                     AIDS Daily Summary 
                      February 29, 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 1996, Information, Inc., Bethesda, MD


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"Surgeon Infected Patients Despite Hepatitis Precautions"
"Making Case for Safer Needles"
"Bill Is Passed to Block Loss of Insurance"
"Helping a Family Care for a Child with H.I.V."
"Public Protector or Persecutor?"
"France Rules Out Lottery for Rare AIDS Drug"
"Japan Ministry Report Fails to Answer AIDS Issue"
"Voluntary Inpatient HIV Screening: Cost-Effective"
"New Studies Say Viral Burden Tops CD4 as a Marker of HIV Disease
Progression"
"Up in Asia"
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"Surgeon Infected Patients Despite Hepatitis Precautions"
Washington Post (02/29/96) P. A4
     A heart surgeon who apparently caught the hepatitis B virus from 
a patient during surgery, unknowingly infected at least 19 
patients, even though he wore gloves and followed safety 
precautions, according to a report in the New England Journal of 
Medicine.  An investigation, directed by Rafael Harpaz of the 
Centers for Disease Control and Prevention, found that the 
infections could have been prevented if the doctor had taken the 
hepatitis B vaccine.  About 1 percent of U.S. surgeons are 
estimated to be infected with the virus, which is highly 
infectious and can be fatal.  The infections occurred four years 
ago at two Los Angeles hospitals.  Safety rules of operating 
rooms have been tightened in recent years to protect patients and
health care workers from HIV, which is less infectious than 
hepatitis B.  Related Story: USA Today (02/29/96) P.1D
      
"Making Case for Safer Needles"
Philadelphia Inquirer (02/29/96) P. B1;  McCullough, Marie
     Lynda Arnold, a nurse who was infected with HIV when a patient's 
sudden move forced the needle she was using into her own palm, 
began a campaign Wednesday to convince hospitals to use safer 
needles.  Arnold was wearing latex gloves and practicing  
recommended precautions when she was infected three years ago.  
For her campaign, she plans to ask every health care facility in 
the nation to promise to adopt safer needle devices.  
Occupational transmission of HIV has been documented in 45 other 
health care workers, and 97 more cases are suspected, according 
to the Centers for Disease Control and Prevention.  Many devices 
are already available to make blood-drawing needles and 
intravenous catheter needles safer, including protective shields 
that can be slipped over the needles, and needles that retract 
into protective shields.  The hospital where Arnold worked in 
Lancaster, Pa. was introducing a safer IV catheter when she was 
injured by one that did not have the protective shield.
      
"Bill Is Passed to Block Loss of Insurance"
New York Times (02/29/96) P. B6;  Barron, James
     New York state lawmakers passed a bill Wednesday to prevent 
Empire Blue Cross and Blue Shield from canceling longstanding 
health insurance for 650 of the state's sickest residents, 
including those with AIDS, multiple sclerosis, and hemophilia.  
Gov. George Pataki has not said if he will sign the bill, which 
was designed to eliminate a legal technicality that had 
threatened coverage for chronically ill patients who purchased 
their own insurance.  Empire notified the State Insurance 
Department that it was going to cancel the policies, which cover 
medication, home care, and some doctors' bills, because the 
company had lost some $70 million last year.  Empire expected 
that the affected policyholders would be able to switch to other 
plans, which was not possible because of a Federal Medicare law 
that prohibits insurers from selling coverage that duplicates 
Medicare benefits to individuals eligible for Medicare.  Without 
the bill, the 650 people would have been forced to seek Medicaid 
benefits, which has strict financial ceilings.
      
"Helping a Family Care for a Child with H.I.V."
New York Times (02/29/96) P. B2;  Jay, Sarah
     Selina H. lost one sister to AIDS and when another sister was 
diagnosed last summer, she took in her 6-year-old nephew Calixto 
who had just tested positive for HIV.  Selina has three children 
of her own, and when the Children's Aid Society offered her a 
homemaker to help with household chores, she was reluctant to 
accept the assistance.  She soon realized, however, that the help
was needed to manage the extra care required by her nephew.  The 
Children's Aid Society, one of the seven charities supported by 
the New York Times Neediest Cases Fund, has also provided a bed 
and clothes for Calixto.  The fund has received $4,564,503 so far
this year.
      
"Public Protector or Persecutor?"
Washington Post (02/28/96) P. A3;  Schwartz, John
     Patients of physician Stanislaw R. Burzynski--whose treatment of 
patients with unproven "antineoplastons" derived from urine has 
been the focus of much controversy--have been invited to testify 
at a Congressional hearing about FDA reform on Thursday.  
Although Burzynski has never conducted clinical trials of his 
therapy--which he claims might be able to treat about 300 
illnesses, including cancers of the breast, brain and prostate, 
AIDS, multiple sclerosis, baldness, and neurofibromatosis--some 
Republican members of Congress consider him a symbol of excessive
FDA regulation and his patients say the FDA has a "vendetta" 
against him for not permitting him to ship his experimental 
drugs.  Canadian cancer experts, however, said in a 1992 article 
in the Journal of the American Medical Association that there is 
no evidence that his compounds work.
      
"France Rules Out Lottery for Rare AIDS Drug"
Reuters (02/28/96)
     French Prime Minister Alain Juppe rejected a controversial 
proposal on Wednesday that called for a lottery to determine 
which AIDS patients should receive a new drug in limited supply. 
Juppe said the ministers should make further efforts to provide 
the drug to all eligible patients, at whatever the cost.  The 
National AIDS Council, a government group, was criticized by AIDS
activists and doctors Tuesday for proposing that a computer 
lottery be used to select a small group of patients to receive 
the protease inhibitor ritonavir.  A 100-person supply of the 
drug, made by Abbott Laboratories, will arrive in France next 
month, followed by significantly larger shipments in April, May, 
and June.  About 18,000 people in France have AIDS, and more than
150,000 are infected with HIV.
      
"Japan Ministry Report Fails to Answer AIDS Issue"
Reuters (02/28/96)
     A new report from Japan's health ministry does not provide 
answers to some critical questions about why health officials 
could not prevent the spread of HIV through tainted blood 
products in the early 1980s.  A panel was set up last month to 
study the issue and explain a 1983 decision to postpone emergency
imports of safer treated blood products.  The report states that 
there was conflicting information about whether the government 
considered emergency imports of safer blood products.  Health and
Welfare Minister Kan Naoto admitted earlier this month that the 
government was responsible for the spread of HIV through the 
tainted blood products.  An estimated 1,800 to 2,000 hemophiliacs
were infected with the virus, and some are suing the government 
and five drug companies for compensation.
      
"Voluntary Inpatient HIV Screening: Cost-Effective"
Reuters (02/28/96)
     Voluntary, inpatient HIV screening is cost-effective under 
certain conditions, report researchers at Stanford University.  
Douglas Owens and colleagues found that when the HIV 
seroprevalence rate was 1 percent, the cost-effectiveness of 
screening for the virus was "within the range of other accepted 
interventions."  With that seroprevalence rate, Owens estimated 
that about 110,000 cases of HIV could be identified in the first 
year, and the cost-effectiveness of screening would be "$47,200 
per year of life saved."  Owens said that public health and 
quality of life would benefit further from testing and counseling
if the measures influence risk behaviors.
      
"New Studies Say Viral Burden Tops CD4 as a Marker of HIV Disease
Progression"
Journal of the American Medical Association (02/14/96) Vol.275, 
No.6, P. 421;  Voelker, Rebecca
     Preliminary results of two new studies show that the change in 
the amount of HIV in a patient's blood before and after therapy 
is a better predictor of AIDS progression than the CD4 cell 
count.  The studies, sponsored by Pharmacia & Upjohn, confirm 
the value of viral load.  Both trials, which were conducted in 
Canada and the United States, were designed to assess the 
anti-HIV efficacy of delavirdine mesylate, a non-nucleoside 
reverse transcriptase inhibitor.  The results were based on 1,740
HIV patients.  The study is continuing, but a computer model was 
used to determine the relationship between changes in viral load 
and disease progression.  Researchers found that a 70 percent 
decrease in viral load lasting more than eight weeks resulted in 
a 55 percent reduction in the risk of progressing to AIDS or 
dying.  A person's immunity also figures into their future health
status, scientists said.  The drug delavirdine has shown promise 
in the studies and the company hopes to make it available to 
patients outside the trial in a few months.  The value of viral 
load to predict disease progression is still controversial, 
however the measure is considered more credible now.  Dr. Calvin 
Cohen, research director of the Community Research Initiative of 
New England, says doctors want a predictive test, and that viral 
load appears to be promising.
      
"Up in Asia"
Economist (02/10/96) Vol.338, No.7952, P. 42
     While the spread of HIV has slowed in Europe, the Americas, and 
Africa, it continues to rise in Asia, according to the Global 
AIDS Policy Coalition of Harvard University, which recently 
reported higher figures than the World Health Organization.  The 
new figures show that 30.6 million individuals are HIV-infected, 
a figure which the researchers predict may double by the end of 
the century.  In addition, of the 4.7 million people who became 
infected last year, more than half were in Southeast Asia while 
less than 4 percent were in industrialized nations.  The 
researchers estimate that with 19.2 million infected persons, 
Africa now represents some 60 percent of the global number of 
infections.  A total of 7.6 million of the 9.2 million 
AIDS-related deaths in 1995 occurred in Africa.
      
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