AIDS Daily Summary March 22, 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 1996, Information, Inc., Bethesda, MD ************************************************************ "TB Threat Grows Worldwide" "Glendening Targets $1 Million to Help Some AIDS Patients" "On Every Argentine Cellblock, Specter of AIDS" "Mother Whose Home Was Torched Asks Aid for Hemophiliacs" "Research Attacks Immune System Theory" "A Menu of Rare Antibodies For Drug Firms" "Morrison Says He Will Beat HIV, Fight Again" "HIV Subtypes Raise Vaccine Anxieties" "Outbreak of Primary and Secondary Syphilis--Baltimore City, Maryland, 1995" "Rolipram: Antidepressant Used in Europe and Japan Might Have Promise Against TNF, HIV" ************************************************************ "TB Threat Grows Worldwide" USA Today (03/22/96) P. 1A; Manning, Anita Tuberculosis (TB) killed more people worldwide than ever before in 1995, and at least 30 million will die in the next ten years if efforts are not made to stop the epidemic. The Centers for Disease Control and Prevention has announced that the number of TB cases in the United States in 1995 is expected to decline from 1994's 24,361 total; however, the World Health Organization (WHO) said 3 million would die from the disease worldwide in 1995. The disease carries the threat of incurability because drug-resistant strains thrive when medications are not taken correctly, but a new combination therapy holds great promise to eliminate the resistant strains. Related Stories: Baltimore Sun (03/22) P. 14A; Philadelphia Inquirer (03/22) P. A6 "Glendening Targets $1 Million to Help Some AIDS Patients" Washington Post (03/22/96) P. D2 Maryland Gov. Parris N. Glendening will allocate $1 million of the state's budget over the next two years to help inadequately insured individuals who are not eligible for Medicaid to afford new AIDS drugs. The money will cover expected shortfalls in a federal program that helps people buy AIDS drugs, which are promising but expensive. Congress is currently considering a request from the Clinton administration to provide an extra $52 million for the program, but Glendening said he wanted to act now to make the drugs available as soon as possible. Related Story: Baltimore Sun (03/22) P. 2B "On Every Argentine Cellblock, Specter of AIDS" New York Times (03/22/96) P. A4; Sims, Calvin In Argentina, the World Health Organization (WHO) estimates that 30 percent of the 5,800 inmates in the federal prison system are infected with HIV. Prisoners, however, are often not found to have the virus until they develop AIDS symptoms. The WHO study found that intravenous drug use and sexual activity between inmates and inmates and outsiders are common in the prison system. The estimated incidence HIV infection is based on results of voluntary tests since the Argentine law does not allow mandatory testing of inmates. Health officials say the rate of HIV is probably as high in local prisons and in prisons in other Latin American countries. They cite the high prevalence of drug use and prostitution before incarceration for reasons the prison population is especially at risk. Argentina is the only country in the region with an AIDS treatment facility for federal prisoners, but inmates' advocates question whether care is actually available to every person who needs it. "Mother Whose Home Was Torched Asks Aid for Hemophiliacs" Philadelphia Inquirer (03/22/96) P. A5; Shaw, Donna Louise Ray, a Florida woman whose home was torched when neighbors found out her sons had AIDS, has asked Congress to approve a $1 billion compensation package for HIV-infected hemophiliacs. Hundreds of supporters of the measure, named after Ray's son Ricky, who died of AIDS in 19922, rallied on the Capitol steps. Ricky was one of an estimated 8,000 to 10,000 U.S. hemophiliacs who were infected with HIV by tainted clotting factors. The measure, which would pay each HIV-infected hemophiliac $125,000, was introduced last year, but has seen little action. "Research Attacks Immune System Theory" Wall Street Journal (03/22/96) P. B14; Bishop, Jerry E. Three different research teams have reported evidence that substantiates a controversial theory about how the immune system defends the body against disease. If proven, the theory would change the prevailing approach to immunology and dramatically alter the development of anti-AIDS drugs, vaccines, and drugs to prevent the rejection of transplants. Immunologists have long believed that the immune system learns to recognize and tolerate "self" while attacking tissues recognized as "nonself," but Polly C.E. Matzinger of the National Institute of Allergy and Infectious Diseases proposes an alternative theory--that the immune system waits for a signal that somewhere in the body tissues are dying unnatural deaths. Her theory is not widely accepted among the immunology community, but is being tested nevertheless. "A Menu of Rare Antibodies For Drug Firms" Investor's Business Daily (03/22/96) P. A4; Benko, Laura B. Finding rare antibodies needed to make certain drugs can be difficult, but Serologicals Corp. of Atlanta, Ga. has been stockpiling elusive proteins by increasing its donor network, and is in some cases, cloning antibodies it collects. The company--which collects antibodies for hepatitis, rabies, HIV and other diseases--has 39 donor centers, 22 of which are licensed by the Food and Drug Administration to collect at least one type of rare antibody. Serological's largest product is intravenous immune globulin, or IVIG, antibodies that boost the body's defense against HIV, Lupus, and anemia. The firm also clones 49 commercial antibodies, using cultures to copy single antibodies in a laboratory. "Morrison Says He Will Beat HIV, Fight Again" Reuters (03/21/96) Former heavyweight boxer Tommy Morrison says he will beat HIV and fight again, possibly later this year. Morrison predicted in an interview of ESPNET SportsZone Wednesday that his HIV infection would disappear and he would return to boxing. He said he believes he knows how he got the virus and how to make it disappear--by magic. Morrison said at the time of his retirement that he would spend time educating children about HIV and AIDS. "HIV Subtypes Raise Vaccine Anxieties" Lancet (03/02/96) Vol. 347, No. 9001, P. 603; Rowe, Paul M. The biology of different strains of HIV may be related to the different ways the virus is transmitted around the globe. Max Essex of the Harvard AIDS Institute has reported that in purified epithelial Langerhans cells (LC), subtype E virus grows better than subtype B. LCs are found in epidermis, oral and genital mucosal epithelium, but not in rectal mucosa. Most HIV-1 in the United States and Europe is subtype B, and in Asia and Africa different strains predominate. In Thailand, both E and B subtypes are found, but E is more common, especially in those who contract HIV via vaginal intercourse. Beatrice Hahn of the University of Alabama at Birmingham has reported finding hybrid HIV-1 strains in high-risk individuals in Asia and Africa. She believes the mixing of previously-separate subtypes is a result of the epidemic's growth. Most vaccines now being developed contain subtype B antigens, although non-B viruses predominate in Africa and Asia, where the first trials will likely be conducted. Non-B vaccines may have a better chance of inducing vaginal mucosal immunity, however, because non-B viruses target LCs as well as lymphocytes and monocytes. "Outbreak of Primary and Secondary Syphilis--Baltimore City, Maryland, 1995" Morbidity and Mortality Weekly Report (03/01/96) Vol. 45, No. 8 , P. 166 The Centers for Disease Control and Prevention, along with the Baltimore City Health Department (BCHD) and the Maryland Department of Health and Mental Hygiene, studied data on syphilis cases in Baltimore City between 1992 and 1995 to determine what trends were responsible for the outbreak there. BCHD attempts to notify partners and provide treatment for patients, but decreases in personnel during the time period may have attributed to the outbreak. A significant increase in cocaine use in the community is also implicated. During the study period, the number of self-referred patients that visited the two public sexually transmitted disease (STD) clinics declined 12 percent, and the number of cocaine-related deaths in Baltimore City increased 737 percent from 1990 to 1994. An editorial note accompanying the study suggests that the use of crack cocaine and the exchange of sex for drugs were major factors in the syphilis epidemic in Baltimore, as in other urban areas. Furthermore, the authors warn, HIV infection may be increasing as another result of the increase in crack cocaine use and the syphilis outbreak. The BCHD is alerting the medical community about the outbreak, filling STD program vacancies, and expanding surveillance activities. "Rolipram: Antidepressant Used in Europe and Japan Might Have Promise Against TNF, HIV" AIDS Treatment News (03/01/96) No. 242, P. 3; Smith, Denny The antidepressant drug Rolipram has been found to be an active inhibitor of tumor necrosis factor (TNF), a chemical messenger overproduced by the immune system in some diseases, including HIV infection. Many AIDS symptoms--including fatigue, fever, and dementia--that are not caused by an opportunistic infection are associated with too much TNF. Researchers have also suspected an HIV/TNF feedback loop, in which TNF enhances HIV replication while HIV progression increases TNF production. Of the few TNF inhibitors studied, only thalidomide--which causes side effects in HIV-infected individuals--has been found to be clinically valuable. New TNF inhibitors are being developed by Celgene, but could take years to test. Rolipram is considered an essentially safe drug, but laboratory tests show that the amount of the drug necessary to inhibit TNF may not be tolerable in practice. Clinical studies are needed to determine if the drug could be used to treat HIV infection.