[CDC News] CDC HIV/STD/TB Prevention News Update 10/20/98
preven...@cdcnpin.org
Tuesday, October 20, 1998
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
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HEADLINES
PEER-REVIEWED JOURNALS
"Temporal Trends in the Progression of Human Immunodeficiency
Virus Disease in a Cohort of Drug Users"
GENERAL MEDIA
"Congress Ready to Vote on DC Spending Plan"
"AIDS Has Killed 250,000 Kenyans--Health Ministry"
"Film on AIDS to Honor Crusading Doctor"
"HIV/AIDS Funding Increases Included in Congressional FY99
Budget"
"Drug Adherence Overestimated by HIV-Positive Patients"
"Tuberculosis Spreads to 2.5 Million Russians"
"India's Efforts to Check HIV Spread Lauded"
"While Stocks Last ..."
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PEER-REVIEWED JOURNALS
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"Temporal Trends in the Progression of Human Immunodeficiency
Virus Disease in a Cohort of Drug Users"
Epidemiology (11/98) Vol. 9, No. 6, P. 613; Webber, Mayris P.;
Schoenbaum, Ellie E.; Gourevitch, Marc N.; et al.
To examine changes over time in the progression to AIDS among
intravenous drug users in a methadone maintenance program,
researchers from Montefiore Medical Center and the Albert
Einstein School of Medicine evaluated 524 HIV-positive IDUs
between 1986 and 1995. After controlling for CD4 cell counts and
age, the hazard ratio of progression was 1.0 for program
participants in 1988-1999, 0.3 in participants in 1990-1991, 0.5
among those in 1992-1993, and 0.2 among participants in
1994-1995. The authors note that the morbidity decline in the
cohort coincides with the implementation of a federally funded
project to provide comprehensive on-site primary care to drug
users involved in the methadone clinic in 1989. Despite the
decline in hazard ratios, the researchers concluded that the
longer AIDS-free time of individuals who entered the study later
was not linked to lower mortality. The scientists said that
"through 1996, the primary effect of HIV treatments in our cohort
was to delay an AIDS-defining opportunistic infection rather than
to extend the life of HIV-seropositive individuals." The study
ended in 1996, after which time a decrease in AIDS mortality was
noted among the general HIV-positive population--including
IDUs--in New York City.
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GENERAL MEDIA
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"Congress Ready to Vote on DC Spending Plan"
Washington Times (10/20/98) P. C7; Ferrechio, Susan
Congress will vote today on a $5.2 billion spending package for
the District of Columbia that includes a ban on the use of city
funds for needle-exchange programs. A number of District
activists and leaders have raised objections to the ban of the
use of funds for needle exchanges; however, congressional leaders
would not back down on the issue. According to Rep. Thomas M.
Davis III (R-Va.), chairman of the House Government and Oversight
Committee on the District, "Giving free needles to use drugs
sends the wrong message in our nation's capital."
"AIDS Has Killed 250,000 Kenyans--Health Ministry"
Reuters (10/20/98)
The Kenyan health ministry reports that at least 256,750 people
in the country have died from AIDS since 1980. The National AIDS
Control Program also said that an estimated 1.5 million
Kenyans--5 percent of the total population of the country--have
HIV or AIDS.
"Film on AIDS to Honor Crusading Doctor"
Los Angeles Times--National Edition (10/20/98) P. D3; Berger,
Leslie
Renowned AIDS researcher Jonathan Mann had been working on a
documentary based on his book, "AIDS in the World II," before he
and his wife, Mary Lou Clements-Mann, died in the crash of
Swissair Flight 111 in early September. The epidemiologist's
work will be continued by a group that is beginning production of
the film next month in Haiti. Mann's intention, according to
some admirers, had been to disseminate the importance of fighting
HIV to the general public. Mann believed that the AIDS epidemic
endangered efforts to stabilize developing nations' economies.
The film now also serves as a tribute to Mann, but the producers
say they do not want to overshadow the importance of his message.
The film, directed by Robert Bilheimer, is titled "A Closer Walk:
Lessons from AIDS in the World." The makers of the movie hope to
have a global simulcast of the movie on World AIDS Day 1999.
"HIV/AIDS Funding Increases Included in Congressional FY99
Budget"
Reuters Health Information Services (10/19/98)
The fiscal year 1999 budget passed last Thursday by Congress will
include a $350 million increase for HIV/AIDS prevention and
treatment, U.S. Newswire has reported. The Ryan White Care Act
will provide $1.6 billion--with a 61 percent increase for the
AIDS Drug Assistance Program--while the Centers for Disease
Control and Prevention will receive about $630 million for HIV
prevention efforts. An additional $130 million will be allocated
for HIV/AIDS prevention and treatment in minority communities,
focusing on prevention programs in high-risk groups and increased
access to antiretroviral drugs.
"Drug Adherence Overestimated by HIV-Positive Patients"
Reuters Health Information Services (10/19/98)
Dr. Kathleen M. Melbourne of the University of Rhode Island in
Providence and colleagues have concluded that when used alone,
self-reports of drug adherence do not provide an accurate
assessment of compliance among HIV-infected individuals. The
researchers compared self-reported rates of adherence with an
electronic monitoring system, finding that self-reported rates of
adherence were consistently higher than rates observed with the
monitoring system. Electronic monitoring indicated that up to 43
percent of subjects did not take their protease inhibitors within
two hours of the self-reported time and only one of 44 patients
took 100 percent of the doses in a three-month period. The
researchers, who reported their findings at the 38th Interscience
Conference on Antimicrobial Agents and Chemotherapy in San Diego
last month, also found that 24 percent of the subjects
overestimated the number of doses they took by more than 10
percent.
"Tuberculosis Spreads to 2.5 Million Russians"
Russia Today Online (10/19/98)
A senior Russian Health Ministry official announced last week
that 2.5 million Russians are infected with tuberculosis. There
has been an 8.5 percent increase in the number of infected people
so far in 1998. TB prevalence has risen from 7.7 cases per
100,000 Russians in 1990 to 17.7 cases per 100,000 in 1998, with
rates reportedly 50 times as high among prisoners. According to
Gennady Onishchenko, the first deputy health minister, health
authorities are losing the fight against tuberculosis as
drug-resistant strains are becoming more widespread.
Furthermore, doctors are currently debating the best method of
treatment--imported Western techniques for TB management or the
national treatment developed under the Soviet Union.
"India's Efforts to Check HIV Spread Lauded"
Hindu Online (10/17/98)
Dr. Peter Piot, the executive director of the Joint UN Program on
HIV/AIDS, said Friday that while he is satisfied with India's
efforts to combat AIDS, the country should take greater help from
non-governmental organizations (NGOs). Piot commended the
initiation of the safe blood transfusion policy and said that he
appreciated the work done by the National AIDS Control
Organization. Still, he called for increased collaboration
between governmental organizations and NGOs, asserting that group
action from NGOs, women's organizations, trade unions, and youth
and religious groups could help stem HIV's spread from high-risk
groups to the general population.
"While Stocks Last ..."
New Scientist (09/26/98) Vol. 159, No. 2153, P. 20; Day, Michael
Hoffmann-La Roche has said that it will donate saquinavir, ddC,
and AZT to hospitals in Kenya, Tanzania, Uganda, Zimbabwe,
Zambia, Malawi, Cameroon, and the Ivory Coast. The drugs are
valued at 400,000 British pounds; when supplies run out, the
company said it will sell the drugs at reduced prices.
Hoffmann-La Roche will purchase the AZT from rival Glaxo Wellcome.
Some advocates say the measure is not enough, claiming that ddC
and saquinavir are inferior to other anti-HIV drugs on the
market. Others praised Hoffmann- La Roche for the contribution,
but warned that the supplies should be maintained and that patients
should be observed for adherence. Agathe Lawson, the Joint
UN Program on HIV/AIDS advisor for the Ivory Coast, said, "The
donations are definitely a good thing because the situation in Africa
is so urgent."
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