
                     AIDS Daily Summary 
                       July 12, 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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"AIDS Conferees Debate How Early to Offer New Drugs" 
"AIDS Therapy Faces a Turning Point"
"Scientists Display Substantial Gains in AIDS Treatment" 
"Health Plans to Cover New AIDS Drugs But Issues of Cost, 
Treatment Remain"
"Many See Hope in AIDS Meeting; Marketers Also See Opportunity"
"Many AIDS Patients Opt for Suicide"
"Firm Fired HIV Positive Employee Over Illness, Suit Charges" 
"AIDS Activists Disrupt Meeting of Researchers"
"A Shot in the Dark"
"Progress Report: Prophylaxis and Therapy for MAC" 
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"AIDS Conferees Debate How Early to Offer New Drugs" 
Wall Street Journal (07/12/96) P. B1; Waldholz, Michael
     Throughout the 11th International Conference on AIDS this
week, researchers discussed how soon newly-infected HIV patients 
should be treated with protease inhibitors, costly new drugs that 
have been able to reduce the amount of virus to undetectable 
levels.  Treating the estimated 800,000 Americans with HIV could 
cost at least $5 billion a year and increase the risk of HIV 
developing resistance to the drugs, but Aaron Diamond AIDS Center 
scientist David Ho says that his studies support treatment at the 
first sign of infection.  In a current study, 12 patients were 
treated early and have no detectable virus after a year.  Ho wants 
to remove the therapy and see if the virus comes back or if it is
still hiding in certain tissues of the body.  Doctors who treat 
poor patients say the debate over early treatment is meaningless 
for them because their patients cannot afford the costly drugs.
     
"AIDS Therapy Faces a Turning Point" 
Washington Post (07/12/96) P. A1; Brown, David
     As the 11th International Conference on AIDS ended Thursday,
researchers tempered the positive news about promising new drugs 
with caution that a cure is still not in sight.  Studies 
presented at the meeting demonstrated the ability of protease 
inhibitors, combined with other drugs, to reduce the amount of 
HIV in the bloodstream to undetectable levels for up to two 
years.  Scientists are considering whether drug therapy could be 
stopped in patients who have no detectable HIV.  However, before 
stopping treatment, doctors would offer to biopsy a patient's 
lymph node, where the virus may still be growing.  If a cure is 
not found, infected people may be able to live longer lives 
through long-term virus suppression.  Survival may depend on how 
soon treatment is started, however.

"Scientists Display Substantial Gains in AIDS Treatment" 
New York Times (07/12/96) P. A1; Altman, Lawrence K.
     Data from several studies of new AIDS treatments were
released on Thursday at the 11th International Conference on 
AIDS.  The researchers who conducted the trials, however, 
cautioned that the findings could not be deemed a cure.  Two 
studies involved combinations of drugs, including AZT, 3TC and 
the protease inhibitor ritonavir; in both trials, patients' viral 
loads were reduced to undetectable levels for long periods of 
time.  While the new treatments are extremely promising, experts 
note that the virus could develop resistance to the new 
drugs--just as it has to older ones--or patients could prove to 
be unable to tolerate the harmful effects of the drugs over an 
extended period.
     
"Health Plans to Cover New AIDS Drugs But Issues of Cost, 
Treatment Remain"
Wall Street Journal (07/12/96) P. A3; Winslow, Ron
     While health insurers and managed care plans say they will
pay for the costly new protease inhibitors for patients with HIV,
the potential cost for the drugs could vary widely.  Researchers 
are debating how soon patients should be treated with the drugs, 
a factor that could affect cost dramatically.  The drugs cost at 
least $12,000 a year, and a test to monitor patients costs 
another $1,000.  Moreover, early treatment would increase both 
the number of patients being treated and the cost to insurers.  
Concerns may be exaggerated, though, considering that the drugs 
help improve the health of seriously ill patients and thus save 
money on hospital stays and antibiotics.  Tim Westmoreland of the 
Georgetown University Law Center noted that protease inhibitors 
may actually save money for health plans that pay for both 
prescription-drug benefits and hospital care.
     
"Many See Hope in AIDS Meeting; Marketers Also See Opportunity" 
Wall Street Journal (07/12/96) P. B1; Tanouye, Elyse
     The 11th International Conference on AIDS held in Vancouver,
British Columbia, this week was sponsored by drug makers and other 
companies eager to display their products.  According to Graeme 
White, the conference's corporate relations manager, 
pharmaceutical firms and other sponsors contributed nearly a third
of the $11 million cost of holding the event.  While many 
conference attendees merely picked up their free Abbott 
Laboratories' tote bags and eagerly stood in line at the Gilead 
Sciences booth to get a free water bottle, some AIDS activists 
protested the commercial hype of the event, marching through the 
aisles while chanting, "We die. You make money," and putting down 
roach motels at the Roche Holding booth while waving signs that 
said "Greed Infestation."  According to one drug company 
executive, however, the commercial hubbub was "extraordinarily 
subdued," compared with meetings of such groups as the American 
Heart Association, where celebrities often pitch products.
     
"Many AIDS Patients Opt for Suicide"
Miami Herald (07/11/96) P. 9A; Haney, Daniel Q.
     People with AIDS commonly attempt suicide and doctors seem 
increasingly willing to assist them, according to survey results 
presented Wednesday.  Failed suicides are frequent, because 
physician-assisted suicide is illegal in most places, but surveys 
show that doctors and nurses are more willing to bend or break the 
rules to help patients end their pain.  Thomas Mitchell of the
University of California at San Francisco reported that 53 percent 
of 114 San Francisco-area AIDS specialists surveyed said they had 
helped patients end their lives by writing prescriptions for 
narcotic overdoses.  Five years ago, 28 percent of doctors said 
they would probably help in a suicide.
     
"Firm Fired HIV Positive Employee Over Illness, Suit Charges" 
Chicago Tribune (07/11/96) P. 1-7; O'Connor, Matt
     Robert Viola, who served as a board member of AIDS Care, a 
residence for homeless AIDS patients in Chicago, was sued by a 
former employee for firing him because he thought the man had 
developed AIDS.  Patrick N. Martinez says he told Viola 
previously that he had HIV and that Viola wrongly believed a case 
of bronchitis indicated that Martinez had developed full-blown 
AIDS.  When Martinez returned to work after being ill, Viola 
confronted Martinez with the information and tried to force him 
to quit.  Viola fired him the next month.  Martinez says he 
believes Viola was concerned about the potentially high health 
care costs to his company.  Jim Flosi, founder and president of 
AIDS Care, said that such allegations are completely out of
character for Viola, noting that he has volunteered many hours 
and offered the services of his marketing, communications, and 
graphics design firm to the cause.
     
"AIDS Activists Disrupt Meeting of Researchers" 
Boston Globe (07/11/96) P. 8; Knox, Richard A.
     A small group of AIDS activists from ACT-UP San Francisco 
disrupted a meeting at the 11th International Conference on AIDS 
Wednesday, throwing red liquid that broke glassware and soaked 
the clothes of participants.  The protest was one of many at the 
conference, but the first violent disruption.  The protesters 
were apparently upset about the toxicity of AZT.
     
"A Shot in the Dark"
Discover (06/96) Vol. 17, No. 6, P. 66; Cohen, Jon
      Thailand, a country particularly hard-hit by AIDS, is
preparing for the world's first large clinical trial of an HIV 
vaccine.  The country began experiencing an explosive HIV 
epidemic in 1988, and unlike the epidemic in the United States 
and Europe, 90 percent of the people infected were heterosexuals.
Researchers found a new strain of HIV, subtype E, in northern 
Thailand and suspected it was more easily transmitted through 
heterosexual sex than the more common subtype B.  A panel at the 
National Institute of Allergy and Infectious Diseases recommended 
in 1994 that efficacy trials of the Biocine and Genentech 
vaccines begin, but the trials were delayed indefinitely.  That 
same year, a World Health Organization panel approved beginning 
vaccine trials in hard-hit developing countries.  Genentech had a 
large supply of vaccine, but it was designed for subtype B.  The 
company began testing the vaccine in a small number of Thai drug 
users who were infected with subtype B.  Even as this trial was 
being prepared, though, subtype E was spreading rapidly among 
drug users.  Biocine hopes to start a trial of a subtype E 
vaccine this fall and is working on a vaccine for both subtypes 
that may enter a trial by the end of 1997.
     
"Progress Report: Prophylaxis and Therapy for MAC"
AIDS Clinical Care (06/96) Vol. 8, No. 6; P. 45; Currier, Judith
     Several studies in the past year have reported advances in
the prophylaxis and treatment of disseminated Mycobacterium avium
complex (MAC), a common cause of morbidity and mortality in
patients with advanced HIV infection.  Rifabutin was the first
agent shown to reduce the incidence of disseminated MAC, but
further analysis of favorable studies showed no survival benefit.
Clarithromycin has been shown to improve survival by 33.1
percent, although resistance was also found to develop to the
drug.  Studies showed that both daily clarithromycin and weekly
azithromycin are better than rifabutin for MAC prophylaxis, but
the relative effect of the two is difficult to determine.
Clarithromycin appears to be slightly more effective, although
resistance was more commonly associated with it than with
azithromycin.  To treat MAC, therapy with a macrolide and at
least one other agent is currently recommended, although some
studies have suggested that a three-drug combination may be more
beneficial.
