CDC HIV/STD/TB Prevention News Update

Possible HIV Error Unreported

"Possible HIV Error Unreported" Washington Post (02/11/00) P. A1; Weiss, Rick; Nelson, Deborah
Researchers at St. Jude Children's Research Hospital in Memphis and Baylor College of Medicine in Houston may have accidentally exposed over 24 young cancer patients to HIV-1 in a gene therapy experiment last year. The discovery was made in December, but the researchers did not inform regulators until last week. Both the researchers and federal officials said Thursday that the gene-based treatment may have contained HIV-1 and hepatitis C virus (HCV). Evidence of contamination has appeared in two tests; however, officials stressed that the scare could be a false alarm, as the tests are highly sensitive and can return "false positive" results on the types of samples involved. Nonetheless, patients and their parents have been notified about the possibility of exposure, and the research has been halted. The failure to report the discovery immediately raises questions about how gene therapy projects protect study patients and also about compliance with government regulations. St. Jude's is already being investigated by the National Institutes of Health for its handling of patient deaths in another study. Laura Bowman, lead investigator of the cancer study at St. Jude's, explained that the patients may have received engineered viruses that were processed incorrectly, which could increase the risk of contamination. Bowman said that eight patients in the study--four of the 20 patients she treated at St. Jude's and four of the six treated at Baylor--are still alive; however, the researchers said that all the participants involved were close to death from recurrences of their cancers, and all the deaths were the result of cancer.

Studies Bring Warnings About a Popular Herb

"Studies Bring Warnings About a Popular Herb" New York Times (02/11/00) P. A20
Results of two new studies suggest that St. John's wort, a popular herb for depression and anxiety treatment, can interfere with both an AIDS drug and a drug used for transplant recipients. The herb may affect the protease inhibitor indinavir, which is sold under the name Crixivan, by causing levels of drug in the blood to drop "dramatically," according to Dr. Stephen Piscitelli of the National Institutes of Health. This could allow HIV to strengthen or develop resistance. In the second study, researchers from University Hospital in Zurich report that St. John's wort could conflict with cyclosporine, a drug that helps prevent organ rejection in transplant recipients.

FDA Targets Recycled Medical Devices

Las Vegas Sun Online (02/10/00)
Few patients know that some medical devices like cardiac catheters and angioplasty balloons are being resterilized and used on other patients. On Thursday, the Food and Drug Administration (FDA) told Congress that the practice must meet strict standards of safety, following reports of reused equipment malfunctioning or causing infections. Some studies have found that a few patients contracted tuberculosis, hepatitis, or pneumonia from incorrectly resterilized equipment; however, the FDA said it has no proof that reusing disposable devices is much more dangerous than using other medical equipment. The FDA's proposal would require hospitals and resterilizing companies to prove they can safely clean and reuse medical devices.

CDC Director Plans Audits and Overhaul

Washington Post (02/11/00) P. A39; Stephens, Joe; Strauss, Valerie
Jeffrey P. Koplan, director of the Centers for Disease Control and Prevention, promised on Thursday an overhaul of the agency after misleading Congress about its spending. Koplan told a House subcommittee he replaced the CDC's head of the viral division, Brian Mahy, and plans for audits to make sure future spending reports are correct. Health and Human Services (HHS) Secretary Donna Shalala announced earlier this week that, for the next year, financial decisions at the National Center for Infectious Diseases must be approved by senior financial officers at the both the CDC and HHS.

Ministers Back Holy Alliance for Health Education

Atlanta Journal and Constitution (02/10/00) P. 14JE; Charles, Alfred
About 70 ministers of minority churches in south Fulton, Georgia, have agreed to let the county health department partner with church members to educate congregations about HIV and AIDS, cancer, teen pregnancy, and sexually transmitted diseases. Churches, especially those in African-American communities, have long been criticized for ignoring the AIDS epidemic and other public health matters. The new approach will include events like a teen summit and health screenings. HIV is infecting more minorities than Whites, according to the Centers for Disease Control and Prevention, with minorities accounting for over half of the 18,153 AIDS cases diagnosed among gay men in 1998.

Tuberculosis Stalks Cellar-Bound Chechens

"Tuberculosis Stalks Cellar-Bound Chechens" Fox News Online (02/10/00); Melikyan, Karina
In Chechnya's war-torn capital of Grozny, tuberculosis (TB) is threatening many individuals who have been forced to stay in damp cellars with little food. At the only specialist hospital in Russia's Ingushetia, which borders the rebel region, many supplies are lacking, and physicians there warn that "the tuberculosis situation is catastrophic." Most patients at the hospital came from Chechnya after rebel fighting, and already nine people have died from TB. The clinic has few beds and also lacks bandages, syringes, and drugs, including TB treatments.

German Condom Maker to Build Kenya Factory

Reuters (02/11/00)
Germany's largest specialist condom maker, Condomi AG, is joining with Kenya's Olago Enterprises to form a $2.5 million condom factory in Nairobi. Kenya's demand for condoms has grown 250 percent and continues, even though the government has refused to promote their use. AIDS was declared a national disaster in the country in 1999, as the disease takes the lives of 500 Kenyans each day. The factory will initially produce about 100 millions condoms a year, according to Condomi AG.

Lipodystrophy: Options Widen for Treatments

AIDS Alert (02/00) Vol. 15, No. 2, P. 21
Lipodystrophy and metabolic anomalies are increasing among HIV patients, but more treatment options are now available for them, including Serostim, a human growth hormone. One of the most surprising treatments is a narcotic called naltrexone, which has been used by New York physician Bernard Bihari on AIDS patients since 1986. The drug was originally prescribed to boost the patients' immune systems but had the added benefit of protecting patients from peripheral fat wasting and metabolic abnormalities. Bihari recommended a 3 mg dose of the drug to each of 136 HIV patients. Only four of the subjects who were treated with protease inhibitors and other drugs had signs of lipodystrophy; three of the patients developed the condition after they stopped taking naltrexone during a trip or a move to Europe. Their conditions improved once they began taking the drug again. Although the study was purely observational, the results are impressive, according to Bihari. He notes that the 50 mg dose approved by the Food and Drug Administration to block heroin addicts' high is too much for HIV patients, as its side effects include anxiety, insomnia and stress intolerance.