                     AIDS Daily Summary
                      February 8, 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
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Copyright 1995, Information, Inc., Bethesda, MD


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"Settlement Reached in AIDS Suit"
"Who Will Care for Children when Parents Die of AIDS?"
"Parole Denied to Top Figure in French AIDS Scandal"
"Growing AIDS Epidemic Becomes More Diverse"
"Chronicle"
"Across the USA: Mississippi/New Mexico"
"HIV Population Dynamics in Vivo: Implications for Genetic 
Variation, Pathogenesis, and Therapy"
"Drug Malabsorption and Resistant Tuberculosis in HIV-Infected 
Patients"
"Danish Haemophiliacs Court Case Nears Conclusion"
"Silence=Stigma"
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"Settlement Reached in AIDS Suit"
Philadelphia Inquirer (02/08/95) P. B2;  Vedantam, Shankar
     An undisclosed settlement has been reached in the AIDS 
discrimination lawsuit filed by surgeon Paul Scoles against Mercy
Health Corp., with both sides claiming vindication.  The 
settlement came after a federal judge's ruling in December that 
Mercy Health did not discriminate against Scoles, who is 
HIV-positive, when it required him to disclose his status to his 
patients before treating them.  Scoles and his lawyers claimed 
victory for making hospitals in the United States "change their 
behavior" toward doctors who are infected with HIV.  Mercy Health
said that because AIDS meant "nearly certain death," it was 
impossible to hide risks of infection from patients, no matter 
how small such risks may be.  In 1992, Scoles charged that Mercy 
Health suspended his surgical privileges and ruined his practice 
after he revealed he was HIV-positive.  He claimed that 
Misericordia Hospital, which is operated by Mercy Health, sent 
more than 1,000 letters to his former patients informing them 
that he was infected.
      
"Who Will Care for Children when Parents Die of AIDS?"
Philadelphia Inquirer (02/08/95) P. H1;  Martin, Antoinette
     Since late last summer, a series of public service announcements 
by the National Council for Adoption (NCFA) has urged parents 
with AIDS to arrange adoptions for their children before they 
die.  One of the ads says, "AIDS. Kids. If you have both, maybe 
it's time to take a closer look at adoption."  The ads have been 
on television and radio stations in cities including 
Philadelphia, New York City, Detroit, and San Francisco.  "We are
targeting areas where the AIDS epidemic is prevalent," says 
William Pierce, president of the Washington, D.C., non-profit 
group.  Pierce says that hundreds of calls--from people with 
AIDS, support groups, and people wanting to adopt--have flooded 
the phone lines since the ads began airing last spring in the 
Washington area.  There have been no negative responses.  So far,
64 children have been adopted as a result of the national 
campaign.  The number of children in the United States that have 
been orphaned by AIDS is estimated to be about 35,000.  Health 
officials project that by the year 2000, there will be between 
70,000 and 125,000 AIDS orphans, says Pierce.
      
"Parole Denied to Top Figure in French AIDS Scandal"
Philadelphia Inquirer (02/08/95) P. A6
     On Tuesday, a Paris court rejected a bid for parole by Dr. 
Michael Garretta, the head of France's state-run blood bank 
during the mid-1980s.  It was during that period that more than 
1,000 hemophiliacs became HIV-infected from tainted blood as 
officials used up stocks to save money rather than import 
virus-free products.  In making its decision, the three-judge 
panel cited the "exceptional extent of damages" in the scandal, 
and noted that "parole...is not an automatic right of the 
convicted."  Garretta was jailed in October 1992 for "fraud in 
the quality of merchandise."
      
"Growing AIDS Epidemic Becomes More Diverse"
Boston Globe (02/07/95) P. 32;  Walsh, Pamela M.
     Although AIDS was once thought of as a disease of only gay men 
and intravenous drug users, recent data from the Centers for 
Disease Control and Prevention show that it is now moving into 
the mainstream.  A study at the Living Center, a resource center 
in Boston for HIV-infected people, identified a shift toward more
women and minorities.  In 1992, 17 percent of the center's 
members were black and Hispanic males, but now they make up 32 
percent of the 1,000 members.  Hispanic women make up 25 percent 
of the center's female membership, whereas in 1992 there were 
none.  While there were 12 heterosexual members three years ago, 
there were 40 in 1994.
      
"Chronicle"
New York Times (02/08/95) P. B4;  Steinhauer, Jennifer
     The feathered white wings used in the Broadway production "Angels
in America" will be donated the AIDS Resource Center's "Valentine
Auction," to be held Monday in SoHo, New York.  Works donated by 
artists Louise Bourgeois and Jenny Holzer and the estate of the 
photographer Robert Mapplethorpe will also be sold.  Proceeds 
from the auction will benefit the AIDS Resource Center, which 
provides housing for homeless people with AIDS.
      
"Across the USA: Mississippi/New Mexico"
USA Today (02/07/95) P. 11A
     Jury selection began on Tuesday in Laurel, Miss., for the murder 
trial of 16-year-old Marvin McClendon, who is accused of killing 
two gay men last October.  According to his lawyer, McClendon 
shot the unarmed men to protect himself from rape and possible 
exposure to AIDS.  In New Mexico, lawmakers are considering a 
bill to permit state health workers distribute clean needles to 
drug addicts.  The measure, which is intended to stem the spread 
of AIDS and other diseases, would use $220,000 to initiate pilot 
programs in two counties.
      
"HIV Population Dynamics in Vivo: Implications for Genetic 
Variation, Pathogenesis, and Therapy"
Science (01/27/95) Vol. 267, No. 5197, P. 483;  Coffin, John M.
     Several recent reports show that the long, clinically latent 
phase characteristic of human HIV infection is not a period of 
viral inactivity, but an active process in which cells are being 
infected and dying at a high rate and in large numbers.  John M. 
Coffin of the Department of Molecular Biology and Microbiology at
Tufts University School of Medicine used these results to develop
a simple, steady-state model in which infection, cell death, and 
cell replacement are in balance.  The findings suggest that the 
unique feature of HIV is the exceptionally high number of 
replication cycles that occur during infection of a single 
person.  A consequence of rapid turnover is the development of 
genetic variation, which can build up populations of HIV strains 
resistant to antiviral drugs.  Coffin also notes that 
understanding the dynamics of the latent period may lead to ideas
for new therapeutic strategies.
      
"Drug Malabsorption and Resistant Tuberculosis in HIV-Infected 
Patients"
New England Journal of Medicine (02/02/95) Vol. 332, No. 5, P. 
336;  Patel, Kalpana B.;  Belmonte, Romelle;  Crowe, Helen M.
     In a letter to the editor published in the New England Journal of
Medicine, Patel et al. describe their experiences in caring for 
two HIV-infected patients who relapsed into drug-resistant 
isolates of Mycobacterium tuberculosis (TB).  The relapse is 
presumed to be because of subtherapeutic drug levels caused by 
malabsorption.  The first patient received isoniazid, rifampin, 
and pyrazinamide daily for ileocecal and pulmonary TB.  After 
four months of observed therapy, he was found to have a new 
cavitary pulmonary lesion.  Sputum cultures grew M. tuberculosis 
that was resistant to rifampin, but still sensitive to isoniazid,
pyrazinamide, ethambutol, and streptomycin.  The second patient, 
diagnosed with pulmonary TB, received rifampin, pyrazinamide, and
ethambutol daily under direct supervision in a homeless shelter. 
A new right-upper-lobe infiltrate appeared after 10 months.  An 
isolate of sputum was resistant to both isoniazid and rifampin, 
but still sensitive to pyrazinamide, ethambutol, and 
streptomycin.  The cases illustrate that drug malabsorption may 
contribute to the emergence of drug resistance, as some 
researchers have theorized.  The researchers suggest routine 
screening of antimycobacterial-drug levels in HIV-infected 
patients with TB, especially those with advanced HIV disease.
      
"Danish Haemophiliacs Court Case Nears Conclusion"
Lancet (02/04/95) Vol. 345, No. 8945, P. 313;  Skovmand, Kaare
     On Feb. 9, a Danish High Court will determine whether the 
National Board of Health, the Ministry of Health, and factor VIII
maker Novo Nordisk are liable for the HIV-infection of eight 
hemophiliacs.  They are being sued by the Danish Haemophiliacs 
Association, which claims that the patients were infected through
factor VIII received after Jan. 1, 1985.  The association claims 
that by Jan. 1, 1985, the authorities and the producer should 
have been aware of the risk of HIV-transmission via factor VIII. 
To support the claim that action to prevent HIV transmission 
through factor VIII products was taken late, the prosecution 
presented evidence of very poor communication among the 
authorities in 1985.  The defendants claim that their actions 
were based on what they thought to be right in light of existing 
knowledge at the time.  The trial has added to the bad publicity 
Novo Nordisk received in 1988 when it was fined Dkr15,000 for 
having marketed products prepared from blood not screened for 
HIV.  A total of 90 Danish hemophiliacs became HIV-infected 
during the 1980s through therapy with factor VIII.
      
"Silence=Stigma"
Advocate (02/07/95) No. 674, P. 31;  Gallagher, John
     Many AIDS activists say that the stigma attached to AIDS will 
continue unless individuals, especially famous ones, acknowledge 
their illness.  A. Cornelius Baker, director of public policy and
education at the National Association for People With AIDS, said 
that AIDS is more likely to be hidden if the person who has it is
a gay man, particularly if he is a celebrity.  For example, 
journalist Randy Shilts, who died in 1994, has been the object of
scorn because he only revealed his illness after his health 
declined significantly.  Despite Shilts' status as a prominent 
historian of the AIDS epidemic and perhaps the first openly gay 
reporter in mainstream media, he remained silent for several 
years about being HIV-infected.  Most often, however, the AIDS 
closet involves the suppression of AIDS as the cause of death in 
tributes and obituary notices.  Often survivors avoid naming AIDS
as the cause of death, using instead a kind of code where young 
men die from "long-term illness" or "heart failure."  Although 
activists hope for more openness, they understand why many people
do not choose it.  "There has to be a respect for privacy," said 
Baker.  "You have to allow people to die in the fashion they 
choose."
      
