The CDC National Center for HIV, STD, and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases, and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.
"Tolerability and Side-Effects of Post-Exposure Prophylaxis for
HIV Infection (Research Letter)"
Lancet (www.thelancet.com) (02/26/00) Vol. 355, No. 9205, P. 722;
Parkin, J. M.; Murphy, M.; Anderson, J.; et al.
Researchers conducted a retrospective analysis of the use of
post-exposure prophylaxis (PCP) for occupational HIV-1 exposure
in three hospitals in London. Between 1996 and January 1999, 28
people experienced inoculation injuries while working with 27
patients, including 24 who had confirmed HIV-1 infection. All
but 10 of the injured healthcare workers were give the
recommended combination therapy of zidovudine, lamivudine, and
indinavir; the others received different triple-drug regimens.
The researchers note that only 15 of the 28 individuals completed
the full course of PCP therapy. Thirteen recipients discontinued
or changed therapy, with nine citing intolerable side effects as
reasons for stopping. Overall, it was found that PCP regimens
that included indinavir were not well tolerated. The authors
note that other protease inhibitors and non-nucleoside inhibitors
may be tolerated better and should be researched. The
researchers assert there needs to be a balance "between giving
complex therapies that may lead to poor adherence and giving
adequate therapy to protect the individual."
Lancet (www.thelancet.com) (02/26/00) Vol. 355, No. 9205, P. 731;
Kumar, Sanjay
India's Revised National Tuberculosis Control Program, which is
based on directly observed treatment short course (DOTS), has
seen great success after a previous plan failed. A review team
has concluded the new program to be twice as effective as the
previous one. The program, which was launched three years ago
and covers 14 percent of the people, has seen cure rates of over
80 percent and saved approximately 40,000 lives. Each year, an
estimated 2 million Indians develop tuberculosis-a disease which
costs India over $2 billion annually. Using a World Bank loan of
$142 million, officials plan to expand the program to 50 percent
of the population within the next two years.
"New Drugs Are Urged by Clinton"
Boston Globe Online (www.boston.com/globe) (03/03/00) P. A2;
Donnelly, John
President Clinton met with the heads of four large pharmaceutical
companies on Thursday to discuss vaccine development. Clinton
announced a measure that would establish a $1 billion tax credit
over 10 years to be given to companies to cover the costs of
economical vaccines for AIDS, tuberculosis, or malaria in the
developing world. Also at the meeting, Merck & Co. said it would
donate 5 million doses of hepatitis B vaccine, SmithKline Beecham
agreed to continue a second phase of clinical tests for a malaria
vaccine, American Home Products gave 10 million doses of
Haemophilus influenza type-B vaccine, and Aventis Pharm donated
50 million doses of polio vaccine to five nations in Africa.
Raymond Gilmartin, chairman, president, and CEO of Merck, noted
that the White House plan is a means of "providing funding to the
developing world to be able to develop the infrastructure, the
healthcare delivery systems, as well as to be able to finance
health programs within each of these countries."
PANA Wire Service (03/02/00)
The International AIDS Vaccine Initiative (IAVI) has said it will
spend $10 million this year on the development of six AIDS
vaccine candidates. The head of the organization, Dr. Seth
Berkley, made the announcement at Thursday's White House summit
on vaccine development. IAVI currently funds the development of
three potential AIDS vaccines, including two that are expected to
begin clinical trials in the coming year.
Washington Post (www.washingtonpost.com) (03/03/00) P. B1; Witt,
April
Preliminary new statistics show that in Montgomery County,
Maryland, 75 of 78 people diagnosed with tuberculosis (TB) last
year were immigrants or refugees. According to the Centers for
Disease Control and Prevention, immigrants represented 42 percent
of new TB cases nationwide in 1998, an increase from 22 percent
in 1986. One-third of the global population has TB, and one in
10 will at some point develop the disease, the CDC said. In
Montgomery County, 99 percent of patients are cured, and experts
say it usually it takes extended exposure to TB in order to
develop the disease. Despite their reassurances, however, area
healthcare workers note the hysteria that often surrounds TB
cases. Screening for TB is a key challenge to immigration
officers, since the bacteria can be dormant for years. Global
infection control is also important as more people are traveling
and diseases can rapidly spread across continents. Rep.
Constance A. Morella (R-Md.) plans to co-sponsor a bill with Rep.
Sherrod Brown (D-Ohio) that calls on the United States to spend
$100 million next year in the global fight against TB.
Reuters Health Information Services (03/02/00)
On Thursday, Rep. Tom Coburn (R-Okla.) told the Senate Committee
on Health, Education, Labor and Pensions that Congress needs to
shift its emphasis from people with AIDS to people with HIV. The
Ryan White Comprehensive AIDS Resource Emergency (CARE) Act,
which is up for reauthorization, currently awards grants based on
AIDS information. However, Coburn noted that AIDS can take years
to develop and said that using only AIDS data could neglect
certain demographic groups. Coburn also restated his support for
mandatory HIV testing of pregnant women and/or newborns.
Reuters (03/02/00); Emery, Gene
A protein found in the cells of the vagina, cervix, and rectum
has been shown to protect HIV and deliver it into the body. New
research in the journal Cell explains that HIV uses a protein
called DC-SIGN to enter dendritic cells. Dr. Dan Littman of the
New York University School of Medicine and colleagues found that
DC-SIGN embraces HIV and protects the virus from deteriorating.
The finding that DC-SIGN helps HIV spread should provide
information on how the virus is first transmitted., Littman said.
Reuters Health Information Services (03/02/00); Mozes, Alan
Researchers from University College Medical School in London
tested the efficacy of home chlamydia screening kits for
individuals who have rare contact with health services. The
study of more than 400 men and women between the ages 18 and 35
found that 39 percent of the women and 46 percent of the men
participated in chlamydia home test kits there were mailed to
them. The researchers had no personal contact with the subjects,
who, in addition to the tests kits, also received information
about chlamydia and were surveyed about their sexual history.
Dr. Judith Stephenson, the lead author of the report, which is
published in the journal Sexually Transmitted Infections
(2000;76:25-27), said the results show that both genders were
able and willing to use the kits.
Boston Globe Online (www.boston.com/globe) (03/02/00)
Over 30,000 people in Russia are infected with HIV, with over
half contracting the virus in the past year, according to new
statistics. Irina Savchenko, a specialist on AIDS prevention in
the Russian Health Ministry, announced the new figures at the
launch of a new program with Doctors Without Borders that will
focus on safe sex practices and the dangers of drug use.
Savchenko noted that 90 percent of the HIV infections are among
young injection drug addicts. The Health Ministry also reported
that the number of registered alcoholics in the country has
increased sharply since 1992, to 2.2 million.