the drug of choice,  despite the 
higher incidence of adverse events among patients  administered the 
drug, write Margriet M.E. Schneider et al. of  the University Hospital 
Utrecht in Utrecht, Netherlands.  The  researchers conducted a 
multicenter trial involving 215  HIV-positive patients with no history 
of PCP but with CD4 cell  counts below 200 per cubic millimeter.  The 
patients were  randomly assigned to one of three regimens: aerosolized  
pentamidine once a month; 480 mg of trimethoprim-sulfamethoxazole once a 
day; or 960 of trimethoprim-sulfamethoxazole once a day.   The 
cumulative incidence of PCP was estimated by Kaplan-Meier  survival 
analysis.  After a mean follow-up of 264 days, 6 of the  71 patients in 
the pentamidine group had a confirmed first  occurrence of PCP (11 
percent), but none of the patients in the  two trimethoprim-
sulfamethoxazole groups had PCP.   Discontinuation of the drug due to 
side effects was much more  frequent in the trimethoprim 
sulfamethoxazole groups than in the  pentamidine group.  The adverse 
reactions occurred significantly  sooner in the group given 960 mg of 
trimethoprim-sulfamethoxazole than in the group given 480 mg.  The 
researchers conclude that  trimethoprim-sulfamethoxazole taken once a 
day is more effective  as a primary prophylaxis against PCP than 
aerosolized pentamidine given once a month, even though adverse drug 
reactions are more  common with trimethoprim-sulfamethoxazole. 

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