                     AIDS Daily Summary 
                      February 28, 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
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Copyright 1995, Information, Inc., Bethesda, MD


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"Study Finds Clue on HIV Transmission"
"Japanese Blood Controversy"
"Nurse with H.I.V. Emphasizes Safety"
"Proposed French AIDS Drug Lottery Under Attack"
"Overexpression of Fas Antigen Seen in Advanced HIV Infection"
"New Guidelines for PCP Prophylaxis in HIV Positive Children 
Proposed"
"HIV-Positive Substance Abusers Frequently Require Psychoactive 
Drug Treatment"
"Resistance to Protease Inhibitors"
"Computer Censorship Law, ACLU Test Case, Begin February 8"
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"Study Finds Clue on HIV Transmission"
Washington Times (02/28/96) P. A6
     A new study reveals that a HIV-infected pregnant woman's level of
HIV RNA provides a strong indicator of the risk that she will 
transmit the virus to her child.  The study, reported in the 
Journal of the American Medical Association, also concludes that 
the HIV drug AZT may reduce an infected pregnant woman's HIV RNA 
level before delivery to levels about the same as those in women 
who did not transmit the virus to their babies.  Related Story: 
Los Angeles Times--Washington Edition (02/28/96) P.B2
      
"Japanese Blood Controversy"
Washington Post (02/28/96) P. A22
     A leading Japanese pharmaceutical company, which is being sued 
along with the government and four other drug makers by 
HIV-infected hemophiliacs, has acknowledged that it filed a false
report about when it withdrew untreated blood products from the 
market.  Green Cross Corp. disclosed that it had shipped the 
untreated products for three to 10 months after the date given in
a report to the Health and Welfare Ministry in 1987.  Naoto Kan, 
Health and Welfare Minister, said the ministry now believes that 
the final withdrawal of the untreated blood products may have 
taken one year longer than Green Cross had claimed.  Related 
Story: Financial Times (02/28/96) P.6
      
"Nurse with H.I.V. Emphasizes Safety"
New York Times (02/28/96) P. A15;  Hilchey, Tim
     Lynda Arnold, a nurse at Community Hospital in Lancaster, Pa., 
was infected with HIV three and a half years ago, when a 
patient's sudden move forced a needle she was using in his arm 
into her palm.  Today, Arnold and her colleagues are launching a 
national campaign to urge hospitals to adopt safer needle 
systems, which might have prevented her accident.  Arnold says 
the campaign will not endorse specific products, but will 
encourage the use of many safer needle systems at "little or no 
increase in total costs."  Dr. Janine Jagger, of the 
International Health Care Worker Safety Research and Resource 
Center at the University of Virginia, claims that self-sheathing 
blood-drawing needles would prevent "at least 80 percent of all 
transmissions of bloodborne pathogens to the nation's health care
workers."  Forty-six cases of job-related HIV transmission were 
documented as of July 1995, according to the AIDS Surveillance 
Report by the Centers for Disease Control and Prevention.
      
"Proposed French AIDS Drug Lottery Under Attack"
Reuters (02/27/96)
     In France, AIDS activists criticized on Tuesday a government plan
to use a lottery to choose a small group of AIDS patients to 
receive a new drug.  Junior Health Minister Herve Gaymard said 
the government would try to make Abbott Laboratories' protease 
inhibitor Ritonavir available to all patients, and that a lottery
would be used only if there is not enough of the drug available. 
The government, which will receive the drug next month, said it 
will only have enough initially to treat about 100 patients.  
About 18,000 AIDS patients in France could benefit from the drug,
according to officials.  AIDS action group, ACT-UP, criticized the 
lottery, noting that the drug was available in unlimited 
quantities in the United States.  Gaymard said that France would 
receive 1,000 doses in April, 2,000 in May, and 3,000 in June, 
and that the lottery would only be used as a last resort.
      
"Overexpression of Fas Antigen Seen in Advanced HIV Infection"
Reuters (02/27/96)
     The overexpression of Fas antigen on T cells increases with HIV 
infection, says Dr. Franco Silvestris of the University of Bari. 
Silvestris' study confirmed that the Fas pathway has a role in 
increasing the lymphocyte apoptosis during the HIV infection.  He
and his colleagues studied the Fas antigen in peripheral 
lymphocytes and the extent of apoptosis in cells from 59 
HIV-positive patients.  According to Silvestris, the mechanism by
which HIV-1 infection promotes Fas-mediated apoptosis of T cells 
is still unclear, but the results support the connection between 
the susceptibility of T cells to apoptosis and Fas expression.
      
"New Guidelines for PCP Prophylaxis in HIV Positive Children 
Proposed"
Reuters (02/27/96)
     Pneumocystis carinii pneumonia (PCP) is the most common serious 
opportunistic infection in HIV-infected children, and the 
incidence of PCP among infants with HIV who do not receive 
prophylaxis is about 12 percent in the first year of life.  
Current guidelines for prophylaxis of PCP in children with HIV 
were developed in 1991 by the National Pediatric and Family HIV 
Resource Center.  Data from the Centers for Disease Control and 
Prevention shows, however, that no significant declines in PCP 
rates occurred in children after the guidelines were implemented.
The guidelines were modified last year, and now recommend the 
commencement of PCP prophylaxis for all HIV-exposed children at 
four to six weeks of age.  Prophylaxis for HIV-exposed infants 
should continue for one year, or until HIV infection is ruled 
out.  In children one year old or older, CD4 cell counts should 
be used to determine if PCP prophylaxis is needed.  The new 
guidelines also stress the importance of early identification of 
infants exposed to HIV and maternal education during pregnancy 
about PCP prophylaxis.
      
"HIV-Positive Substance Abusers Frequently Require Psychoactive 
Drug Treatment"
Reuters (02/27/96)
     Psychopharmacologic treatment is suggested for nearly 75 percent 
of HIV-infected substance abusers who are diagnosed with a 
psychiatric disorder.  Dr. Steven Batki of San Francisco General 
Hospital has found no evidence that these drugs are harmful to 
the immune system.  In his study, 52 of 66 patients on methadone 
maintenance who had a psychiatric disorder were prescribed "at 
least one" psychiatric drug.  Psychoactive drugs were the second 
most commonly prescribed drug type.  Batki found that 
benzodiazepines are useful for acute anxiety, common in HIV 
patients.  For severe depression, he says psychostimulants may 
also be useful, although treatment with all psychotropics must be
monitored.
      
"Resistance to Protease Inhibitors"
Lancet (02/10/96) Vol.347, No.8998, P. 383
     Researchers may be able to help doctors treat AIDS patients with 
protease inhibitors thanks to new studies of HIV resistance to 
the drugs.  Scientists at the Aaron Diamond AIDS Research Center 
in New York have identified specific locations on the HIV 
protease gene where drug resistance-causing mutations occur.  
With this new information, experts now advise doctors to be 
aggressive with the drugs, not to skip doses, and to stick to the
dosage scheduled.  The scientists said that combining protease 
inhibitors may keep the mutation dominance from happening.
      
"Computer Censorship Law, ACLU Test Case, Begin February 8"
AIDS Treatment News (02/09/96) No.240, P. 8;  James, John S.
     Under the computer censorship provisions of the new 
Communications Act of 1995, it is a felony punishable by five 
years in prison for anyone in the United States to receive an 
"obscene" communication by computer.  A person does not need to 
know that the communication is legally obscene, only that it is 
sexually oriented.  AIDS organizations did not have an 
opportunity to lobby against the bill, but they now can act to 
challenge the law.  Three AIDS groups, the Critical Path AIDS 
Project in Philadelphia, AIDS Education Global Information 
System, and The Safer Sex Page, have signed on as plaintiffs in a
test case that the ACLU is bringing against the provisions.  Much
of the law may be found to be in violation of the First 
Amendment.  AIDS groups should find ways to publish information, 
by targeted e-mail distribution, for example, in ways that do not
break the law.  It is not yet clear how the law will be enforced,
but it will probably be used against those involved with 
pornography, and possibly against individuals and organizations 
targeted for their political views.  Well-organized mass 
movements are necessary to defend the rights provided by the 
First Amendment.
      
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