                     AIDS Daily Summary 
                      February 21, 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 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 1996, Information, Inc., Bethesda, MD


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"Genentech Inc. Forms a Firm for HIV Drug"
"Chiron Will Pay About $120 Million For 49 Percent of Hoechst's 
Vaccine Business"
"A  Vaccine for AIDS at Least 5 Years Away"
"'Dreaded-Disease' Policies Rise, But Some Say They're No Cure"
"Recurrent Varicella-Zoster Virus Infections Common in 
HIV-Positive Children"
"Skin Cancer and HPV 16 Infection Linked in AIDS Patient"
"Origin and Interstate Spread of a New York City 
Multidrug-Resistant Mycobacterium Tuberculosis Clone Family"
"Jobs at Risk for HIV-Infected Doctors"
"A Kinder, Gentler War Against Hepatitis B"
"An Epidemic's Evolution"
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"Genentech Inc. Forms a Firm for HIV Drug"
Wall Street Journal (02/21/96) P. B6;  King, Ralph T.
     Genentech Inc. announced that it has created a separate company, 
Genevax Inc., to develop its HIV vaccine, gp1120.  The new 
company will ask for $18 million from private investors for a 
pivotal-phase clinical trial for the vaccine.  Genentech will 
contribute a total of $2 million, giving it a 25 percent stake in
the firm whose research will be supervised by Donald Francis, a 
public health expert who supervised the gp120 research at 
Genentech.  Genentech had spent more than $50 million on gp120, 
and had more than 100,000 doses ready for a trial that was halted
in June 1994 when funding from the National Institutes of Health 
(NIH) was refused.  A Genentech spokesman explained that forming 
the new company provided a way to perform the trial without 
government involvement.  Last week NIH announced a new plan for 
AIDS vaccine development which included the use of a version of 
gp120 made by Chiron Corp.  Related Story: Investor's Business 
Daily (02/21/96) P.A1
      
"Chiron Will Pay About $120 Million For 49 Percent of Hoechst's 
Vaccine Business"
Wall Street Journal (02/21/96) P. B6;  King, Ralph T.;  Moore, 
Stephen D.
     Chiron has agreed to buy 49 percent of Hoechst's vaccine business
for about $120 million, a move that should make it one of the top
five vaccine suppliers worldwide and a strong player in Germany 
where the Hoechst subsidiary--Behringwerke AG--is based.  The 
transaction will also make European vaccine markets more 
accessible to the biotechnology firm, which currently has several
promising vaccines in development--including vaccines for genital
herpes and cytomegalovirus--as well as new vaccines for hepatitis
B and whooping cough already on the market.  Hoechst, which is 
seeking to streamline its health-care operations, may form 
research alliances with Chiron in areas such as gene therapy and 
combinatorial chemistry.  Under the terms of the agreement, 
Chiron will have an option to acquire the remaining 51 percent 
stake between 1998 and 2001.  Related Story: New York Times 
(02/21) P. D5
      
"A  Vaccine for AIDS at Least 5 Years Away"
Philadelphia Inquirer (02/19/96) P. C1;  Vedantam, Shankar
     AIDS researchers say there is little hope for an AIDS vaccine, 
which would be the only way to successfully deal with the 
disease, in the next five years.  Anthony Fauci, director of the
National Institute for Allergies and Infectious Diseases, said 
that even the AIDS vaccine furthest along in trials "will not be 
ready until 2001 or 2002," if it proves safe and effective.  A 
vaccine prepares the immune system for infection, and wipes out 
the virus before a person gets sick.  Therapeutic drugs, which 
are too expensive to be widely relied upon, have never eliminated
a major disease.  In addition, HIV's ability to rapidly mutate 
makes vaccine development especially difficult.  Also, drug 
companies have been hesitant to pursue a vaccine because of the 
technical difficulty and financial risk involved.  AIDS is a 
particular threat to the developing world, where about 90 percent
of new infections now occur.   The vaccine with the most 
potential was developed by Pasteur Merieux-Connaught to defend 
against HIV-type B, the strain most common in the United States. 
Scientists are unsure whether a vaccine could protect against 
more than one strain of the virus, though Fauci said that if the 
vaccine proved successful, it would be fairly easy to make 
similar vaccines for others HIV types.
      
"'Dreaded-Disease' Policies Rise, But Some Say They're No Cure"
Wall Street Journal (02/21/96) P. C1;  Jeffrey, Nancy Ann
     "Limited benefit" health insurance policies to cover cancer, 
heart disease, and hospital stays are being offered in 
employee-pay-all programs, usually as supplements to an 
employer's comprehensive health plan.  Consumer advocates warn 
against policies that cover a specific disease, however they note
hospital-stay policies can be beneficial for seriously ill 
individuals.  American Family Life Assurance Co., or Alfac Inc., 
offers two hospital plans which pay $100 or $200 a day for the 
first 30 days in the hospital and $200 or $400 a day for the next
150 days.  The benefits are usually paid in cash, and can be used
for food, rent, a private hospital room, or anything else not 
covered by regular insurance.  For example, David Petersen, 
president of Affording Care, a nonprofit in New York, has been in
the hospital for 44 days since testing positive for HIV in 1988. 
He pays $1,400 a year for six hospital policies, and has used the
benefits to help pay his monthly $7,000 drug bill.  Other methods
of paying for disease costs include disability insurance, 
accelerated death benefits, and very high-deductible health 
insurance.
      
"Recurrent Varicella-Zoster Virus Infections Common in 
HIV-Positive Children"
Reuters (02/20/96)
     Varicella-zoster virus infection in HIV-infected children tends 
to be recurrent and persistent.  Hospitalization and morbidity 
are often attributed to the disease in these children, according 
to researchers at the Harbor-UCLA Medical Center in Torrance, 
Calif.  Dr. Margaret Keller led the study of 117 cases of 
varicella-zoster infection in 73 HIV-positive children and found 
that 53 percent had recurrent episodes of infection.  Keller's 
team also found that the number of episodes of varicella-zoster 
infection was strongly associated to low CD4+ cell counts.  
Keller concluded that new preventative and therapeutic therapies 
are needed to deal with the infection.
      
"Skin Cancer and HPV 16 Infection Linked in AIDS Patient"
Reuters (02/20/96)
     Evidence of a relationship between human Papillomavirus infection
and squamous cell carcinoma in an AIDS patient was reported by 
Dr. Hunter Maclean and colleagues at the Western General Hospital
in Scotland.  There, a 42-year-old AIDS patient was diagnosed 
with squamous cell carcinoma on the eyelid.  The researchers 
identified the human Papillomavirus infection using polymerase 
chain analysis, noting that squamous cell carcinoma is the third 
most common malignancy in HIV patients.  Maclean therefore 
recommends that the carcinoma be considered in the diagnostic 
tests for HIV patients with eyelid lesions.
      
"Origin and Interstate Spread of a New York City 
Multidrug-Resistant Mycobacterium Tuberculosis Clone Family"
Journal of the American Medical Association (02/14/96) Vol.275, 
No.6, P. 452;  Bifani, Pablo J.;  Plikaytis, Bonnie B.;  Kapur, 
Vivek; et al.
     The resurgence of tuberculosis (TB) in the United States can be 
attributed to the AIDS epidemic, immigration from countries where
TB is prevalent, and the discontinuation of TB control measures. 
A number of drug-resistant strains of the disease have been 
identified in New York City, and the number of TB patients in the
city has tripled from 1978 through 1992.  In this study, Bifani 
et al. analyzed multidrug-resistant strains of TB to determine if
they were new genetic clones of Mycobacterium tuberculosis or 
unrelated organisms.  Samples of M. tuberculosis were taken from 
1,943 patients in New York and samples of multidrug-resistant 
isolates were taken from six patients elsewhere in the United 
States.  Multidrug-resistant isolates of M. tuberculosis were 
found in 273 New York City patients as well as patients from 
Florida, Nevada, and Georgia.  The strains of tuberculosis found 
in these patients were closely related at the molecular level.  
According to the researchers, the data suggest that these 
organisms are the product of a single ancestral M. tuberculosis 
cell.  Numerous strains of bacteria have resulted from the 
sequential clonal expansion of this one cell.  Cases of 
multidrug-resistant TB associated with HIV have a mortality rate 
of up to 90 percent.
      
"Jobs at Risk for HIV-Infected Doctors"
American Medical News (02/05/96) Vol.39, No.5, P. 1;  Kent, 
Christina
     Five years after Florida dentist David Acer was found to have 
transmitted HIV to his patients, the debate about whether 
HIV-positive health care workers should be allowed to continue to
work with patients continues.  The incident led to the 
development of new policies that some argue are unfair to 
HIV-infected health care workers.  Medical and public health 
experts say that the risk of an HIV-infected health care worker 
spreading the virus to patients is small.  The Acer case is the 
only known instance of a professional infecting a patient.  The 
Centers for Disease Control and Prevention instituted a policy in
1991 that states that HIV-infected health care workers should 
avoid any "exposure-prone" procedures not approved by a panel of 
experts that has reviewed their case.  The American Medical 
Association argued that there was no scientific basis for 
identifying such procedures.  Medical groups also objected to the
provision suggested by Congress that health care workers who 
perform such procedures be required to tell patients if they are 
HIV-positive.  Most state policies do not require such 
notification.  Health care workers feel that disclosing their HIV
status could lead to job discrimination.  Fear of discrimination 
could also prevent workers from reporting on-the-job infections.
      
"A Kinder, Gentler War Against Hepatitis B"
Science News (02/03/96) Vol.149, No.5, P. 69;  Travis, J.
     Cytotoxic T lymphocytes (CTLs) kill viruses by attaching 
themselves to infected cells and releasing toxins that kill the 
cell and the virus.  Francis Chisari of the Scripps Research 
Institute has found that, in fighting hepatitis B, CTLs release 
compounds that stimulate infected cells to destroy the virus, 
leaving the cell itself intact.  A vaccine for hepatitis B 
exists, but it is not widely available.  To determine CTLs 
mechanism of action, Chisari and his colleagues developed mice 
that make the virus.  They found that injecting the mice with 
CTLs that target the cells producing the viral proteins causes 
the mice to almost rid themselves of the virus.  The CTLs killed 
only about 5 percent of the targeted cells, leading researchers 
to conclude that the CTLs recognize infected cells and release 
two compounds that stimulate antiviral activity in them.  The 
stimulated cells make proteins that disrupt the virus' ability to
replicate.  Chisari says that human cells may try to inhibit the 
virus in a similar way and that what they now know about the 
CTLs' role against hepatitis B could be applied to other viruses,
including HIV.
      
"An Epidemic's Evolution"
Newsweek (02/05/96) Vol.127, No.6, P. 72;  Will, George F.
     In Newsweek magazine, columnist George F. Will writes that good 
news about the AIDS epidemic in America is, according to data 
from Philip Rosenberg, published in Science magazine, that the 
previous estimate of the incidence of AIDS was too high and that 
the epidemic is slowing down.  The bad news is that the incidence
is still high and that the epidemic is now spreading to new 
segments of the population.  The AIDS epidemic started in the 
white homosexual male population in the late 1970s and early 
1980s, centered in large cities.  Now the epidemic is increasing 
in racial minority populations and women, and is spreading to 
rural areas, especially in the South.  It is spreading 
increasingly through drug use and heterosexual sex, despite 
aggressive public education about the disease.  The fact that 
AIDS has become endemic is surprising, Will notes, because HIV is
difficult to acquire and almost completely preventable.  Hopes 
for fighting AIDS lie in the fact that the epidemic is driven by 
behavior that can be changed.  But, comparing AIDS to lung-cancer
and other smoking-related diseases lessens that hope.  Smoking 
involves the pull of nicotine, as AIDS often involves sex and 
drug use.  Thirty-two years after the first surgeon general's 
warning linking smoking and cancer, smoking has become less 
common, but has also become concentrated in the poor and 
under-educated populations, a trend that AIDS appears to be 
following, Will concludes.
      
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