                     AIDS Daily Summary 
                      April 24, 1996
     
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 National AIDS 
Clearinghouse, or any other organization. Reproduction of this 
text is encouraged; however, copies may not be sold, and the CDC 
National AIDS Clearinghouse should be cited as the source of this 
information. Copyright 1996, Information, Inc., Bethesda, MD
     
     
************************************************************ 
"An AIDS Cure or a False Hope? Disputed Drug Starts NIH Test" 
"U.S. Checks Phoenix Company for Lapses in Handling Blood" 
"Merck's Chairman Talks Up AIDS Drug at Annual Meeting" 
"Senate Votes 100 to 0 for Health Bill"
"D.C. Gets Help in Effort to Revamp Health Care" 
"Poll on Blood Finds Anxiety"
"HIV Infection Remains Stable Among STD Patients"
"Influence of Combinations of Human Major Histocompatibility 
Complex Genes on the course of HIV-1 Infection"
"Pneumococcal Infectious Arthritis in Two HIV Infected Patients" 
"Palliative Care and HIV, Part II: Systemic Manifestations and 
Late-Stage Issues"
************************************************************
     
"An AIDS Cure or a False Hope? Disputed Drug Starts NIH Test" 
Washington Post (04/24/96) P. D1;  Goldstein, Amy
     After a five-year debate involving racial, religious, and
medical issues, the National Institutes of Health is launching a 
nationwide clinical trial of a drug that has been called an AIDS 
cure by Nation of Islam leaders but has been rejected by NIH 
scientists.  The drug, known as low-dose interferon or Kemron, has 
become popular among some African Americans who favor alternative 
medicine and has become the focus of some African Americans who say 
they have suffered discrimination by the U.S. research community.  
One of the three Washington, D.C., sites that will participate in 
the trial is the Abundant Life Clinic, an AIDS clinic run by the 
Nation of Islam's health minister Abdul Alim Muhammad.  Muhammad, 
who treats his patients with interferon instead of approved drug 
treatments, has become a prominent figure in AIDS policy, attacking 
the federal government's lack of support for interferon research.  
Some doctors said Tuesday that they thought NIH had given in to 
political pressure brought by the black physicians.  NIH officials 
said they decided to go ahead with the trial to try to resolve the 
debate about the efficacy of the drug.  Related Story: Washington 
Times (04/24) P. A3
     
"U.S. Checks Phoenix Company for Lapses in Handling Blood" 
New York Times (04/24/96) P. A6
     The Food and Drug Administration has identified blood safety
problems at United Blood Services, which supplies blood to 
hospitals in 18 states, since 1994.  The agency announced a 
consent decree Monday, which requires the company to spend $16 
million on improving the safety of its products.  The FDA found 
that blood donors were not properly questioned about possible 
risk of infection with an infectious disease and that the company 
did not always follow instructions for testing blood for certain 
viruses.  Although the FDA has not learned of any instances where 
improperly screened blood was also not properly tested, FDA 
deputy commissioner Mary Pendergast noted that "it's a 
possibility; we're not certain," adding that the government is 
investigating some reports from patients who fear they were 
exposed to HIV or hepatitis.
     
"Merck's Chairman Talks Up AIDS Drug at Annual Meeting" 
Wall Street Journal (04/24/96) P. B2
     Raymond V. Gilmartin, chairman of Merck & Co., focused on
the company's new AIDS drug at the firm's annual meeting Tuesday, 
emphasizing that Merck has its own promising supply of new drugs 
and does not need to merge to grow.  Gilmartin termed Crixivan, 
the new drug, "one of Merck's greatest accomplishments."  The 
drug renders HIV virtually undetectable in about 40 percent of 
patients, a Merck official said.  The drug is effective in more 
than 90 percent of patients when combined with  AZT and 3TC, he 
added.
     
"Senate Votes 100 to 0 for Health Bill"
Washington Post (04/24/96) P. A1;  Havemann, Judith
     The Senate voted unanimously to pass a bill Tuesday that
would make it easier for people with chronic diseases and those 
switching jobs to retain health insurance coverage.  Congress, 
however, remains divided over the measure, which will be the 
subject of a House-Senate conference committee.  The Senate bill 
included a provision to allow dying individuals, like people with 
AIDS, to cash in their life insurance policies while still 
living.  An especially controversial provision of the Senate's 
legislation would require insurance policies to offer "parity" of 
coverage for mental and physical illnesses.
     
"D.C. Gets Help in Effort to Revamp Health Care" 
Washington Post (04/24/96) P. D3;  Schneider, Howard
     Washington, D.C., Mayor Marion Barry announced on Tuesday a
plan to revolutionize the city's suffering health care system. 
Former D.C. public health commissioner Mohammad N. Akhter will 
lead the effort.  Barry noted that the city spends almost a third 
of its budget on health care but still faces many serious health 
problems, including high rates of AIDS and infant mortality.  The 
concentration of poverty in the city is part of the problem, but 
the system, which is currently inefficiently organized, overly 
generous, and unproductive, is also to blame, Barry said.  
Akhter, a senior adviser in the U.S. Department of Health and 
Human Services, vowed to make visible changes within six months.
     
"Poll on Blood Finds Anxiety"
Toronto Globe and Mail (04/23/96) P. A4;  Picard, Andre
     Only 7 percent of Canadians would want to receive blood from
the country's Red Cross if they needed a blood transfusion and 
had a choice, a new poll shows.  The poll results indicate that 
the tainted blood tragedy has influenced public opinion and has 
left more Canadians scared of getting blood than of dying during 
surgery.  The poll also reflected Canadians' desire for 
alternatives to transfusions of donated blood, including 
self-donated blood, blood donated by a relative, and drugs that 
would make transfusion unnecessary.
     
"HIV Infection Remains Stable Among STD Patients" 
Reuters (04/23/96)
     The rate of HIV infection among patients with sexually 
transmitted diseases (STDs) is fairly stable over all 
transmission groups, a European study shows.  Dr. Laurence Meyer 
and colleagues studied more than 4,000 patients treated at an STD 
clinic in Paris.  The researchers found no significant trend in 
HIV prevalence in the different transmission groups, although HIV 
prevalence was 2.5 times higher among heterosexual patients from 
Africa or the Caribbean than among those from other countries.  
The researchers also found that despite a decrease in both the 
overall STD rate and HIV rate among patients under the age of 25, 
overall HIV incidence did not decrease, at least among homosexual 
and bisexual males.
     
"Influence of Combinations of Human Major Histocompatibility 
Complex Genes on the Course of HIV-1 Infection"
Nature Medicine (04/96) Vol. 2, No. 4, P. 405;  Kaslow, R.A.;  
Carrington, M.;  Apple, R.; et al.
     The various patterns of progression from HIV infection to
AIDS are associated with immunoregulatory host factors, including 
products of major histocompatibility (MHC) genes, known as HLA 
genes in humans.  R.A. Kaslow at the University of Alabama and 
colleagues analyzed genetic information from two groups of 
homosexual men.  The research identified products of HLA Class I, 
class II, and transporter genes, and resulted in an HLA profile 
that predicted time from HIV-1 infection to the onset of AIDS.  
The profile identified a sixfold difference between those with 
the shortest and longest time from infection to AIDS.  The 
authors claim that the results of the study uphold current 
beliefs about control of antigen processing by HLA genes and 
could affect the immunopathogenesis of HIV-1.
     
"Pneumococcal Infectious Arthritis in Two HIV Infected Patients" 
Journal of the American Medical Association (04/17/96) Vol. 275, 
No. 15, P. 1142o
     Researchers at the Hopital Bichat in France report two cases
of septic arthritis due to pneumococci in non-hemophiliac 
HIV-positive patients.  In one case, a drug addict who had 
undergone a splenectomy developed a hip joint infection during an 
episode of meningitis due to pneumococci.  The second case 
concerned the knee joint of a woman who developed pneumococcal 
pneumonia after a trip to Zaire.  In both cases, the joint 
infection developed after antibiotic treatment had begun.  In 
HIV-infected individuals, joint infections--while rare when 
compared with other types of immunodepression--can occur in all 
stages of the disease.  Seventy-five cases have been documented, 
some 10 percent of which are related to pneumococci.
     
"Palliative Care and HIV, Part II: Systemic Manifestations and 
Late-Stage Issues"
AIDS Clinical Care (04/96) Vol. 8, No. 4, P. 27;  Reiter, Gary 
S.;  Kudler, Neil R.
     The last stages of HIV infection are marked by increasing
pain, gastrointestinal discomfort, and depression.  These 
conditions should be treated aggressively with restorative and 
prophylactic therapies, write Reiter and Kudler in AIDS Clinical 
Care.  Patients who are bedridden or are suffering from an 
inflammatory or infiltrative process may suffer from somatic or 
visceral pain, which can be treated with analgesics.  Patients 
with chronic pain and a history of narcotic abuse are not likely 
to develop addictions to opiates, and narcotics can be 
prescribed.  Meanwhile, the authors note that neuropathic pain, 
characterized as burning and tingling, is treated with tricyclic 
antidepressants and antiepileptic drugs.  Also, depression, which 
affects up to 30 percent of HIV patients, should be treated with 
the selective serotonin reuptake inhibitors.  Nausea and 
vomiting--often brought on by opportunistic infections, 
neoplasms, and medications--can be treated in AIDS patients, 
while diarrhea can usually be treated with over-the-counter 
agents.  The authors note that as a patient approaches death, 
talking with the patient, providing physical contact, and 
encouraging spiritual reflection can be beneficial.  They suggest 
that current hospice care for AIDS patients be improved, 
predicated on patient preference, ease of administration, and 
minimization of side effects.
     
\
