                     AIDS Daily Summary 
                       June 14, 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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"New Drug 'Cocktails' Mark Exciting Turn in the War on AIDS" 
"Across the USA: Florida"
"TB, Measles Outbreak Reported in Liberia"
"Infectious Disease Control Plan Gets High-Level Backing" 
"Birth Canal Cleansing Fails to Deter AIDS--Study"
"Many Injection Drug Users Uninformed About HIV Transmission 
Risks"
"Celgene to File for Synovir by End of Year"
"Rifampin Resistant TB Reported in HIV-Positive Patient" 
"Importance of Age at Infection With HIV-1 for Survival and 
Development of AIDS in UK Haemophilia Population"
"Sounding Board:  AIDS Prevention--Sexual Ethics and 
Responsibility"
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"New Drug 'Cocktails' Mark Exciting Turn in the War on AIDS" 
Wall Street Journal (06/14/96) P. A1; Waldholz, Michael
     Combination therapy, including a protease inhibitor and two
drugs based on AZT, is showing promise for many AIDS patients. 
This has led some experts to the conclusion that AIDS may soon be 
seen as a long-term, manageable disease.  After years of 
development and testing, scientists may have found the 
appropriate combination of drugs to control HIV.  In a new 
approach that researchers hope may be a cure, scientists are 
targeting newly infected patients, rather than those in the 
advanced stages of disease.  Martin Markowitz of Aaron Diamond 
AIDS Research Center claims that the effort "will answer the 
question of whether HIV infection can be eradicated in man."  
Nearly 60,000 Americans and 10,000 more people in other countries 
have already received the new drugs, the first of which was 
approved in mid-December.  The cost of the drugs and possible 
side effects are drawbacks to the therapy, but many in the AIDS 
community are optimistic about the recent advances.
     
"Across the USA: Florida"
USA Today (06/14/96) P. 9A
     For the first time ever, doctors in Florida are now required
to report the names of HIV-positive individuals to public health 
officials, according to the state's new AIDS disclosure law.
     
"TB, Measles Outbreak Reported in Liberia" 
Washington Times (06/14/96) P. A18
     An outbreak of tuberculosis and measles has sent 16,000
Liberians to the U.S. Embassy residential compound in Monrovia 
for treatment.  Varsay Cooper, a physicians' assistant working at 
the Red Cross-sponsored clinic at the compound, said that clinic 
workers see at least four new cases every day and that many 
people have contracted the communicable diseases.
     
"Infectious Disease Control Plan Gets High-Level Backing" 
Washington Post (06/13/96) P. A27
     A two-year-old program to stop the worldwide spread of
infectious diseases received a $26 million budget increase on 
Wednesday.  The boost would expand the Centers for Disease Control 
and Prevention's Infection Center, which has been directing the 
12-year-old effort.  The center's budget would increase from $18.4 
million to $44.4 million to help create a "global surveillance 
system," including a worldwide computer system linking poor 
countries with medical researchers.  Moreover, the CDC would 
expand its regional infectious disease center system, which would 
grow from 4 centers to 10.  Also to be expanded is a surveillance 
network to track emerging and re-surfacing germs.
     
"Birth Canal Cleansing Fails to Deter AIDS--Study" 
Reuters (06/13/96) 
     Cleansing the birth canal with disinfectant did not prevent
a mother from transmitting HIV to her infant, National Cancer 
Institute researchers report today in the medical journal Lancet. 
Robert Biggar and colleagues in the United States and Malawi 
conducted case studies in which they cleaned out the birth canals 
of infected women just before delivery.  The procedure did not 
prevent the transmission of HIV from mother to child, and the 
researchers suggest that a different antiseptic might be more 
effective.  "Perhaps birth canal exposure is not a major 
contributor to perinatal infection risk," they wrote.
     
"Many Injection Drug Users Uninformed About HIV Transmission 
Risks"
Reuters (06/13/96) 
     Besides drug sharing, many injection drug users have other 
drug-related risk behaviors for HIV infection, researchers at the 
University of Colorado report.  Stephen Koester and colleagues 
found that the sharing of drug injection paraphernalia, including 
water, drug-mixing containers, and drug filters was twice as 
prevalent as sharing of syringes.  They also discerned that heroin 
injectors were at the greatest risk of contracting HIV through 
risky injection practices.  Individuals who received some 
community HIV prevention education reported a lower rate of 
injection-related risk behaviors.
     
"Celgene to File for Synovir by End of Year" 
Reuters (06/13/96) 
     Celgene will seek Food and Drug Administration approval for
its drug Synovir (thalidomide) by the end of the year.  The 
company will first seek approval for the drug as a treatment for 
leprosy and will then seek acceptance to market the drug for 
AIDS-related wasting.  A trial of Synovir for AIDS-related 
wasting, which affects some 100,000 AIDS patients, is expected to 
be completed by the end of the summer.  Celgene hopes to have the 
drug approved for both applications by September 1997.
     
"Rifampin Resistant TB Reported in HIV-Positive Patient" 
Reuters (06/13/96) 
     Using rifabutin for the prophylactic treatment of
tuberculosis in AIDS patients may lead to rifampin-resistance, 
researchers reported in Thursday's issue of the New England 
Journal of Medicine.  Rifabutin and rifampin are related drugs 
used to treat bacterial infections.  William Bishai and 
colleagues report that a 35-year-old HIV-positive man given 
rifabutin to prevent a second tuberculosis infection was found to 
have a rifampin-resistant strain of the bacterium.  Bishai said 
the case demonstrates that adherence to recommended guidelines, 
which call for screening patients for active tuberculosis before 
starting rifabutin prophylaxis, is critical.
     
"Importance of Age at Infection With HIV-1 for Survival and 
Development of AIDS in UK Haemophilia Population"
Lancet (06/08/96) Vol. 347, No. 9015; P. 1573; Ewart, David W.; 
Giangrande, Paul L. F.; et al.
     While infection with HIV-1 later in life has been associated
with a shorter time to development of AIDS, adequate studies have 
not been done to determine the degree of difference between 
patients infected in infancy and those infected in old age.  To 
evaluate this difference, British researcher Sarah C. Darby, of 
the Imperial Cancer Research Fund in Oxford, and colleagues 
studied the role of age at infection in the entire population of 
hemophiliacs in the United Kingdom.  Their sample consisted of 
1,216 HIV-1 infected hemophiliacs, with age at infection ranging 
from 8 months to 79 years.  The researchers found that survival 
was strongly related to age at time of infection.  Among the 
survivors after 10 years, 86 percent had been infected before the 
age of 15, 72 percent between the ages of 15 and 34, 45 percent 
between the ages of 35 and 54, and 12 percent at or after age 55. 
The authors say that the differences in survival times are not 
explained by deaths expected in the absence of HIV infection.  
They conclude that age at infection should be considered in 
further studies of disease progression.
     
"Sounding Board:  AIDS Prevention--Sexual Ethics and 
Responsibility"
New England Journal of Medicine (06/06/96) Vol. 334, No. 23; P. 
1540; Bayer, Ronald
     Since the beginning of the AIDS epidemic, questions of sexual
ethics have become increasingly important.  The responsibilities 
of an HIV-infected individual had to be considered, ranging from 
wearing a condom to informing past and present partners.  Condom 
use was advocated for everyone--infected or not--because it was 
the only way to ensure self-protection.  From one perspective, it 
was seen as the infected person's moral obligation to inform sex 
partners of one's infection.  Many states even made laws imposing 
criminal penalties against those whose actions could result in 
HIV transmission.  This idea was opposed, however, for fear that 
distinguishing the infected from the uninfected would lead to 
discrimination.  The principle of self-protection removed 
responsibility from those with HIV, although by the late 1980s 
and early 1990s, calls for self-disclosure began to be heard.  
Consideration of personal responsibility leads to the question of 
whether or not an infected person is obligated to tell their 
partner.  Because people may be infected without knowing they 
are, some experts have recommended that even couples in long-term 
relationships use condoms, because the idea of trust 
"disempowers" partners.
     
     
