HICNet Medical News Digest Mon, 23 May 1994 Volume 07 : Issue 22 Today's Topics: AIDS Daily News Summary +------------------------------------------------+ ! ! ! Health Info-Com Network ! ! Medical Newsletter ! +------------------------------------------------+ Editor: David Dodell, D.M.D. 10250 North 92nd Street, Suite 210, Scottsdale, Arizona 85258-4599 USA Telephone +1 (602) 860-1121 FAX +1 (602) 451-1165 Internet: mednews@stat.com Bitnet: ATW1H@ASUACAD Compilation Copyright 1994 by David Dodell, D.M.D. All rights Reserved. License is hereby granted to republish on electronic media for which no fees are charged, so long as the text of this copyright notice and license are attached intact to any and all republished portion or portions. The Health Info-Com Network Newsletter is distributed biweekly. Articles on a medical nature are welcomed. If you have an article, please contact the editor for information on how to submit it. If you are interested in joining the automated distribution system, please contact the editor. Associate Editors: E. Loren Buhle, Jr. Ph.D. Dept. of Radiation Oncology, Univ of Pennsylvania Tom Whalen, M.D., Robert Wood Johnson Medical School at Camden Douglas B. Hanson, Ph.D., Forsyth Dental Center, Boston, MA Lawrence Lee Miller, B.S. Biological Sciences, UCI Dr K C Lun, National University Hospital, Singapore W. Scott Erdley, MS, RN, SUNY@UB School of Nursing Subscription Requests = mednews@stat.com anonymous ftp = vm1.nodak.edu; directory HICNEWS FAX Delivery = Contact Editor for information ---------------------------------------------------------------------- Date: Mon, 23 May 94 06:35:27 MST From: mednews (HICNet Medical News) To: hicnews Subject: AIDS Daily News Summary Message-ID: AIDS Daily Summary 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, and the CDC Clearinghouse should be cited as the source of this information. Copyright 1994, Information, Inc., Bethesda, MD Topic in this issue - AIDS Researchers Seek Redirection of Efforts - Medical Briefs: Life Quality With AZT Studied - Medical Briefs: HIV Vaccine Enters Trial Phase - Professor Honored for AIDS Research - Deadly Transfusions - CD8 Antiviral Factor Found - Coping With HIV - Scientists Sabotaging AIDS Gene - India Tests Herbal Drugs for AIDS Treatment - Administration of Aerosol Pentamidine: A Program Design - Virus Similar to AIDS Implicated in Diseases "AIDS Researchers Seek Redirection of Efforts Toward Learning Basics of the Disease" New York Times (05/12/94) P. A20 (Kolata, Gina) Top scientists from around the country are forming a new consensus that America's $1.3 billion AIDS research program is on the wrong track and in need of redirection. Dr. Bernard Fields, chairman of the department of microbiology and molecular genetics at Harvard Medical School, has drafted a blueprint for change that advocates a broadened definition of AIDS research. The hope is that a broader look at the disease could bring a new understanding to the disease process. In the first decade, writes Fields, government's main approach to research was to "isolate the virus, develop a vaccine, and prevent the virus"--a straightforward approach that was successful in combating polio. Quick testing of potential AIDS drugs and vaccines, however, yielded only widespread frustrations and a growing sense that AIDS was much more complicated than scientists first suspected. Now, Fields says, the focus should be placed on understanding the basic biology of HIV and AIDS. How the virus enters the cell, for example, is still a mystery. Many other leading researchers, including Dr. Harold Varmus, director of the National Institutes of Health, and Dr. William Paul, the newly appointed head of the office of AIDS Research, say they endorse Fields' comments. Federal AIDS administrators say they expect to make some changes according to Fields' suggestions. "Medical Briefs: Life Quality With AZT Studied" Advocate (05/03/94) No. 654, P. 33 Among patients who take AZT, the reduction in the quality of life caused by severe side effects is equally balanced with the improved quality of life associated with delayed disease progression, according to a recent study of 1,338 patients enrolled in a clinical trial of the drug. The results of the study calculate the average time in which neither a progression of disease nor an adverse event occurred was 15.7 months for patients receiving a placebo, 15.6 months for patients receiving 500 mg of AZT, and 14.8 months for patients receiving 1,500 mg of AZT. Adverse events were identified either as symptoms or abnormal laboratory findings. After 18 months, the group receiving 500 mg of AZT gained an average of half a month without disease progression in comparison to the placebo group. "Medical Briefs: HIV Vaccine Enters Trial Phase" Advocate (05/03/94) No. 654, P. 33 Therion Biologics Corp. of Cambridge, Mass., will initiate Phase I clinical trials of an experimental recombinant vaccine known as TBC-3B. The vaccine is made from a live, restructured virus and aims to protect against HIV by triggering an immune response against the virus. Trials will be conducted at AIDS vaccine evaluation units in St. Louis; Rochester, N.Y.; Seattle; and Nashville, Tenn. "Professor Honored for AIDS Research" Baltimore Sun (05/16/94) P. 1B (Selby, Holly) The AIDS research conducted by Dr. Michael Summers has won the scientist a position as an investigator at Howard Hughes Medical Institute (HHMI), one of the largest philanthropic foundations in the nation. Summers, an associate professor of biochemistry at the University of Maryland--Baltimore County, was the first to describe a key component of HIV. Under his guidance, a research team developed a model of the nucleo- capsid protein found in HIV-infected cells. Only three of the dozens of such proteins have been described as of yet. The team demonstrated that, in test tubes, certain compounds eject zinc from the nucleocapsid protein, and inhibit HIV replication. The finding could prove useful in the development of AIDS treatments. Summers says that he and his graduate students are in "hot pursuit" of the fourth HIV protein. Beginning next month, HHMI will underwrite Summers' research, create a laboratory for him at UMBC, pay for a research team, and provide funding of up to $800,000 for the next five years. Then, if the institute is satisfied with Summers' work, the appointment may be renewed. "Deadly Transfusions" Associated Press (05/15/94) (Gordon, Marcy) The American Red Cross and other blood banks in 1983 rejected a screening test, saying that--despite assertions by the Centers for Disease Control--there was no proof that AIDS could be transmitted through trans- fusions. The groups also refused to adopt the hepatitis test--HIV tests were not yet developed--because it was too expensive. Internal documents obtained by the Associated Press, however, show that Red Cross officials acknowledged that the disease could be transmitted through blood. "The available evidence strongly suggests that AIDS is transmissible" through blood, wrote Red Cross planning and marketing manager Paul Cumming, in an internal memo. "To the extent the [blood] industry ... sticks together against CDC, it will appear to some segments of the public at least, that we have a self-interest which is in conflict with the public interest, unless we can clearly demonstrate that CDC is wrong." That memo and others are among pages of documents that were, at the request of the Red Cross, placed under protective orders by judges in various court cases. Although public disclosure of the contents are prohibited, AP acquired them through sources familiar with the issue. "CD8 Antiviral Factor Found" Advocate (05/03/94) No. 654, P. 34 Control of HIV pathogenesis usually occurs through the antiviral- suppressing activity of CD8 cells. A presentation at the Novel Therapies for AIDS conference held in Palm Springs in early March suggests that there may be a cellular antiviral factor (CAF) associated with CD8 cells. CAF inhibits the ability of the virus to replicate at the genetic level. Dr. Jay Levy, of the University of California at San Francisco, encouraged the use of therapies designed to maintain a strong CD8-cell response, including the administration of certain chemical messengers between cells, selected CD8-cell populations, or CAF. "Coping With HIV" Washington Post (Health) (05/17/94) P. 14 (Siwek, Jay) Because of rapid changes in AIDS research, it is particularly important for HIV patients--more so than patients of other illnesses--to be aware of their condition and how to treat it. If infected with HIV, family physician Dr. Jay Siwek recommends a series of steps to remain abreast of the condition and its treatment. Establishing a long-term relationship with a health care provider is the first step, he says. Then, learn all about HIV infection and AIDS. Periodically, a patient's CD4 level should be checked and, if the count becomes low, the doctor should recommend medicine to treat both the HIV and prevent other types of infection. Immunization shots will help prevent other infections as well, according to Siwek. Patients should also get checked for syphilis and other infections that are transmitted through sex or shared needles. Siwek advises women to have regular Pap smears, for the risk of cervical cancer and other pelvic problems is amplified with HIV infection. And, of course, there is always the risk of transmitting the virus to a baby. Finally, recommends Siwek, HIV patients should consider enrolling in an AIDS clinical treatment trial, joining a support group, or subscribing to a publication devoted to people living with HIV. "Scientists Sabotaging AIDS Gene" Houston Chronicle (05/16/94) P. 8B (King, Warren) Targeting two of the proteins most crucial to HIV, scientists hope to stop the virus in its tracks by throwing monkey wrenches into its genetic machinery. Researchers at Houston's Baylor College of Medicine insert into HIV-infected cells a gene that inhibits the ability of the virus to repro- duce. Just as HIV gets its reproductive machinery up and going, the gene produces a protein that short-circuits it. John Belmont and five colleagues found their laboratory success with a combination of purposely flawed versions of two proteins made by HIV to ensure its survival. "Tat" turns on the HIV, gets the genetic machinery started, and tells it to keep going, while "Rev" causes the virus to change gears and begin making the structural parts of new HIV. Researchers at the University of Michigan and the University of Southern California discovered that altered versions of Tat and Rev slow down the virus, and the Baylor group extended the research by constructing "Trev," a gene that has the same effect on HIV as Tat and Rev, but has the more lasting effect of halting HIV in already-infected cells. While this type of gene therapy is effective only in the laboratory right now, its creators hope within the next year to initiate trials in infected babies of mothers carrying HIV. "We want to do it in patients as quickly as possible," says Belmont, director of the project and associate professor of molecular and human genetics at Baylor. "It could give us some real answers and a basis on which to improve." "India Tests Herbal Drugs for AIDS Treatment" United Press International (05/16/94) The government-funded Indian Council of Medical Research, India's top medical body, says it will begin AIDS-related clinical trials involving ancient Indian herbal drugs said to stop the spread of HIV. A task force chose 10 drugs for clinical experiments in patients who have tested HIV- positive. The council will investigate whether the drugs curb the spread of AIDS in the human body. The drugs were selected from the ancient Indian school of Ayurvedic medicine, which uses herbal and root extracts for treatment of chronic diseases. "Administration of Aerosol Pentamidine: A Program Design" Journal of the Association of Nurses in AIDS Care (03/94-04/94) Vol. 5, No. 2, P. 41 (O'Hara, Constance M.; Anton, William R.; Gormley, Francis X.) Pneumocystis carinii pneumonia is the most common opportunistic infection diagnosed in HIV patients, note O'Hara et al. of the University of Washington Medical Center. For patients with constitutional symptoms, CD4 counts below 200, or who have a history of PCP but cannot tolerate oral therapies, aerosolized pentamidine is the preferred prophylactic treatment. AP has minimal side effects and a convenient once-a-month regimen, which increases the likelihood of patient compliance. Successful treatments, however, are subject to the skill and training of the professionals administering AP, thoroughness of patient teaching, and patient compliance. Safety of administration is a priority for both patients and healthcare providers. Because of the risk of exposure to mycobacterium tuberculosis, patients should be tested for TB before AP treatment is initiated. The staff must adhere to universal precautions at all times, and administer treatment in an appropriately ventilated area. The AP program at UWMC, which centers around a multidisciplinary team approach, yields a high rate of patient compliance. O'Hara et al. believe the essential components of UWMC's program can be adapted to most clinical offices, agencies, or institutions. "Virus Similar to AIDS Implicated in Diseases" Reuters (05/16/94) (Mikkelsen, Randall) New research on HTLV-II, a little-understood cousin of HIV, suggests that the former is linked to higher death rates than HIV among those exposed to it. According to rough estimates, about 250,000 to more than 500,000 Americans may be infected with HTLV-II, and the virus is spreading rapidly among intravenous-drug users in the developing world. Scientists also said that although it is much less easily transmitted than HIV through donated blood, it may often escape the most common screening test used by blood banks to detect it. Like HIV, HTLV-II belongs to a family of viruses known as retroviruses. Unlike HIV, however, HTLV-II is thought to have been present among humans for tens of thousands of years. It is found among the indigenous people of the Americas and central Africa. A decade- long study of 567 drug users conducted in New Jersey found a three-fold increase in the death rate among the 67 patients who died of respiratory ailments. Other studies have found links between HTLV-II and nervous systems disorders, according to scientists. Dr. Stanley Weiss, author of the New Jersey study, also found that many patients who were infected with HTLV-II had also been exposed to HIV, but not infected by it--which suggests that their bodies might have been able to fend off the virus. These findings could be significant in the search for an AIDS vaccine, said Dr. William Blattner, chief of viral epidemiology at the National Cancer Institute. ------------------------------ End of HICNet Medical News Digest V07 Issue #22 *********************************************** --- Editor, HICNet Medical Newsletter Internet: david@stat.com FAX: +1 (602) 451-1165 Bitnet : ATW1H@ASUACAD -------------------------------------------------------------------------------