                     AIDS Daily Summary 
                       May 24, 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 National AIDS Clearinghouse, or any
other organization. Reproduction of this text is encouraged;
however, copies may not be sold, and the CDC National AIDS
Clearinghouse should be cited as the source of this information.
Copyright 1996, Information, Inc., Bethesda, MD
     
     
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"Virus Levels Called Better Predictor of AIDS Progress Than Cell 
Counts"
"AIDS Programs Are Saved by Increase in U.S. Funds" 
"Appeals Court Throws Out Tobacco Class-Action Suit" 
"Technician Dropped HIV Needle, Lawyer Says"
"TB Under Ultraviolet Spotlight"
"Thousands Test Blood in Taiwan Hepatitis Scare"
"Health: Antibiotics Less Effective Than Ever In [Fighting 
Disease]"
"Number of AIDS Sufferers in Bulgaria Rises"
"Perinatal HIV Infection and the Effect of Zidovudine Therapy on 
Transmission in Rural and Urban Counties"
"AIDS Advocates, Caregivers Must Play Major Role in Managed Care 
Debates"
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"Virus Levels Called Better Predictor of AIDS Progress Than Cell 
Counts"
Philadelphia Inquirer (05/24/96) P. A5;  Recer, Paul
     New research published in the most recent issue of the journal
Science suggests that the amount of HIV in the bloodstream may be 
a more accurate predictor of disease progression than tests that 
measure the decline of CD4 blood cells.  According to Lawrence A. 
Kingsley of the University of Pittsburgh Medical Center and the 
lead author of the study, "Even those patients who appear healthy 
with a high CD4 count can progress very rapidly toward AIDS."  Of 
the 180 HIV-infected men in the study, nearly half who started 
with a viral concentration greater than 36,260 HIV RNA molecules 
per milliliter of blood died within five years, compared with 
just 5 percent of those who started with an HIV level below 
4,350.
     
"AIDS Programs Are Saved by Increase in U.S. Funds" 
Philadelphia Inquirer (05/24/96) P. B3;  Collins, Huntly
     Philadelphia city officials report that the city will receive
a $455,000 increase in federal AIDS money for fiscal 1996, as 
opposed to the planned $1.8 million reduction in federal support 
that was announced in March.  President Clinton's approval of the 
increase will now give Philadelphia a total of $10.3 million in 
Ryan White CARE Act dollars.
     
"Appeals Court Throws Out Tobacco Class-Action Suit"
Wall Street Journal (05/24/96) P. A3;  Geyelin, Milo;  Hwang, 
Suein L.
     On Thursday, a federal appeals court in New Orleans dismissed
the Castano class action lawsuit brought against the tobacco 
industry on behalf of millions of allegedly addicted smokers, 
saying there were too many differences in the plaintiffs' 
circumstances and too many conflicts among state laws that would 
have to be resolved for the case to proceed to a jury.  In making 
its decision, the court relied on a key ruling made last year by 
Seventh U.S. Circuit Court Judge Richard A. Posner in Chicago for 
a case that involved injury and wrongful death suits made by 300 
hemophiliacs against several major drug companies. The suits 
charged that the hemophiliacs became infected with HIV from their 
blood-clotting medicines.  Posner held that multiple trials would 
violate defendants' rights to a single jury to determine the 
critical issues in the case.
     
"Technician Dropped HIV Needle, Lawyer Says"
Chicago Tribune (05/23/96) P. 1-7;  Schreuder, Cindy
     An infant at a Chicago hospital apparently was stuck in the
leg with an HIV-infected needle after a hospital technician 
misplaced a needle containing blood drawn from another infant.  The
technician, who has since been fired "for reasons unrelated to 
patient care," admits she dropped or misplaced the needle and did 
not report its loss.  Another nurse later found the needle 
sticking in the leg of the swaddled infant.  While no criminal 
charges have been filed, a hospital spokeswoman said she could 
not offer an explanation as to how the misplaced needle ended up 
in the other infant's leg.  The baby stuck with the needle has 
been tested for HIV and has thus far tested negative, and 
hospital officials have offered other infants in the nursery free
HIV-antibody testing as well.  A lawsuit filed in early May against

the hospital is expected to be amended to name the technician as a 
defendant.
     
"TB Under Ultraviolet Spotlight"
Financial Times (05/23/96) P. 12
     Researchers at the California-based Electric Power Research 
Institute are studying the use of ultraviolet light as a means of 
eradicating certain drug-resistant strains of tuberculosis (TB). 
The institute will conduct a controlled trial of the 
effectiveness of UV lamps in homeless shelters, where TB is 
frequently transmitted. It is also planning tests in Africa, where 
TB is particularly prevalent.
     
"Thousands Test Blood in Taiwan Hepatitis Scare" 
Reuters (05/23/96);  Hsu, George
     Thousands of people in Taiwan lined up for blood tests on 
Thursday, fearing that recent injections of an anti-hepatitis 
drug may have transmitted the hepatitis B virus.  According to 
health officials, 20,000 to 50,000 people were administered the 
tainted inoculations, which were intended to offer temporary 
protection against hepatitis A, a milder and non-viral form of 
the liver condition.  The health department, which administered 
many of the shots, says it has recalled the tainted shots and 
will help people infected with the virus seek compensation from 
the Italian manufacturer.  Many students who received the shots 
expressed anger at what they believed to be poor screening of 
drugs by the Taiwan government.
     
"Health: Antibiotics Less Effective Than Ever In [Fighting 
Disease]"
IPS News Service (05/23)
     The increasing resistance of many microbes to existing drugs
is one of the main dangers facing world health today, warns a 
1996 World Health Report, issued by the World Health 
Organization. "The resistance of diseases to antimicrobials has 
increased dramatically in the last decade, with a deadly impact 
on the control of diseases such as tuberculosis, malaria, 
cholera, dysentery, and pneumonia", the report states.  According 
to Stuart Levy, a professor at Tufts University, part of the 
problem is that "drug companies concentrated on cardiovasculars 
and abandoned infectious diseases," because heart drugs, which 
must be taken by many patients for life, are more profitable.  
However, fear of a growing epidemic of diseases resistant to all 
drug therapies has prompted several companies, including Eli 
Lilly, Rhone-Poulenc Rorer, Schering-Plough, and Upjohn, to begin 
development of new drugs.
     
"Number of AIDS Sufferers in Bulgaria Rises" 
Xinhua News Agency (05/23/96)
     According to a state official in Bulgaria, the number of 
diagnosed AIDS cases in the country reached 22 in the first 
quarter of 1996, up from 18 one year ago.  Four of the 22 HIV 
infections were the result of tainted blood transfusions, and the 
remainder were associated with sexual intercourse.  To date, HIV 
has killed 38 people in Bulgaria and infected 172.  The true 
number of AIDS cases in Bulgaria is thought to be much higher, 
since less than 2 percent of the country's citizens have been 
tested for the virus.
     
"Perinatal HIV Infection and the Effect of Zidovudine Therapy on 
Transmission in Rural and Urban Counties"
Journal of the American Medical Association (05/15/96) Vol. 275, 
No. 19, P. 1483;  Fiscus, Susan A.;  Adimora, Adaora A.;  
Schoenbach, Victor J.; et al.
     Susan A. Fiscus and colleagues at the University of North 
Carolina, Chapel Hill, studied records of babies born in the state 
to determine how often HIV exposure was identified and how often 
at-risk babies were given zidovudine treatment.  Studies have shown
that zidovudine therapy can significantly reduce the risk of 
perinatal transmission, but identifying HIV-positive mothers is 
critical to this preventive therapy.  In 1994, North Carolina 
doctors were advised to provide pregnant women with HIV counseling 
and to encourage HIV testing.  The researchers found that the 
proportion of HIV-exposed children who were identified and tested 
increased from 60 percent in 1993 to 82 percent in 1994.  
Identification of HIV-exposed infants was higher for those born in 
rural counties than in urban counties.  Moreover, in cases where 
HIV exposure was identified, transmission decreased significantly 
between 1993 and 1994.  After doctors were advised of the efficacy 
of zidovudine, it was given to 75 percent of HIV-positive women 
giving birth in North Carolina.  Among infants who received the 
drug, only 5.7 percent became infected, compared to 18.9 percent 
among those who received no treatment.
     
"AIDS Advocates, Caregivers Must Play Major Role in Managed Care 
Debates"
AIDS Alert (05/96) Vol. 11, No. 5, P. 49
     As managed care becomes the primary delivery mode for health 
maintenance organizations and more states try to shift Medicaid 
programs to managed care, HIV patients and providers should 
become active in making sure their states formulate adequate 
Medicaid managed care plans.  People with HIV have experienced 
problems with Medicaid managed care plans, including restricted 
access to HIV-experienced providers and specialists, restrictions 
on drugs available through the plan, and limits on coverage of 
pharmaceuticals.  AIDS advocates helped to reject Medicaid waiver 
proposals in New York City and New York State by showing that 
managed care companies were not prepared to provide adequate care 
to HIV patients.  The shift to managed care has been anticipated, 
and with it, new opportunities to improve health care.  The first 
Medicaid managed care program specifically for AIDS patients was 
created last year in Los Angeles and is now operating 
successfully.  A New York state law implemented this year is 
designed to make it easier for people with AIDS and other chronic 
diseases to join health maintenance organizations and to see 
specialists without referrals, in exchange for higher premiums 
and copayments.
     
HIV Prevention Works, An International Symposium
     OTTAWA -- HIV Prevention Works, an international symposium on
HIV prevention, highlights accomplishments and addresses emerging
issues in the efforts to stop the spread of HIV. It is coordinated
by the Canadian Public Health Association AIDS Program, Health
Canada, Centers for Disease Control and Prevention, National
Institutes of Health, and Joint United Nations Programme on
HIV/AIDS. HIV Prevention Works takes a unique approach to
prevention by exploring and uniting the full spectrum of issues
including underlying societal conditions which make certain groups
vulnerable to HIV/AIDS. The focus will be on behavioral, social and
economic change as strategies of prevention.  This one-day,
state-of-the-art event is designed for HIV/AIDS prevention
programmers, educators, administrators, people living with AIDS,
caregivers, researchers, policy-makers and the media. Participants
will be involved in discussion. The plenary sessions will be
available through simultaneous interpretation, in English, French,
and Spanish. The concurrent sessions will be offered in English
only. The meeting will be held in Vancouver, British Columbia,
Canada, on July 6, 1996, one day before the XI International
Conference on AIDS. To register, contact: HIV Prevention Works,
Conference Department, Canadian Public Health Association, 400-1565
Carling Ave., Ottawa, ON K1Z 8R1. (613)725-3769; (613) 725-9826
(Fax); preventionhiv@cpha.ca. Cost: $100 (CDN).
     
AIDS Daily Summary will not publish on Monday, May 27, in 
observance of Memorial Day.  Publication will resume on May 28. 
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