                          AIDS Daily Summary
                           January 5, 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
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Copyright 1994, Information, Inc., Bethesda, MD


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"Virus Linked to Muscle Tumors in AIDS Victims"
"Cardinal Describes 'Profound Reconciliation' with Former 
Accuser"
"Manila Health Minister an Unlikely Agent of Satan"
"Frenchmen Have More Sex than Most--Playboy Survey"
"Cyclospora Infection in Adults Infected with HIV: Clinical 
Manifestations, Treatment, and Prophylaxis"
"Bacterial Bronchitis and Bronchiectasis in Human 
Immunodeficiency Virus Infection"
"Mycobacterium Avium in the AIDS Patient: An Analysis Using the 
Epidemiologic Paradigm"
"The Care of Injection-Drug Users with HIV Infection"
"Knowledge, Attitudes, Beliefs and Behaviors (KABB) Surveys"
"A Helping Hand"
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"Virus Linked to Muscle Tumors in AIDS Victims"
Reuters (01/04/95)
     The Epstein-Barr virus may play a role in causing muscle tumors 
in young people who have AIDS.  While the study does not prove 
that the virus which is responsible for infectious mononucleosis 
actually causes the tumors, it suggests that the virus is somehow
involved.  A companion study found traces of the Epstein-Barr 
virus in muscle tumors that had appeared in children who immune 
systems had been chemically suppressed as part of their treatment
following a liver transplant.  In each study, the researchers 
found that the tumors came from one mutated cell in smooth 
muscle, which surrounds blood vessels and tissues of the gut.  
The cells all showed signs of viral infection.  Children with 
AIDS or who have had transplants have an unusually high chance of
developing the tumors, known as leiomyomas and leiomyosarcomas.  
The first research team found remnants of the virus in tumors 
taken from patients with AIDS, but no copies of the Epstein-Barr 
virus in smooth muscle tumors taken from HIV-negative patients.  
The other study found traces of the virus in three liver 
transplant recipients, ages 18 months to five years.
      
"Cardinal Describes 'Profound Reconciliation' with Former 
Accuser"
Washington Post (01/05/95) P. A7;  Walsh, Edward
     One of the nation's most respected clergymen, Cardinal Joseph 
Bernadin, met privately last week with Steven J. Cook, the man 
who leveled and later retracted sexual abuse charges against him.
Bernadin said the two experienced the most "profound 
reconciliation" he has ever seen during his 43 years as a priest.
Cook made a "simple, direct, and deeply moving" apology for the 
accusation of sexual abuse.  The cardinal also said of Cook, who 
has AIDS, that "it was very evident that he was in precarious 
health."  Cook claimed, in a November 1993 lawsuit, that he was 
"repeatedly and continually" sexually abused in the late 1970s by
the Rev. Ellis N. Harsham, a priest at the St. Gregory Seminary 
in Cincinnati.  The $10 million suit alleged that on at least one
occasion, Harsham "delivered" Cook to the private quarters of 
Bernadin, then archbishop of Cincinnati, who also abused him.  
Three months later, Cook asked that the charges against Bernadin 
be dropped because he could "no longer be sure that his memories 
of the abuse by the cardinal are true or accurate."
      
"Manila Health Minister an Unlikely Agent of Satan"
Reuters (01/04/95);  McIntosh, Alistair
     While opinion poles regularly rate Philippine Health Secretary 
Juan Flavier one of the most popular government figures and his 
ministry one of its most effective, the Roman Catholic Church 
hierarchy has spent much of 1994 condemning him because of his 
support of artificial family planning methods, particularly the 
condom.  Flavier, who was publicly denounced as an agent of Satan
at a Catholic rally, said, "It's very hard for me to understand" 
the church's attitude.  While Flavier is trying to help the poor 
have a choice when it comes to family planning, he is also trying
to slow the spread of HIV.  Officially, there have been just 
under 600 people identified as HIV-infected in the Phillipines, 
and approximately 100 deaths.  Experts, however, believe there is
massive under-reporting because of the stigma attached to AIDS.
      
"Frenchmen Have More Sex than Most--Playboy Survey"
Reuters (01/04/95)
     The Playboy International Sex Survey has determined that French 
men have sex the most frequently.  The survey, to be published in
the February 1995 edition of Playboy magazine, asked its readers 
how and what they do during sex; where and with whom they do it; 
and whether AIDS has changed their behavior.  The magazine found 
that most men--90 percent in Brazil, 81 percent in France, 78 
percent in Greece, 75 percent in the United States, and 70 
percent in Japan--are worried about sexually transmitted diseases
(STDs).  Poles are the least concerned about STDs.  A total of 57
percent of American men said they have had more than 11 sexual 
partners--the highest in the survey and more than the 33 percent 
reported in the University of Chicago "Sex in America" survey 
released in 1994.  Among other findings, Playboy discovered that 
Brazilians visit prostitutes more than in other countries; most 
German men leave birth control to their partner; and Japanese men
most frequently use condoms.
      
"Cyclospora Infection in Adults Infected with HIV: Clinical 
Manifestations, Treatment, and Prophylaxis"
Journal of the American Medical Association (12/28/94) Vol. 272, 
No. 24, P. 1884c
     At a clinic in Haiti, researchers studied stool samples from 
HIV-seropositive adults who had diarrhea to determine the 
prevalence and clinical manifestations of Cyclospora in 
HIV-infected Haitians as well as to evaluate therapy and 
prophylaxis.  The patients, who had had diarrhea for at least 
three weeks, were treated with trimethoprim-sulfamethoxazole 
given orally for 10 days.  One-third of the 2,400 patients 
seropositive for HIV had a history of chronic or intermittent 
diarrhea.  Forty-three patients, who had diarrhea and Cyclospora 
infection, were found to have symptoms indistinguishable from 
those seen in patients with isosporiasis or cryptosporidiosis.  
Diarrhea stopped in all patients and results from stool samples 
were negative within two and a half days after beginning oral 
trimethoprim-sulfamethoxazole therapy.  Twelve of 28 patients who
were followed for one month or more developed recurrent 
symptomatic cyclosporiasis, which promptly responded to 
trimethoprim-sulfamethoxazole therapy.  The researchers concluded
that Cyclospora infection is common in HIV-infected Haitians, 
responds to therapy with trimethoprim-sulfamethoxazole, and has a
high recurrence rate that can largely be prevented with long-term
trimethoprim-sulfamethoxazole prophylaxis.
      
"Bacterial Bronchitis and Bronchiectasis in Human 
Immunodeficiency Virus Infection"
Journal of the American Medical Association (01/04/95) Vol. 273, 
No. 1, P. 4f
     Researchers noticed an increased incidence of bacterial 
bronchitis and bronchiectasis among their HIV-infected patients. 
They discovered 18 episodes of bacterial bronchitis in 10 
patients.  Bacterial bronchitis was defined by a Gram's stain 
showing an abundance of neutrophils with a predominance of one or
more bacteria and by a confirmatory sputum culture.  
Bronchiectasis was diagnosed by a bronchogram and computed 
tomography (CT) in one patient and only CT in two more.  The most
common pathogens in the bacterial bronchitis episodes were 
Haemophilus influenzae, Streptococcus pneumoniae, and Pseudomonas
aeruginosa.  Although there were frequent recurrences, antibiotic
therapy was usually successful.  The researchers concluded that 
recurrent bacterial bronchitis should be added to the list of 
bacterial infections that occur with increased frequency with HIV
infection.  Repeated bacterial bronchial may lead to 
bronchiectasis, which may be more common in HIV infection than 
generally thought.
      
"Mycobacterium Avium in the AIDS Patient: An Analysis Using the 
Epidemiologic Paradigm"
Hospital Pharmacy (12/94) Vol. 29, No. 12, P. 1090;  Gourley, 
Greta K.;  Corbett, Cathy E.;  Brown, James R. et al
     The most common systemic bacterial infection found in AIDS 
patients is disseminated infection with Mycobacterium avium 
complex (MAC).  Based on diagnosis by blood culture, the annual 
infection rate is approximately 15 to 20 percent.  During the 
susceptibility period, the first stage of MAC, the disease has 
not yet developed.  The second stage, pathogenesis, represents 
the reaction of the host to the stimulus produced in the first 
stage.  The focus of the final period, advanced disease, is the 
continuation of the treatment regimen and disability limitations.
While tertiary prevention often plays a lesser role in infectious
disease because infection less often results in permanent 
disability or death, diagnosis of MAC may come at such an 
advanced stage of AIDS that a decision is made not to begin 
therapy.   Because of the extremely infectious nature of MAC, it 
is critical that therapeutic issues such as appropriate 
susceptibility tests, ethical guidelines, duration of treatment, 
and optimal dosages be addressed.
      
"The Care of Injection-Drug Users with HIV Infection"
New England Journal of Medicine (12/29/94) Vol. 331, No. 26, P. 
1773;  O'Connor, Patrick G.;  Selwyn, Peter A.;  Schottenfeld, 
Richard S.
     In response to letters to the editor, O'Connor et al write that 
Drs. Selbovitz and Zide-Selbovitz raise the important issue of 
oral health among HIV-infected injection drug users.  Those who 
are HIV-infected are more susceptible to oral candidiasis, a 
variety of viral infections, neoplastic lesions, and other 
lesions such as aphthous ulcers.  Substance abuse has been linked
to oral and pharyngeal disease.  Physicians caring for 
HIV-infected injection drug users should take a history of oral 
symptoms and perform a careful oral, head, and neck examination. 
Several efforts are being made to educate health care 
professionals about issues related to HIV and substance abuse.
      
"Knowledge, Attitudes, Beliefs and Behaviors (KABB) Surveys"
United States Conference of Mayors: AIDS Information Exchange 
(12/94) Vol. 11, No. 5, P. 1
     Knowledge, Attitudes, Beliefs, and Behaviors (KABB) 
surveys--designed to assess the knowledge, attitudes, beliefs, 
and behaviors of a given target population--can be a critical 
factor in a successful community HIV prevention needs assessment.
The surveys can measure how much a specific population knows 
about HIV and whether that knowledge has changed behaviors.  
Survey results can also demonstrate the deficiencies in a 
community's HIV prevention services by exploring the needs of 
underserved populations and identifying barriers that prevent 
people from receiving the HIV prevention messages.  A KABB survey
should be population-sensitive.  For example, cultural and social
attitudes within the Asian and Pacific Islander (API) community 
toward illness, drug use, and sexuality--especially 
homosexuality--present barriers to effective HIV prevention.  
There are also more than 70 API languages spoken in some U.S. 
cities, which necessitates collaboration with the target 
population and the agencies that serve that population.  A 
well-designed survey includes appropriately-structured questions,
proper population sampling, and measures of statistical validity 
and reliability.
      
"A Helping Hand"
Adweek (12/19/94) Vol. 31, No. 51, P. 18;  Voight, Joan
     Inspired by a former colleague who is HIV-positive, Rachel Gaunt,
a partner at Sampson & Moore advertising agency in San Francisco,
devotes much of her free time to local AIDS projects.  In 
November, for example, she joined about 30 other volunteers to 
transform the old Ross Pharmacy in San Anselmo, Calif., into a 
center where people with HIV and AIDS can go for advice, 
treatment, and support.  Gaunt is also an emotional support 
counselor with the Marin AIDS Project.  While most counselors 
care for one client at a time, she has two--spending anywhere 
from one to four hours a week with each.  Gaunt's compassion 
stems from a close friendship with a former colleague, Barney 
Pina.  A hemophiliac who became HIV-infected through tainted 
blood, Pina found the old drugstore and decided to convert it 
into a nonprofit community center--called The Positive 
Center--for people with AIDS and other life-threatening diseases.
"This work helps you to be open to the natural phenomenon of 
dying, that it is a part of life," says Gaunt.
      
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