AIDS Daily Summary March 24, 1995 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 ************************************************************ "Pfizer and Myco to Develop Fungus Drugs" "AIDS Vaccine Research Faces a New Setback" "AIDS Rate Increasing Faster Among Women Than Men, Study Shows" "World's First AIDS Case May be False--British Paper" "Court Bans Dentist from Refusing AIDS Patients" "U.N. Agency Boosts Anti-AIDS Project in Vietnam" "Study Calls for Tracking Partners of HIV Victims" "'Thank You for Pot Smoking'" "Prophylaxis Against Pneumocystis Carinii Pneumonia at Higher CD4+ T-Cell Counts" "Curtains for New York Sex Clubs?" ************************************************************ "Pfizer and Myco to Develop Fungus Drugs" New York Times (03/24/95) P. D5; Fisher, Lawrence M. On Thursday, Pfizer Inc. announced that it had agreed to collaborate with Myco Pharmaceuticals Inc. in the development of antifungal drugs. Under the agreement, Pfizer will develop, manufacture, and market any antifungal drugs discovered, and will provide Myco with funds for research and development totaling more than $20 million over four years. Pfizer will own just under 15 percent of Myco and Pfizer will make product-based milestone payments to Myco that could exceed $30 million. The number of fungal infections nearly doubled between 1980 and 1990, the Centers for Disease Control and Prevention said. Opportunistic fungal infections are increasing, due to increases in immunosuppressive diseases, such as AIDS, and the use of immunosuppressive drugs and treatments such as chemotherapy. Related Story: Wall Street Journal (03/24) P. B2 "AIDS Vaccine Research Faces a New Setback" USA Today (03/24/95) P. 1A; Levy, Doug An experimental AIDS vaccine that appeared to work in adult monkeys kills newborn monkeys, scientists report in the current issue of the journal Science. Previous studies in adult monkeys were encouraging to scientists who believe a weakened version of HIV could be used in the vaccine. However, the study--which used a weakened form of the virus that causes AIDS in monkeys--suggests that such a strategy could lead to infection instead. "This approach to an AIDS vaccine is full of hidden danger," said Dr. Ruth Ruprecht of Harvard University and the Dana-Farber Cancer Institute. Ruprecht's team administered a vaccine of virus that causes AIDS in monkeys with key genes removed to four newborn monkeys. Although none were exposed to normal HIV, two died of the disease and two have severe immune deficiency. "AIDS Rate Increasing Faster Among Women Than Men, Study Shows" USA Today (03/24/95) P. 7A; Elias, Marilyn As many heterosexuals continue to have unsafe sex, the number of women in the United States with AIDS is likely to keep increasing, a researcher will report today. In 1994, 18 percent of AIDS patients were female--almost three times the rate 10 years ago. The number is increasing fastest among women infected by heterosexual contact, the Centers for Disease Control and Prevention said. Joseph Catania of the University of California Medical School in San Francisco says that a one-year study of 4,539 heterosexuals in 26 cities demonstrates "widespread practices that put people at risk for HIV and sexually transmitted diseases." Catania found that 56 percent of the subjects under the age of 30 had multiple partners by the end of year. He also found that only one-third of the men having extramarital affairs wore condoms. "World's First AIDS Case May be False--British Paper" Reuters (03/24/95) Proof of the world's first AIDS case--a Briton who died in the 1950s--may have been false, the Independent Paper said today. The discovery may undermine accepted thinking about the origins of HIV and how the global AIDS epidemic began, the paper said. A member of the British research team which published the original study in 1990 said he stood by his work and could not understand the discrepancy. Some U.S. scientists, however, believe that the tissue samples used by the British-based researchers in the original analysis were not from the 1959 patient but from an AIDS patient who died around 1990. According to the paper, researchers from the New York University School of Medicine repeatedly tried but failed to detect HIV in tissue taken from the man's corpse. Experts says the strain of HIV found could not have existed more than 30 years ago because of the speed at which viruses mutate. The team also determined that the samples used in the 1990 research came from a different person than the man who died in 1959. "Court Bans Dentist from Refusing AIDS Patients" Reuters (03/24/95) In what the Justice Department called a landmark case, a federal court ruled Thursday that a Louisiana dentist who refused to treat AIDS patients violated the Americans with Disabilities Act (ADA). The decision prohibits Dr. Drew Morvant from discriminating against people with AIDS by refusing to treat them or referring them to other dentists. This was the first suit brought by the Justice Department under the ADA. In an October 1993 lawsuit, the Justice Department claimed that Morvant denied dental services to two men, both of whom were told that the office did not treat HIV-infected patients. The Centers for Disease Control and Prevention and the American Dental Association have released policy guidelines saying there is no medical justification for excluding people from treatment solely on the basis of their HIV or AIDS status. "U.N. Agency Boosts Anti-AIDS Project in Vietnam" Reuters (03/23/95) Under an agreement signed Thursday, the United Nations Development Programme (UNDP) will give $1 million to Vietnam to help coordinate foreign aid for its fight against AIDS. The two-year program will involve information exchanges between donor agencies and training for officials involved in the anti-AIDS drive. UN agencies have warned of an outbreak of AIDS in Vietnam, with 15,000 deaths predicted by 1998. The first AIDS case in Vietnam was reported in 1990. Fifty-four people have died of the disease so far. "Study Calls for Tracking Partners of HIV Victims" Reuters (03/23/95) A new report demonstrates the scope of the AIDS epidemic by linking one HIV-infected prisoner with 142 people through a chain of sexual encounters or shared syringes. Fifty of those people were found to be infected with HIV and 24 were unaware of their infection, the Centers for Disease Control and Prevention (CDC) said. "Despite what a lot of people think, people who do inject drugs and people who are in prison will accept partner notification services when they're offered to them," said Kathy Waldron of the University of Pittsburgh's AIDS education and training center, one of the authors of the report. Waldron said it was much easier to track HIV exposure in prisons than among the general population. Almost 90 percent of the 142 people identified through contact tracing were drug users and 75 percent were present or former inmates who had been infected before they were imprisoned. Health departments should provide voluntary confidential HIV testing and should have a good working relationship with prisons, the CDC concluded. "'Thank You for Pot Smoking'" Richmond Times-Dispatch (03/23/95) P. A1 AIDS, cancer, and glaucoma patients come to the San Francisco Cannabis Buyer's Club to buy and smoke the illegal drug they claim is one of the few things that give them relief. To become a member, patients must provide a doctor's letter certifying a condition that could be alleviated by marijuana. The drug is purchased underground and is thus more expensive than growing it oneself. Club founder Dennis Peron, however, says the prices are about 50 percent less expensive than street prices. The club's members represent many different races, backgrounds, and ages. Bob, for example, is a 36-year-old AIDS patient who comes to the club for the marijuana that keeps his appetite up and the support that boosts his spirit. Similar clubs have been formed in other major U.S. cities, said Bob Randall of the Alliance for Cannabis Therapeutics. "Prophylaxis Against Pneumocystis Carinii Pneumonia at Higher CD4+ T-Cell Counts" Journal of the American Medical Association (03/15/95) Vol. 273, No. 11, P. 848; Chu, Susan Y.; Hanson, Debra L.; Ciesielski, Carol et al. Some members of the U.S. Public Health Service Task Force feel that prophylaxis for Pneumocystis carinii pneumonia (PCP) could be considered in patients with CD4 counts greater than 200, write Chu et al. of the Adolescent and Adult HIV Spectrum of Disease Project Group at the Centers for Disease Control and Prevention, in a letter to the editor of the Journal of the American Medical Association. Current recommendations for the prevention of PCP in HIV-infected individuals state that prophylaxis should begin when the CD4 level falls below 200. Chu et al. estimated that out of 3101 initial PCP diagnoses, 5.6 percent of HIV-positive patients experienced their first episode when their CD4 counts were between 200 and 299. If the estimate of 5.6 percent is applied to the 12,604 cases of PCP reported in the United States in 1992, 635 cases were potentially preventable, assuming a 90 percent efficacy for primary prevention. Based on data from the study, however, 262 cases would have first developed thrush, which is also considered a marker for initiating PCP prophylaxis. Thus, a total of 373 PCP cases would be prevented if the guidelines were raised to a CD4 count of less than 300. Although the benefits of preventing additional cases of PCP are obvious, Chu et al. conclude, they must be balanced against the high frequency of adverse reactions to the medications given for a prolonged period of time and the implications of providing a large number of people medication to prevent a relatively small number of cases. "Curtains for New York Sex Clubs?" Advocate (03/21/95) No. 677, P. 20; Morales, Jorge In February, AIDS activists united against the New York City health department, which is required to enforce the New York State Sanitary Code. The code, which is posted all over sex clubs, warns patrons that it is illegal for them to have oral, anal, or vaginal sex on the premises. "I think the city is clearly negligent in upholding the public-health law," said Darren Britton, the editor of the newsletter "Cure AIDS Update" and a founding member of Gay & Lesbian HIV Prevention Activists--a group formed to monitor gay commercial establishments for compliance with public health laws and safer-sex guidelines. Britton said the laws have not been enforced because the department is afraid of being seen as insensitive to gay rights. Margaret Hamburg, the city's health commissioner, said it was not "the politics of homophobia" that made the department move slowly in some instances, but "a question of...having a strong enough case for closure." Although other cities have also struggled with the problem of HIV transmission in bathhouses or sex clubs, New York's problem is compounded by staff cutbacks and underfunding of the health department, noted Mike Isbell, deputy executive director for public policy at Gay Men's Health Crisis--a nonprofit AIDS group.