                          AIDS Daily Summary
                           August 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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"Circuit Court Backs Insurer on HIV Test Nondisclosure"
"Tax Report: Many Patients With Severe Illnesses Win Tax Relief" 
"Genes That Protect Against AIDS"
"Across the USA: Michigan"
"When Savings Run Out, Some Shun Lifesaving"
"Epidemic of HIV Infection in Odessa Called 'Explosive'" 
"Thailand Places HIV/AIDS Information in Internet"
"750 Cases of AIDS Reported in Lebanon Since 1989"
"Extensive Polymorphisms Observed in HIV-1 Clade B Protease Gene 
Using High-Density Oligonucleotide Arrays"
"Serostatus and Counseling"
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"Circuit Court Backs Insurer on HIV Test Nondisclosure" 
Washington Post (08/14/96) P. A3; Schwartz, John
     A federal appeals court has ruled that a Mississippi life 
insurance company was not obligated to tell a policyholder that 
he had tested positive for HIV.  Following the death of her 
husband, Jody Deramus sued Jackson National Life Insurance (JNL) 
in 1992 for not revealing why the company refused her husband 
additional coverage.  The couple did not learn of Frank Deramus' 
infection until 18 months after the company's tests, and thus 
took no precautions to prevent HIV transmission during that time. 
To date, Jody Deramus has tested HIV-negative.  The appeals 
court's decision upheld a ruling by U.S. District Court Judge 
Henry T. Wingate last year.  JNL, meanwhile, has been notifying  
applicants' physicians of HIV-positive results since 1993,
although it is not required to do so by law.  Jody Deramus said 
she hopes to appeal the decision.
     
"Tax Report: Many Patients With Severe Illnesses Win Tax Relief" 
Wall Street Journal (08/14/96) P. A1
     The health insurance bill recently approved by Congress
includes a significant tax break for people with chronic or 
terminal illnesses.  The bill allows these people to exclude 
accelerated death benefits or payments they receive from selling 
their life insurance policies to qualified "viatical settlement 
providers" from their reported income.  Currently, people who 
receive such payments must pay federal income tax on the money.
     
"Genes That Protect Against AIDS"
New York Times (08/14/96) P. A20
     Genetic mutations are not necessarily bad, as evidenced by the
recently discovered mutation that protects some people from HIV 
infection, notes a New York Times editorial.  Researchers at the 
Aaron Diamond AIDS Research Center in New York City announced 
last week that they had found a genetic mutation in two
homosexual men who remained uninfected despite repeated exposure 
to HIV.  Because they had a defective gene, their cells also 
lacked a receptor needed for the virus to enter.  The scientists 
say the finding could help explain why some people, who may only 
have one copy of the gene, are able to survive HIV infection 
longer than others.  The new discovery could also be used for the 
development of better drugs or a vaccine, the editors conclude.
     
"Across the USA: Michigan"
USA Today (08/14/96) P. 12A
     Michigan's Housing Opportunity for People With AIDS has
granted the Lighthouse of Oakland County $37,800 to provide 
emergency housing aid.
     
"When Savings Run Out, Some Shun Lifesaving" 
New York Times (08/14/96) P. C9; Gilbert, Susan
     A new study suggests that seriously ill patients are more
likely to forgo life-prolonging care if they are also suffering 
economic hardship.  Kenneth E. Covinsky, of Case Western Reserve 
University, and colleagues report that the likelihood of such
patients deciding to seek comfort care rather than continued 
treatment was 30 percent greater for those whose illnesses had 
created serious financial hardship.  Doctors say the results 
suggest that patients are not denying themselves care because 
they think it is futile but because they do not want to bankrupt 
their survivors or cause them to make major life changes, like 
putting off education.  The study also found that family members 
or friends generally said they would have made the same decision 
as the patient.
     
"Epidemic of HIV Infection in Odessa Called 'Explosive'" 
Reuters (08/13/96) 
     The number of HIV infections in the Odessa region of the
Ukraine had reached 3,715 by August 1, 39 more than had been 
reported in the entire country as of March 1.  Since the 
beginning of 1996, 2,863 new HIV infections, 917 among  women, 
have been diagnosed in the region.  Of the infections, about 70 
percent are drug-related and the majority of the others are 
attributed to sexual contact. Most of those infected are between 
the ages of 18 and 40.
     
"Thailand Places HIV/AIDS Information in Internet" 
Xinhua News Agency (08/14/96) 
     Information about HIV prevention, treatment, diagnosis, and 
other issues is now offered on the World Wide Web by Thailand's 
Public Health Ministry.  Data about the rights of people with 
AIDS is also included, and officials say a more in-depth version 
will be created for medical students and people interested in 
scientific developments related to AIDS.  A version for children 
is also planned.
     
"750 Cases of AIDS Reported in Lebanon Since 1989" 
Xinhua News Agency (08/14/96) 
     Since 1989, 750 AIDS cases have been reported in Lebanon, and
the average age of patients is under 31.  A health specialist noted
that 75 percent of the cases involved transmission through sexual 
contact, while 15 children had been infected by their mothers and
a few cases were attributed to blood transfusions.  She added that 
since 1993, there has been a decrease in the number of women 
infected by their husbands.
     
"Extensive Polymorphisms Observed in HIV-1 Clade B Protease Gene 
Using High-Density Oligonucleotide Arrays"
Nature Medicine (07/96) Vol. 2, No. 7; P. 753; Kozal, Michael J.; 
Shah, Nila; Shen, Naiping; et al.
     HIV-1 is able to mutate and develop resistance to protease 
inhibitors, but little is known about such mutations.  Thomas R. 
Gingeras, of Affymetrix in Santa Clara, Calif., and other 
researchers, used high-density oligonucleotide array sequencing 
to determine the sequences of 167 viral isolates from 102 
patients. They report that the DNA sequence of USA HIV-1 clade B 
proteases was extremely variable and that 47.5 percent of the 99 
amino acid positions varied.  This is the greatest level of amino 
acid diversity known out of all worldwide HIV-1 clades combined.  
Many of the amino acid changes that are known to play a role in 
drug resistance occurred as natural polymorphisms in isolates 
from patients who had never received protease inhibitors.  The 
authors suggest that the current evaluation of protease 
inhibitors in clinical trials could be adversely affected by the 
presence of naturally occurring mutations.  They say that patient
care may be managed on an individual basis, relying on genotypic 
analysis of viral and bacterial isolates.  Before decisions about 
therapy can be based on vial genotype, however, the authors say 
further study is needed to determine the structural basis of 
viral resistance.
     
"Serostatus and Counseling"
Focus (07/96) Vol. 11, No. 8; P. 1; Ball, Steven
     Just as gay psychotherapists have used self-disclosure as a
tool to help clients feel understood, the disclosure of 
serostatus by social service providers could be beneficial.  By 
serving as role models, counselors can help uninfected gay men 
stay uninfected and help men with AIDS take care of themselves, 
while aiding both infected and affected men in maintaining a 
sense of hope and intimacy.  Role modeling has been useful for 
many HIV-negative gay men, who often feel abandoned by 
communities and social services which focus on the needs of the 
HIV-positive community.  As they serve as caregivers, outsiders, 
and mourners, HIV-negative gay men are often unable to express 
their fears of becoming infected, or to discuss their loneliness
or burnout.  Many even let other people assume they are infected.
As a result, mental health and social service providers have
begun developing services, including support groups, especially for
uninfected men.
