AIDS Daily Summary February 2, 1996 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 1995, Information, Inc., Bethesda, MD ************************************************************ "A New AIDS Drug Yielding Optimism as Well As Caution" "Bills Would Repeal Provision to Expel Troops with H.I.V." "The GOP's HIV Disgrace" "Magic Returns" "AIDS Drug Progress Hailed, Prices Lamented" "AIDS Fears Drop in U.S., Poll Shows" "Romania Faces Syphilis Epidemic" "Inside the Beltway: AIDS and Reality" "How to Ensure the Continued Resurgence of Tuberculosis" "Getting Your Insurer to Cover New HIV Treatments: A Crash Course" ************************************************************ "A New AIDS Drug Yielding Optimism as Well As Caution" New York Times (02/02/96) P. A1; Altman, Lawrence K. The protease inhibitor ritonavir has been found to reduce both the death rate and the number of serious complications in advanced AIDS patients by almost half. In a large international study of more than 1,100 patients, 13 percent of those who received the drug died or had their disease progress, compared to 27 percent who did not receive the drug. The death rate was 4.8 percent among the 543 patients who were taking the drug, compared to 8.4 percent of the 547 who received a placebo, according to Dr. John Leonard, an Abbott Laboratories official. All patients continued with the therapy they were taking before. Doctors caution, that while the results are promising, they do not know how long the drug will be beneficial. Related Story: USA Today (02/02/96) P.1A "Bills Would Repeal Provision to Expel Troops with H.I.V." New York Times (02/02/96) P. A11; Schmitt, Eric An effort is underway in both houses of Congress to reverse a provision in the Defense authorization bill that would discharge HIV-infected military personnel. The bipartisan movement is being supported by such lawmakers as Sen. William S. Cohen (R-Maine), Rep. Peter G. Torkildsen (R-Mass.), and Sen. Sam Nunn (D-Ga.). Bills to eliminate the provision that would discharge in six months more than 1,000 HIV-positive troops will likely be introduced to both the House and Senate in the next few days. Such efforts have received widespread support in the Senate, but may face difficulties in the House. The White House, meanwhile, has requested recommendations on ways to repeal the measure and protect medical and disability payments to HIV-infected service members and their families. Opponents of the discharge provision, which is sponsored by Rep. Robert K. Dornan (R-Calif.), claim that it is discriminatory, and point out that no effort is being made to discharge 4,000 other personnel whose duties are limited because of chronic but not debilitating diseases. "The GOP's HIV Disgrace" Washington Post (02/02/96) P. A19; Krauthammer, Charles In the Washington Post, columnist Charles Krauthammer takes issue with the successes and failures of the Republican revolution in Congress. Krauthammer notes that while the Republicans have not been able to reform welfare or make tax cuts, they have succeeded in forcing the discharge of HIV-positive military members. He calls this "particular disgrace" one of the "petty, petulant legislative crumbs that the Republicans have settled for and that Clinton was prepared to let them have." Moreover, Krauthammer compares the policy to another issue in the Defense authorization bill, the building of a system to protect the country from ballistic missile attack. He says that on this, "the single most important defense issue facing the country," the Republicans caved after Clinton opposed the provision. Krauthammer calls the HIV provision "mean-spirited and useless," and points out that people with other chronic conditions are allowed to serve. "Magic Returns" Baltimore Sun (02/01/96) P. 12A The editors of the Baltimore Sun observe that Earvin "Magic" Johnson's return to the National Basketball Association exemplifies how American's have come to understand AIDS. Johnson wanted to return to the league three years ago, but HIV fears among other players prevented it. Now, however, he is welcomed back into the sport, thus showing that Americans have learned enough about the disease not to fear getting it from casual contact. But, the authors point out, this knowledge has come at the high cost of a great number of people becoming infected with HIV and dying from AIDS. "AIDS Drug Progress Hailed, Prices Lamented" Reuters (02/01/96); Kenen, Joanne AIDS patients and doctors say they are encouraged by major advances in treatment for the disease announced this week, but are wary that high prices will make them inaccessible to many. At the Third Conference on Retroviruses and Opportunistic Infections in Washington, D.C., scientists heard promising results of studies that show some new drugs seem to control HIV when combined with antiviral treatments already available. Although the results are preliminary, scientists are encouraged, and the Food and Drug Administration is expected to approve the drugs quickly. A combination of several antivirals, however, could cost thousands of dollars a year. Several activist groups at the meeting did not blame the drug companies for the high prices, but joined forces with them to lobby the government for more support. "AIDS Fears Drop in U.S., Poll Shows" Reuters (02/01/96) Americans' fear of contracting HIV has dropped dramatically in the past 10 years, according to an ABC poll released Thursday. The telephone survey of 509 adults showed that only 17 percent said they were afraid of becoming HIV-infected. This is the smallest proportion in a decade of polling. The highest level of concern was reported five years ago, at 29 percent. The poll was conducted after Magic Johnson, who had retired after learning he was HIV-positive, returned to the NBA this week. Seventy-four percent of those polled said they approved of Johnson's return. "Romania Faces Syphilis Epidemic" Reuters (02/01/96) Romania, a country that already has the worst juvenile AIDS problem in Europe, is facing a growing syphilis epidemic among young people. Bucharest researcher Dr. Vasile Gradina estimated the number of new syphilis cases to be 6,000 in 1995, with 1,600 in Bucharest alone. He explained that the problem was rooted in juvenile promiscuity, prostitution, and what he termed an essential lack of discipline. Condoms are available in Romania, but are not widely used. The country's rate of AIDS among juveniles is Europe's highest, with up to 90 percent of the cases in children under 12. "Inside the Beltway: AIDS and Reality" Washington Times (01/31/96) P. A9; McCaslin, John The Gertrude Stein Club, a politically active homosexual group in Washington, D.C., has endorsed President Clinton for re-election, despite the fact that he is expected to sign a Defense authorization bill, which includes a provision to force the discharge of HIV-positive military members. A member of the AIDS-awareness group ACT UP is opposed to Clinton's re-election, and says that candidates endorsed by the Stein Club have not been successful in the past. "How to Ensure the Continued Resurgence of Tuberculosis" Lancet (175) Vol.347, No.8995,; Reichman, Lee B. In this "Viewpoint" article Dr. Lee Reichman, of the New Jersey Medical Center and the National Tuberculosis Center, questions the job that the World Health Organization (WHO) is doing to battle tuberculosis, which is the only disease the group has singled out as a "global health emergency." He says the World Health Assembly, the group that sets the WHO's priorities, should give more funding to tuberculosis. He also says more effort should be given to new drug development. While some pharmaceutical companies are working on tuberculosis drugs, according to Reichman, many do not consider the development of such drugs profitable. Tuberculosis cases in the United States declined in 1993 and 1994, attributable, Reichman says, to the "unprecedented appropriation of attention and cash, allowing for the re-establishment of the public-health infrastructure." He says the rise of the disease in the 1980s "is even more easily demonstrated--erosion of state level tuberculosis control programs under the failed block grant funding experiments of the 1970s." "Getting Your Insurer to Cover New HIV Treatments: A Crash Course" AIDS Treatment News (01/05/96) No.238, P. 1; Keller, Irwin E. People with HIV are likely to have difficulty getting health insurance coverage for cutting edge treatments. Insurance policies often exempt an insurer from paying for treatment that is "experimental" or "Investigational." It is important for the patient to find out exactly why the insurer denied a claim. Most policies call for the insurer to cover all "medically necessary" procedures, and, when disputed, courts usually interpret insurance contracts to include the broadest coverage. The patient should show that a procedure is necessary, by offering evidence that all other available treatments were not effective. If an insurer denies a claim on the grounds that the procedure is experimental, the patient should check the definition of "experimental" in the contract. Many courts have decided that without a definition in the policy, the term "experimental" is vague. In that cased, a court may tell the insurer that payment cannot be denied on that basis. The first step in appealing an insurance claim is within the company. If that fails, a patient can sue the company, although if the insurer is unwilling to settle out of court, a lawsuit could take years to complete.