AIDS Daily Summary March 27, 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 ************************************************************ "Ad Ventures for the Disabled" "Rap Star Eazy-E, 31, Dies of AIDS" "Experimental Journey" "Dutch Nurse Sentenced in Euthanasia Test Case" "Haven of Hope" "A Randomized Trial of Three Antipneumocystis Agents in Patients with Advanced Human Immunodeficiency Virus Infection" "HIV Transmission Through Donor Artificial Insemination" "CDC Addresses Failure to Reduce PCP in Infants" "Interview: Paul W. Ewald" "Industry Bash Set to Battle AIDS" ************************************************************ "Ad Ventures for the Disabled" Washington Post (03/27/95) P. D1; Span, Paula After years of lobbying for inclusion, people with disabilities are becoming more visible in mainstream advertising. For example, a television ad for Nike featuring an athletic young man running through Malibu Canyon presents his story in white-on-black titles: "Ric Munoz, Los Angeles. 80 miles every week. 10 marathons every year. HIV-positive." The titles are followed by Nike's slogan "Just Do It." Traditionally, advertising has been the domain of the perfect, and has been off-limits to not only the disabled but almost everyone who is not young, lithe, and beautiful. Sandra Gordon, a former Easter Seals executive who now consults with major corporations on disability issues, recalls in the 1970s urging advertisers to include a single wheelchair-user in group pictures. She was told that she "was crazy, that it was a disgusting idea." The inclusion of people with disabilities in marketing, however, serves several purposes. It shows sensitivity, goodwill, and some business executives believe it may even help effect social change. "Rap Star Eazy-E, 31, Dies of AIDS" Washington Post (03/27/95) P. A20 Rapper Eazy E, whose real name was Eric Wright, died on Sunday from AIDS-related complications at the age of 31. Wright's pioneering "gangsta" rap group N.W.A helped bring inner-city rap to the suburbs. In announcing that he had AIDS on March 16, Wright said he did not know how he became got the disease, but that he wanted to warn his friends and their families. "I've learned in the last week that this thing is real and it doesn't discriminate," Wright said in a statement. Related Story: USA Today (03/27) P. 1D "Experimental Journey" Washington Post (Business) (03/27/95) P. 1; Day, Kathleen Launched over the past two decades with predictions of miracle cures, large profits, and rapid expansion, the U.S. biotechnology industry has yet to fulfill its grand expectations. Maryland's biotech industry is a microcosm of the national trend, and many analysts believe that an industry shakeout could severely reduce the number of biotech companies and jobs in the state. Although the National Institutes of Health, and academic institutions such as Johns Hopkins University continue to draw venture capitalists and scientists to the state, the more than 100 biotech firms in Maryland are likely to follow national trends and diminish in number over the next few years, analysts say. Still, the industry has 27 drugs--including human insulin, a blood clot buster, and a cancer drug for AIDS patients--on the market, and another 270 drugs are in various stages of human trials. Some of the industry's major challenges, however, include failed tests, lawsuits, and a lack of promotion of products. "Dutch Nurse Sentenced in Euthanasia Test Case" Reuters (03/23/95) A Dutch court recently imposed a two-month suspended jail sentence on a nurse who administered a lethal dose of drugs to a 36-year-old man dying of AIDS. In a landmark decision, the court ruled that euthanasia was permissible under Dutch law only if it was carried out by a doctor. The court rejected the nurse's claim that she was acting as a proxy for her supervising doctor. Under the suspended sentence, the nurse will only go to jail if she commits another offense within one year. "Haven of Hope" Chicago Tribune (03/24/95) P. 1-5; Miller, Sarah Bryan Former pediatric nurse Anne Bradley is a photographer and a foster mother for infants in need. Many of the children she cares for are AIDS babies--babies whose mothers are HIV-positive. While some of these children may develop the disease themselves, most--once their mothers' antibodies pass from their systems--will eventually test negative. Bradley has been working through the Lutheran Social Services of Illinois since 1986, specializing in care for infants a few days old to two months. When AIDS became a significant problem for children, she volunteered for the agency's Positive Care program, to apply her skills to AIDS babies. "There was a real need, and it resonated with me," she says. The need for foster parents is great, says Wade Ek, supervisor of Positive Care. Ek notes that Bradley and her husband were the among the first to volunteer for the program. Bradley says that aside from getting up in the middle of the night, the most difficult part for her is giving the babies up when the time comes, whether to long-term care or to return to the birth mother. "A Randomized Trial of Three Antipneumocystis Agents in Patients with Advanced Human Immunodeficiency Virus Infection" New England Journal of Medicine (03/16/95) Vol. 332, No. 11, P. 693; Bozzette, Samuel A.; Finkelstein, Dianne M.; Spector, Stephen A. et al. Bozzette et al. evaluated the efficacy of three treatments for the prevention of a first episode of Pneumocystis carinii pneumonia (PCP) in HIV-infected patients. A combination of zidovudine and either trimethroprim-sulfamethoxazole, dapsone, or aerosolized pentamidine was given to 843 patients with HIV and CD4 counts lower than 200. The estimated three-year risks of PCP were 18 percent, 17 percent, and 21 percent for the groups receiving trimethroprim-sulfamethoxazole, dapsone, and aerosolized pentamidine, respectively. There was an insignificant difference in risk among treatment strategies for the patients who entered the study with 100 CD4 lymphocytes or more. For those who began treatment with less than 100 cells, however, the risk was 33 percent with aerosolized pentamidine--compared to 19 percent with trimethroprim-sulfamethoxazole and 22 percent with dapsone. The average survival rate was about 39 months in all three groups. The researchers concluded that the three strategies have similar effectiveness in patients with advanced HIV infection. Treatments that begin with trimethroprim-sulfamethoxazole or with high doses of dapsone are more effective in patients with less than 100 CD4 lymphocytes. "HIV Transmission Through Donor Artificial Insemination" Journal of the American Medical Association (03/15/95) Vol. 273, No. 11, P. 854; Araneta, Maria Rosario G.; Mascola, Laurene; Eller, Andrea et al. Araneta et al. investigated the transmission of HIV through donor artificial insemination (AI) before 1986 at five infertility clinics in the United States and Canada. The researchers used two methods to identify the HIV-infected donors or recipients: identification of an HIV-infected woman who reported previous AI, followed by identification of the infected donor, and contact tracing of the women inseminated with his semen; and identification of an HIV-infected donor and ensuing examination of women receiving AI using his semen. At the clinics, 230 women were found to have been inseminated with semen from any one of five HIV-infected donors. Of the 199 who agreed to be tested for HIV, seven women, or 3.52 percent, were seropositive for HIV. The researchers concluded that HIV infection through donor AI performed before routine testing of semen donors could be a potentially serious threat to women who had procedures performed. Retrospective studies among women who had AI procedures before 1986 are necessary so that the women can be notified of their infection risk, and, if seropositive, so they can benefit from early therapeutic intervention. "CDC Addresses Failure to Reduce PCP in Infants" AIDS Alert (03/95) Vol. 10, No. 3, P. 35 Due to a failure to reduce the rate of Pneumocystis carinii pneumonia (PCP) in infants, the Centers for Disease Control and Prevention (CDC) has revised its recommendations for preventing the disease. Recent data for exposed children show that just 16 percent of infants received PCP prophylaxis at the time of PCP diagnosis. Data collected from Florida, California, and Massachusetts show that as many as two-thirds of infants exposed to HIV have not been tested for HIV. The new guidelines will recommend that all HIV-exposed infants begin PCP prophylaxis at four to six weeks, regardless of CD4 count and HIV test results. PCP prophylaxis should be stopped once a child has been diagnosed as HIV-negative. The drug regimens previously recommended will remain the same. The new guidelines emphasize how the failure to identify HIV-exposed children has contributed to the increase of PCP in children. It is recommended that HIV testing and monitoring be made more available to children at risk. "Interview: Paul W. Ewald" Omni (03/95) Vol. 17, No. 6, P. 75; Hooper, Judith In an interview with Omni magazine, evolutionary biologist Paul W. Ewald explains how Darwinian ideas of fitness and natural selection apply to parasites. Ewald theorizes that HIV began centuries ago as a mild affliction in an isolated population. During the 1960s and 1970s, war, drought and urbanization in East Africa created a climate where prostitution prospered. That environment permitted the virus to travel from host to host, eventually evolving into the disease known as AIDS. Most of West Africa, however, was spared such upheaval and, not coincidentally, the HIV-2 found in West Africa is much milder than HIV-1. Ewald, who for years argued against premature AZT treatment, does not think that a combination of drugs might eliminate all the variants of HIV. "The virus seems to evolve resistance to the combinations we can generate...We know of five mutations right now that change its shape to allow it to continue to form DNA in the presence of AZT. Many more we don't know about, as well as different combinations of those mutations," he says. Ewald predicts that AIDS "will burn through the population of people who change partners frequently without protection" before the epidemic is over. "Industry Bash Set to Battle AIDS" Home Furnishings Network (03/13/95) Vol. 69, No. 11, P. 51 On May 22, Gift for Life--the gift industry's organization dedicated to raising funds for AIDS research and education--will host its second annual cocktail reception for industry professionals. The event, in honor of the organization's third anniversary, will expand upon the success of last year's party. All Gift for Life events, projects, and donations benefit the American Foundation for AIDS Research (AmFAR). The organization has united the gift, tabletop, decorative accessories, stationery, and related industries in its goal to provide moral and financial support to AIDS patients and to help in finding a cure. Thus far, Gift for Life has raised almost $400,000 for AmFAR.