                     AIDS Daily Summary
                       March 21, 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 1995, Information, Inc., Bethesda, MD


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"WHO Warns Over TB Threat"
"Viagene and Chiron End Merger Talks Without a Deal"
"Cuts Set Off Debate on Helping Homeless with AIDS"
"The AIDS Breakout"
"S. Boston Parade, Already Protesting Gay Group, Bars Veterans 
with AIDS"
"Intestinal Mycobacteria in African AIDS Patients"
"Heart Muscle Disease Related to HIV Infection: Prognostic 
Implications"
"Jury Trial Permitted in Suit Against Red Cross"
"The Gait of Grief"
"Health Heroes: AIDS"
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"WHO Warns Over TB Threat"
Financial Times (03/21/95) P. 4
     Unless new tuberculosis (TB) control strategies are introduced, 
the global death toll from the disease will increase from 3 
million to 4 million a year by 2005, the World Health 
Organization (WHO) cautioned on Monday.  The WHO's recommended 
strategy, called Directly Observed Treatment, Short-course 
(Dots), requires health workers to watch their patients take each
dose of antibiotics, once a day for two months and then three 
times a week for four months.  Without such supervision, many 
patients stop taking their medications before the bacteria is 
completely eliminated, which leads to the emergence of 
drug-resistant strains of TB.  A worldwide campaign based on Dots
could save 12 million lives in the next decade, at a cost of $360
million a year, according to Dr. Arata Kochi, TB program manager 
for WHO.  Related Story: New York Times (03/21) P. C12
      
"Viagene and Chiron End Merger Talks Without a Deal"
New York Times (03/21/95) P. D3
     Viagene Inc., which produces an experimental AIDS treatment, said
on Monday that talks with Chiron Corp. had ended without 
agreement on Chiron's proposed acquisition of Viagene.  Viagene 
is currently testing HIV-IT, a gene therapy drug for HIV-positive
patients.  Related Story: Wall Street Journal (03/21) P. B4
      
"Cuts Set Off Debate on Helping Homeless with AIDS"
New York Times (03/21/95) P. B1;  Lee, Felicia R.
     Last week, the House approved cutting a $186 million housing 
program that would have assisted approximately 50,000 people with
AIDS in the 1995 fiscal year.  According to the National 
Commission on AIDS, half to one-third of all Americans with AIDS 
are either homeless or likely to become so.  Rescissions, or 
midyear budget cuts, were approved last week, which eliminated 
funds for the Housing Opportunities for Persons with AIDS 
program.  The cut in the program has particularly sparked outrage
among advocates for homeless people with AIDS because they 
believe they represent the most desperate people in the 
country--people who are poor, sick, homeless, and dying.  AIDS 
advocates say that the unpredictable nature of AIDS distinguishes
it from other diseases, and that because of the stigma and fear 
surrounding the disease, infected people often have a difficult 
time renting from landlords or staying with family and friends.  
Many people who work with AIDS patients say the cutbacks in a 
number of initiatives would force people with AIDS to compete for
funds with elderly and disabled people.
      
"The AIDS Breakout"
Baltimore Sun (03/21/95) P. 11A;  Jacobs, Joanne
     AIDS activists have long warned that someday the disease would 
"break out" of the gay community to affect heterosexuals, writes 
columnist Joanne Jacobs in the Baltimore Sun.  AIDS is now out of
the gay ghetto, she writes, but not out of the drug ghetto.  Last
year, drug addicts accounted for almost 75 percent of new HIV 
infections, according to the New York Times, which cited an 
as-yet unpublished federal study.  While it is not news that HIV 
is transmitted through shared needles, what is new is the role of
crack cocaine, which fuels reckless promiscuity.  Up to one half 
of the women infected through heterosexual sex may be crack 
addicts, and abuse of other drugs and alcohol is also linked to 
infection.  The role of drug abuse in the AIDS epidemic 
underscores the desperate need for needle-exchange programs.  
Giving addicts clean needles in exchange for dirty ones is an 
effective way to slow the spread of the disease, writes Jacobs.  
Although attacking the crack factor in HIV transmission requires 
more drug-treatment options and more money, but offers no 
guarantee of success, the alternative--letting the drug users 
die--is grim, concludes Jacobs.
      
"S. Boston Parade, Already Protesting Gay Group, Bars Veterans 
with AIDS"
Boston Globe (03/20/95) P. 1;  Lakshmanan, Indira A.R.
     The veterans group that organized the St. Patrick's Day protest 
march in South Boston on Sunday would not permit a group of 
former servicemen who have AIDS to march.  "We don't give 
reasons," said John Hurley, one of the organizers of the event, 
about why the servicemen were banned.  The South Boston Aged War 
Veterans Council called the march a protest rather than a parade 
due to a dispute about the participation of a group representing 
gays and lesbians.  The Supreme Judicial Court had ruled that the
organizers must include a group of gays and lesbians who wanted 
to march.  A U.S. District Court judge, however, ruled that if 
the organizers were protesting the state court ruling, and 
demonstrating in favor of "traditional values"--which they said 
they were--then the protest could take place.  Sunday was the 
first time the AIDS veterans group had attempted to join in St. 
Patrick's Day events in South Boston.  Jon Stuen-Parker, an AIDS 
activist and founder of the Veterans With AIDS Drop-In Center, a 
project of the Boston-based National AIDS Brigade, said that many
veterans with AIDS and their families had anticipated the event, 
only to learn Saturday that they could not march.
      
"Intestinal Mycobacteria in African AIDS Patients"
Lancet (03/04/95) Vol. 345, No. 8949, P. 585;  Pankhurst, C.L.;  
Luo, N.;  Kelly, P. et al.
     Infection with both HIV and Mycobacterium tuberculosis has had a 
significant impact on the epidemiology of tuberculosis (TB) in 
sub-Saharan Africa.  Pankhurst et al. conducted a cross-sectional
study of the prevalence of mycobacteria in 120 fecal samples 
taken from 69 patients with HIV-related diarrhea attending the 
University Teaching Hospital in Lusaka.  Fecal specimens from 
seven of the 69 patients grew mycobacteria--two had Mycobacterium
avium complex (MAC), four had M. tuberculosis, and one had M. 
flavescens.  In a parallel study, the researchers studied fecal 
specimens from HIV-infected patients in London.  Similar rates of
recovery of mycobacteria were found, with seven of the isolates 
being MAC and one M. tuberculosis.  One half of the 
stool-positive cases developed disseminated disease during the 
6-12 months of follow-up.  Pankhurst et al. concluded that M. 
tuberculosis and MAC are found in the gut of 10 percent of 
African patients with HIV-related diarrhea.  There is, however, 
little evidence of the small intestinal mycobacterial disease 
found in AIDS patients in industrialized countries.  Despite high
rates of infection in people with AIDS, M. tuberculosis is not a 
significant contributor.
      
"Heart Muscle Disease Related to HIV Infection: Prognostic 
Implications"
Journal of the American Medical Association (03/08/95) Vol. 273, 
No. 10, P. 758h
     To determine the natural course of heart muscle disease in 
HIV-infected patients, Currie et al. studied HIV-infected adults 
to detect myocardial dysfunction and time to death.  Forty-four 
of the 296 subjects were diagnosed with cardiac dysfunction.  In 
contrast to other forms of cardiac dysfunction, dilated 
cardiomyopathy was strongly associated with a CD4 cell count less
than 100.  Compared to those with normal hearts, patients with 
dilated cardiomyopathy had significantly reduced survival rates. 
While 101 days was the average survival time for those patients 
with cardiomyopathy, those with normal hearts and a CD4 cell 
count less than 20 lived 472 days.  There were no significant 
differences in survival for participants with borderline left or 
isolated right ventricular dysfunction.  Even with the reduced 
cell count with which dilated cardiomyopathy is associated, the 
prognosis for HIV-infected patients with dilated cardiomyopathy 
is poor.  Isolated right and borderline left ventricular 
dysfunction, however, are not linked to diminished CD4 counts and
do not carry adverse negative prognostic implications.
      
"Jury Trial Permitted in Suit Against Red Cross"
National Law Journal (03/13/95) Vol. 17, No. 20, P. B15
     The Third Circuit Court of Appeals held in February that Carol 
Marcella, who contracted HIV after receiving a transfusion of 
contaminated blood in 1985, was entitled to a jury trial.  
Marcella sued Brandywhine Hospital, her doctors, and the American
Red Cross for negligence.  The Red Cross filed a motion for a 
nonjury trial, arguing that it was a federal instrumentality 
which shares governmental immunity to trial by jury.  The circuit
court, however, said that the collection and distribution of 
human blood for medical uses is a commercial operation for the 
Red Cross, and that the organization was chartered by Congress as
a federal corporation.  The court also noted that although the 
Red Cross sometimes appears to be almost an extension of the 
government, the government does not manage the daily activities, 
provide the funds to support the activities, or employ or grant 
civil service status to its workers.
      
"The Gait of Grief"
Maclean's (02/13/95) Vol. 108, No. 7, P. 69;  Young, Pamela
     When dancer and choreographer Margie Gillis--who is known for her
ability to translate basic human emotions into a clear and 
powerful language of movement--recently began her 20th season as 
a solo artist in Toronto, the central emotion was grief.  A year 
and a half ago, her older brother and occasional dance partner, 
Christopher Gillis, died of AIDS-related causes in New York City,
where he had been a dancer and choreographer with the Paul Taylor
Dance Company.  Margie Gillis, who was her brother's primary 
caregiver during his final years, is now touring with works that 
include "Landscape," the final piece her brother created for her.
She opened her tour with the first Toronto performance of 
"Landscape" at Dancers for Life, an AIDS benefit at the Royal 
Alexandra Theatre on Jan. 31.  "We wanted to discuss and share 
what it's like to die," Gillis said of her brother's "Landscape."
"That's what it's about: him teaching me what it felt like from 
the inside," she added.
      
"Health Heroes: AIDS"
Longevity (03/95) Vol. 7, No. 4, P. 56;  Wachter, Sarah;  
Cutting, Lucia
     Americans may learn most of what they know about fatal 
diseases--including cutting-edge research, the best treatments, 
and the latest experimental drugs--from press coverage of an 
ailing celebrity.  Actor Rock Hudson's disclosure in 1985 that he
had AIDS brought the disease out of the closet and into greater 
public discussion.  Also in 1985, Hudson's close friend, 
Elizabeth Taylor, cofounded the American Foundation for AIDS 
Research (AmFAR), which has awarded more than $71 million in 
grants to 1,400 AIDS research groups.  Ryan White, a 13-year-old 
hemophiliac who contracted HIV through a blood-clotting product, 
became an instant celebrity when he was temporarily banned from 
school near his hometown of Kokomo, Ind.  He spoke to other 
youths about AIDS, and testified before the President's 
Commission on AIDS in 1988.  In 1990, after White's death, 
Senators Orrin Hatch and Ted Kennedy cosponsored the "Ryan White 
Bill," to help cities finance AIDS care.  Other heroes include 
Elizabeth Glaser, cofounder of the Pediatric AIDS Foundation, and
former NBA legend Magic Johnson, who has been a major player in 
educating children about safe sex.
      
