                       AIDS Daily Summary 
                        December 21, 1994

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
Clearinghouse should be cited as the source of this information.
Copyright 1994, Information, Inc., Bethesda, MD

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"U.N. Denounces Aid Agency Leaving Refugee Camps"
"FDA Grants Hemocleanse Approval to Expand Hyperthermia Trials 
for AIDS Patients"
"Voluntary HIV Counseling and Testing of Hospital In-Patients to 
Protect Health Care Workers Is Not Cost-Effective, UCSF Study 
Finds"
"In Va., Having a Say in Dying"
"BART Launches Multi-Faceted Community Outreach Programs for the 
Holidays"
"Nevirapine Triple Combination: Preliminary Results Released Nov.
17"
"AIDS and Antibiotic Abuse"
"Home Is Where the Money Is"
"CDC Reorganization Prompts Concern"
"The Elections: What AIDS Organizations Need to Do Now.  
Interview with Tom Sheridan, Sheridan Associates"
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"U.N. Denounces Aid Agency Leaving Refugee Camps"
Reuters (12/21/94);  Bedford, Julian
     The United Nations High Commissioner for Refugees (UNHCR) has 
denounced Medecins San Frontieres' (MSF-Doctors Without Borders) 
decision to leave Rwandan refugee camps in Tanzania, calling it a
callous publicity stunt before Christmas.  The French wing of MSF
announced Tuesday that it would pull out of the camps because aid
was supporting the authority of Rwandan killers.  MSF France also
noted that the refugees were better fed than the Tanzanian 
population and that the flood of international aid was excessive.
Chris Bowers, spokesman for the UNHCR, said he doubted the 
sincerity of the decision to leave and MSF's justification for 
it.  "Are they really suggesting that we should not give these 
people a proper diet?" He asked.  "Are they really suggesting we 
should not give AIDS instruction and try and find ways of 
combating AIDS?  Do they want more people to die from AIDS?" 
Bowers asked.
      
"FDA Grants Hemocleanse Approval to Expand Hyperthermia Trials 
for AIDS Patients"
PR Newswire (12/20/94)
     The Food and Drug Administration (FDA) has granted Hemocleanse, 
Inc. conditional approval to expand its clinical investigation of
the use of the BioLogic-HT machine in the whole body hyperthermia
(WBHT) treatment of patients with AIDS.  An initial study was 
conducted in July with three patients treated at 42 degrees 
Celsius and three patients treated at 40 degrees Celsius.  The 
expanded study will involve 30 participants--20 who receive 
treatment at either 40 or 42 degrees Celsius and 10 control 
patients who receive no treatment.  WBHT has been used as a 
treatment for certain kinds of cancers since the 1960s.  The 
BioLogic-HT system induces a high artificial fever, while 
controlling necessary blood chemistries, thus diminishing the 
risks to the patient.  Patients from the initial study have had 
very encouraging results.  The expanded study will begin in 
February 1995.
      
"Voluntary HIV Counseling and Testing of Hospital In-Patients to 
Protect Health Care Workers Is Not Cost-Effective, UCSF Study 
Finds"
Business Wire (12/20/94)
     A new cost-effectiveness study done by the University of 
California at San Francisco (UCSF) found that there is no 
justification for voluntary HIV testing of hospital in-patients 
to prevent HIV-infection of health care workers.  The researchers
found that screening in-patients to detect infection may be cost 
effective when a significant number of the patients are 
HIV-infected.  There are, however, ethical and policy concerns 
that must be adequately addressed before any large-scale 
counseling and testing program can be supported.  The study was 
prompted by recommendations from the Centers for Disease Control 
and Prevention in 1993 to consider using voluntary HIV testing 
and counseling programs for in-patients between the ages of 15 
and 54 in certain acute care hospitals in the United States.  The
researchers determined that if all in-patients were offered HIV 
counseling and testing, only 3.6 health care worker HIV 
infections would be prevented each year.  The annual program cost
would be $2.7 billion, or $753 million per infection averted.  
"In our view, this is not sufficiently cost-effective to justify 
testing to protect health care workers from HIV infection," said 
lead author Peter Lurie, of the UCSF Center for AIDS Prevention 
Studies.
      
"In Va., Having a Say in Dying"
Washington Post (12/20/94) P. A1;  Hall, Charles W.
     At a time when physician-assisted suicide has sparked great 
controversy, medical professionals and those who counsel the 
terminally ill say that passive euthanasia, in which a patient is
allowed to die through the withholding of medical treatments, has
become far more common with much less debate.  AIDS patient Andy 
Moore, for example, is obtaining the Do Not Resuscitate form, 
which will allow him to die with dignity.  Over the last four 
years, 24 states have quietly approved laws that allowed 
seriously ill patients to reject cardiopulmonary resuscitation by
paramedics.  Court rulings have also opened up many other forms 
of passive euthanasia, such as withdrawing antibiotics to 
patients, presenting families with difficult decisions about when
to let a relative die.  Since 1992, Virginia has issued more than
30,000 Do Not Resuscitate forms.  State officials are planning a 
public awareness campaign, after a expansion of the law in July 
makes non-terminal patients with chronic illnesses eligible.  
Specialists on dying say the Do Not Resuscitate issue has 
provoked little debate because it stems from the legal principle 
that a person can refuse treatment even if that refusal may be 
fatal.
      
"BART Launches Multi-Faceted Community Outreach Programs for the 
Holidays"
Business Wire (12/20/94)
     As part of an effort to be a part of the communities it serves, 
BART has designed a multi-faceted outreach program to help the 
less fortunate during the holiday season.  One part of the 
program is "With Love: From BART," a toy and gift drive for 
children with HIV or AIDS.  There are hundreds of children and 
families in the San Francisco Bay area who live with the 
emotionally and financially draining disease.  The presents will 
be given to patients and their families at Oakland Children's 
Hospital, The University of California San Francisco Medical 
Center, The Hope Project, and Bridge for Kids.
      
"Nevirapine Triple Combination: Preliminary Results Released Nov.
17"
AIDS Treatment News (11/18/94) No. 211, P. 6;  James, John S.
     Preliminary results of a study of the "convergent combination" 
approach to antiviral treatment were released in November.  The 
subjects--who had at least six months prior treatment with AZT, 
ddI, or ddC--randomly received AZT and ddI, or AZT plus ddI plus 
nevirapine.  Nevirapine is an experimental HIV treatment that, 
when used alone, has a very strong anti-HIV effect initially but 
one that diminishes as the virus develops resistance to the drug.
After 48 weeks, the researchers found that patients who received 
all three drugs had 25 percent higher T-helper counts than those 
who only received AZT and ddI.  The ineffectivity of peripheral 
blood mononuclear cells (PBMCs) was reduced by 50 percent more in
the triple combination group.  There were no indications of 
survival or disease-progression benefit for those who received 
the triple combination.  Seventeen percent of those participants 
died or experienced HIV disease progression.  The triple 
combination also produced more side effects than only AZT and 
ddI.  In a commentary, AIDS Treatment News concluded that the 
results suggest the necessity of more flexible research 
strategies, with many small, rapid trials to quickly assess 
promising leads.
      
"AIDS and Antibiotic Abuse"
Futurist (11/94-12/94) Vol. 28, No. 6, P. 58
     In "The Plague Makers," author Jeffrey A. Fisher describes how an
overuse of antibiotics could be a contributing factor to AIDS.  
Fisher believes that extended and excessive use of drugs such as 
tetracycline may suppress the immune system to the point that 
unusual forms of Mycoplasma bacteria develop.  The bacteria 
interacts with HIV to eventually cause AIDS.  "We have to be 
suspicious of the role of HIV in the development of AIDS...It is 
clearly time for us to focus on the co-factors, especially 
antibiotics," says Fisher.  The antibiotic-related model, he 
says, would explain why the incubation period of AIDS takes 
years; why HIV existed as a relatively benign disease in Africa 
up until recently; and why there is a small, but growing, number 
of AIDS patients who are HIV-negative.  The negative role that 
antibiotics play in other diseases must be researched further, 
Fisher warns.
      
"Home Is Where the Money Is"
Advocate (12/13/94) No. 670, P. 32;  Bull, Chris
     In an Oct. 26 letter to the Food and Drug Administration (FDA), 
the National Lesbian and Gay Health Association (NLGHA) alleged 
that pharmaceutical giant Johnson & Johnson had unduly influenced
FDA officials concerning an experimental HIV home test and 
illegally funneled millions of dollars to prominent AIDS 
advocates and public-health officials.  Some AIDS activists, 
however, claim that the NLGHA is trying to delay the approval 
process of the test.  Bruce Decker of the Health Policy and 
Research Foundation--an advocacy group that supports home HIV 
testing--said, "NLGHA has had plenty of time to voice its 
concerns...This is nothing more than an effort to delay and 
confuse a very clear process."  NLGHA called for an inquiry into 
Direct Access Diagnostics (DAD)--the Johnson & Johnson subsidiary
that developed the HIV home test--and its employment of former 
surgeon general C. Everett Koop and Sean Strub--the publisher of 
"POZ", a bimonthly AIDS magazine--to promote the product.  
Although NLGHA claims that several other AIDS activists and 
organizations have accepted Johnson & Johnson's money for 
promotional activities, the groups have denied the accusation.  
Under federal law, it is illegal for companies to promote or 
advertise products that have not received full FDA approval.
      
"CDC Reorganization Prompts Concern"
Science (11/25/94) Vol. 266, No. 5189, P. 1313;  Thompson, Larry
     The Centers for Disease Control's (CDC) plans to consolidate its 
AIDS activities into a single center has some AIDS activists 
worried.  The center is already responsible for tuberculosis and 
sexually transmitted diseases.  Activists are also concerned 
because the move will shift responsibility for the disease from 
the CDC director's office to a lower level in the agency's 
hierarchy.  The reorganization will consolidate approximately 80 
percent of the funds and staff devoted to AIDS, which are 
currently scattered throughout the CDC, into the National Center 
for Prevention Services.  Basic science labs used for studying 
HIV will continue to be a part of the CDC's National Center for 
Infectious Diseases.  Currently, the hundreds of CDC employees 
who work with AIDS often report to more than one person, which 
results in confusion, stress, and difficulties in accountability.
In response to a letter written Nov. 18, Jack Jackson--the CDC's 
associate director for management--said, "Whoever leads this 
center will report directly to [CDC Director] Dr. Satcher.  Dr. 
Satcher remains committed to HIV prevention."
      
"The Elections: What AIDS Organizations Need to Do Now.  
Interview with Tom Sheridan, Sheridan Associates"
AIDS Treatment News (11/18/94) No. 211, P. 7;  James, John S.
     In light of the November elections, AIDS Treatment News 
interviewed Tom Sheridan, a professional lobbyist, AIDS 
organizer, and founder of the Sheridan Group--a government and 
public-relations organization--to find out what people concerned 
about AIDS should do.  Sheridan said there are three levels of 
organization that should begin immediately: internal 
organization, grassroots organization, and political 
organization.  "AIDS advocates need to think about retooling our 
resource pool, and have real political resources available for 
friends, and some resources to fight our enemies," he added.  
"One of the biggest losses concerns our institutional base of 
support," Sheridan said.  He wondered whether key people in the 
House and Senate will be able to keep their jobs.  He also said 
that it is necessary "to join ranks and avoid being caught up in 
competitive--zero-sum gain--discussions on AIDS priorities."  
Sheridan concluded that activists must not compete against each 
other--at a program level, at a community level, or at a national
level.
      
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