                     AIDS Daily Summary 
                      January 31, 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
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Copyright 1995, Information, Inc., Bethesda, MD


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"AIDS Is Now the Leading Killer of Americans from 25 to 44"
"Caremark Will Sell Home Infusion Unit to Coram"
"Drug Companies Act in Hemophiliacs' Suit"
"Long-Term AIDS Survivors Puzzle Scientists"
"AIDS Patient Settles Suit Charging Denial of Care"
"In Love, In Danger"
"Across the USA: Utah/Washington/Wyoming"
"Researchers Find Early Battlers of H.I.V."
"Duesberg and the New View of HIV"
"Planning Process Localizes HIV Prevention Plans, Say CDC 
Officials"
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"AIDS Is Now the Leading Killer of Americans from 25 to 44"
New York Times (01/31/95) P. C7;  Altman, Lawrence K.
     New data has found that AIDS is the leading cause of death among 
all Americans aged 25 to 44.  AIDS surpassed unintentional 
injury, the Government's category for accidents, which dropped to
second place for this age group, said Dr. Harold W. Jaffe, a top 
AIDS official at the Centers for Disease Control and Prevention 
(CDC).  "AIDS was expected to rise to the top of the list 
eventually, but no one had predicted which year," he said  Jaffe 
added that the increase "is due to the accumulating toll from 
AIDS and is almost certain to continue because AIDS deaths 
reflect infections from HIV...that were acquired several years 
earlier."  More than 440,000 cases of AIDS have been reported to 
the CDC since the disease was first identified.  More than 
250,000 people have died from AIDS or AIDS-related causes.  About
75 percent of the cases have been reported in the 25 to 44 age 
group.  AIDS is also the leading cause of death in men and women 
in 79 of 169 American cities with populations over 100,000,  and 
in 15 of the 135 largest cities--including Baltimore, Md.; Miami,
Fla.; and Newark, N.J.  Related Story: Baltimore Sun (01/31) P. 
7A
      
"Caremark Will Sell Home Infusion Unit to Coram"
New York Times (01/31/95) P. D5;  Feder, Barnaby J.
     Caremark International Inc. announced on Monday that it will sell
its home infusion unit to the Coram Healthcare Corporation for 
more than $300 million in cash and securities.  If approved by 
antitrust regulators, Coram would clearly become the leader in 
the highly fragmented business of administering intravenous 
medicines and nutritional products in the home to patients with 
AIDS, cancer, and other chronic or acute diseases.  Caremark said
the sale would give it greater resources to concentrate on other 
businesses that have become more important to it than home 
infusion--particularly buying and managing the practices of 
groups of physicians with multiple specialties.  "Home infusion 
had become the least profitable money-making business in our 
portfolio," said C.A. Lance Piccolo, chairman and chief executive
of Caremark.  Related Stories: Washington Post (01/31) P. D2; 
Wall Street Journal (01/31) P. B5
      
"Drug Companies Act in Hemophiliacs' Suit"
Philadelphia Inquirer (01/31/95) P. A2;  Shaw, Donna
     Attorneys for four drug companies asked a federal appeals panel 
yesterday to overturn a lower-court ruling allowing hemophiliacs 
to sue the companies as a group.  The hemophiliacs involved in 
the suit claim they were infected with HIV by the companies' 
blood clotting medications.  The companies are Armour 
Pharmaceutical Co., Miles Inc., Baxter Healthcare Corp., and 
Alpha Therapeutic Corp.  Douglas F. Fuson, Armour's attorney, 
argued that the court would waste its time listening to the 
companies defend themselves against negligence charges in a 
class-action suit only to hear the same arguments in subsequent 
cases.
      
"Long-Term AIDS Survivors Puzzle Scientists"
Washington Post (Health) (01/31/95) P. 7;  Colburn, Don
     About 5 percent of HIV-positive people seem unaffected by the 
virus either clinically or immunologically after a decade of 
infection.  Three studies of this group have appeared in the New 
England Journal of Medicine.  One of these, a study of a 
hemophiliac who was infected before 1983 with a virus containing 
a defective gene, was conducted at the New England Primate 
Research Center with the University of Massachusetts and Harvard.
The subject's continuing health holds promise for a vaccine 
against more potent forms of the virus, but an upcoming report in
Science magazine indicates that the defective virus caused AIDS 
in monkeys.
      
"AIDS Patient Settles Suit Charging Denial of Care"
Philadelphia Inquirer (01/31/95) P. B2
     A private settlement has been reached in the case of a 
Philadelphia man who alleged that he was denied medical care 
because he tested HIV-positive.  While the plaintiff's attorney 
said on Monday that the suit had been settled on the eve of the 
trial, he refused to disclose the details.  The attorney filed a 
suit last year on behalf of John Woolfolk, a city resident who 
was receiving medical care under the state and federally financed
HealthPass program.  Woolfolk claimed that the doctor assigned to
him told him he did not treat AIDS patients.  The doctor denied 
the allegations.  Judge John R. Padova had rejected motions 
earlier this year to dismiss the suit, which was filed under the 
Americans with Disabilities Act.
      
"In Love, In Danger"
Baltimore Sun (01/31/95) P. 1D;  Lippman, Laura
     To reinforce the message of abstinence, parents and teachers 
often emphasize the scariest potential consequences--pregnancy or
AIDS.  In Towson, Md., for example, approximately 500 Baptists 
will gather this weekend for a "True Love Waits" conference, a 
national movement to encourage teens to sign sexual abstinence 
pledges as part of their commitment to God.  In the shadow of 
AIDS, however, other sexually transmitted diseases (STDs) have 
become secondary in such discussions--which is a disservice to 
everyone, say local doctors who treat adolescents.  While the 
effects of AIDS and pregnancy are more extreme, gonorrhea and 
chlamydia are statistically more likely.  Chlamydia affects as 
much as 35 percent of all sexually active women.  An STD 
infection can also make it easier to become infected with HIV, 
through open sores that allow the virus to enter the bloodstream.
"Teenagers don't believe it can happen to them," says Dr. Alain 
Joffe, director of adolescent medicine at the Johns Hopkins 
Children's Center.  "They think: 'It's people who are 
promiscuous, people who are dirty.  Bad kids get STDs.'  And they
don't see themselves in that light."    Only abstinence can 
guarantee an individual will not contract an STD, but monogamous 
relationships help reduce the risk.
      
"Across the USA: Utah/Washington/Wyoming"
USA Today (01/31/95) P. 11A
     The Utah House sent the Senate a bill that subjects injured state
residents rescued by public safety officers or Good Samaritans to
tests to ensure they do not have AIDS or some other blood-borne 
disease.  Opponents to the bill call it intrusive.  In another 
AIDS-related development, a Washington state study has found that
for the first time, new cases of AIDS in the state are increasing
faster in smaller, rural communities than they are in the 
Seattle-King County area.  Each day, on average, two AIDS-related
deaths occur statewide.   In other news, 110 cases of AIDS have 
been reported in Wyoming since 1984.  Ninety-nine of those cases 
have been in men.  A total of 68 have died from AIDS-related 
causes.
      
"Researchers Find Early Battlers of H.I.V."
New York Times (01/29/95) P. 24;  Kolata, Gina
     Small preliminary studies of protease inhibitors--drugs that 
block a key viral enzyme--to be reported this week at a national 
medical meeting indicate that a new class of drugs is extremely 
effective in eliminating HIV and allowing the immune system to 
recover, at least in the short term.  The investigators, however,
advise caution in interpreting the results, noting that many 
promising early findings have failed to lead to effective 
treatments for AIDS patients.  While the drugs currently on the 
market block a different enzyme, reverse transcriptase, and are 
generally acknowledged to be weak in fighting HIV progression, 
the protease inhibitors appear to be different.  Dr. David Ho, 
director of the Aaron Diamond AIDS Research Center, said the 
protease inhibitors were about 10 times more effective than AZT 
and other reverse transcriptase inhibitors in stopping HIV 
replication.  Dr. John Leonard, director of protease inhibitor 
studies at Abbott Laboratories, said that Abbott will report that
its drug, ABT-538, can shut off 99 percent of HIV's replication 
and can reduce the number of virus particles in the blood by 70 
to 99 percent.  The Merck protease inhibitor, L524, produced 
similar effects, said Ho.
      
"Duesberg and the New View of HIV"
Nature (01/19/95) Vol. 373, No. 6511, P. 189;  Maddox, John
     The new findings on the dynamics of HIV infection are, or should 
be, an embarrassment to Professor Peter Duesberg of Berkeley, 
Calif., writes John Maddox in Nature magazine.  The findings 
resolve the paradox that although the concentration of CD4 cells 
may decline with the persistence of infection, there was no 
dramatic increase in the frequency of infected T cells as 
infection gave way to overt disease.  The new developments show 
that the T cells in an infected person's blood are likely to have
been created in the previous few days.  Only a small proportion 
will have had the time to become infected.  The cells that harbor
the virus will be killed off very soon.  Thus, the scarcity of T 
cells is consistent with the claim that the immune system is in 
overdrive from the onset of HIV-infection.  Duesberg is correct 
to have argued that the usually slow decline of CD4 cells is not 
consistent with what is expected from a specific cytotoxic viral 
mechanism.  The explanation is that the CD4 population has at any
time been freshly created.  Maddox wonders why it has only now 
been found that the response of the immune system to 
HIV-infection is hyperactivity, and not the opposite.  Further 
studies of the viral dynamics will be eagerly awaited, now that 
the basis for the low CD4 T-cell count in AIDS patients is clear.
      
"Planning Process Localizes HIV Prevention Plans, Say CDC 
Officials"
Nation's Health (01/95) Vol. 25, No. 1, P. 10
     The HIV Prevention Community Planning Process--a program that 
helps health departments identify high priority prevention needs 
with the help of community representatives--provides a 
significant step forward in planning services that specifically 
address unique community needs, say officials at the Centers for 
Disease Control and Prevention.  The program was developed last 
year by the CDC with help from governmental and non-governmental 
organizations.  A 1993 guidance document from the CDC required 
all health departments that receive HIV prevention funds from the
CDC's National Center for Prevention Services to initiate an HIV 
Prevention Community Planning Process in fiscal year (FY) 1994 to
qualify for HIV prevention funding in FY 1995 and beyond.  The 
HIV Prevention and Community Planning Process has already made 
the participants realize the need for parity, inclusion, and 
representation in the planning process.  Other issues to be dealt
with include setting priorities and trust among members.
      
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