NetNews Usenet Archive 1992 #31/NN_1992_31.iso/spool/sci/med/aids/2162

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Subject: CDC Summary 12/24/92
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                        AIDS Daily Summary
                        December 24, 1992
 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 Clearinghouse, or any other organization.
Reproduction of this text is encouraged; however, copies may not be
sold. Copyright 1992, Information, Inc., Bethesda, MD

 "FDA Approves Drug Against an Infection Often Linked to AIDS" Wall
Street Journal (12/24/92), P. 11
     A drug to prevent mycobacterium avium complex disease (MAC) in AIDS
patients was approved by the Food and Drug Administration. The drug,
rifabutin, is the first drug approved to prevent the life-threatening
disease.  Chronic debilitating symptoms of MAC infection include fever,
night sweats, weight loss, fatigue, abdominal pain, severe anemia, and
liver dysfunction.  Rifabutin is made by Adria Laboratories in Columbus,
Ohio, and will be sold under the brand name Mycobutin.  Patients
involved in clinical trails who received rifabutin were one-third to
one-half as likely to develop MAC as were patients who received a
placebo. The most common side effects linked with rifabutin are rash,
gastrointestinal symptoms, muscle and joint aches, and discolored urine.
The only serious adverse reaction found in the trials was a decrease in
certain infection-fighting white blood cells. Rifabutin was provided in
February under a Treatment Investigational New Drug protocol, which
enables drug developers to provide patients with access to experimental
drugs for serious and life-threatening conditions that have no
satisfactory treatments.  The FDA's Antiviral Drug Products Advisory
Committee recommended approval of rifabutin in September. Related Story:
Washington Post (12/24) P. A5

"Unimed Wins FDA Approval on AIDS Drug" Chicago Tribune (12/23/92), P.
3-3  (Morris, Steven)
     The Food and Drug Administration granted approval Tuesday to the
marketing of Marinol, a drug that fights the weight loss experienced by
AIDS patients.  The FDA granted Unimed Inc. of Buffalo Grove, Ill.,
approval under the orphan drug provision, which allows the company to
have exclusive marketing rights to this specific use for seven years.
In the 1980s, the orphan drug law was passed to encourage firms to
develop drugs for ailments suffered by small numbers of patients.
Unimed has marketed Marinol since 1985 as a treatment for nausea and
vomiting in chemotherapy patients.  Scott Broder, senior vice president
of sales and marketing, said, "Sales will grow rapidly now that it's
spread out through the growing field of AIDS."  The drug, which
stimulates the appetite, "offers a means for AIDS patients to enhance
the quality of their lives," he said.  The active ingredient in Marinol
is a synthetic marijuana agent called delta-9-tetrahydrocannibinol
(THC).  A physician must prescribe the treatment, which is taken in
capsule form. Related Story: Journal of Commerce (12/24) P. 7A

"Dance Club Barred From Promoting Event as AIDS Benefit" Philadelphia
Inquirer (12/24/92), P. B3  (Cass, Julia)
     A Philadelphia night club has illegally been promoting a New Year's
Eve event as a benefit for AIDS research, and has been asked to stop
doing so by the state Attorney General.  Bob Gentzel, a spokesman for
Attorney General Ernie Preate, said a nonprofit foundation used by the
Aztec Club to sponsor the event was not registered as a charity, as
required by Pennsylvania law. Among the four AIDS organizations listed
as beneficiaries of the event, two have argued that their names were
used without permission and the other two are not listed as charities in
Pennsylvania, said Gentzel.  The event is expected to feature local and
national celebrities at a ticket price of $150.  Rick Miller, the dance
club's marketing director, said the club discontinued ticket sales when
it received a letter from Preate on Tuesday.  He said that the club's
lawyers responded by sending the Attorney General's Office the
information it requested and were "waiting to hear from them so we can
start selling tickets again."  Gentzel said that the club's nonprofit
organization for the event, the New Year's AIDS Foundation, and the two
groups that now will be beneficiaries, must register as charities with
the Department of State.  The two groups that did not give authorization
to use their names in the club's promotional material were Action AIDS
in Philadelphia and the American Foundation for AIDS Research in New
York.  The only two groups now listed as beneficiaries  are Total AIDS
Support Service in Glenside and the Search Alliance in Los Angeles.

"At Simon's Rock, Few Fault College in Shootings" Boston Globe
(12/22/92), P. 31  (Roche, B.J.)
     Some outside observers have suggested that Simon's Rock College of
Bard in Great Barrington, Mass., could have acted to prevent a Dec. 14
shooting rampage by student Wayne Lo that left two people dead and four
injured.  However, many Simon's Rock students and their parents contend
that the school could have done nothing to forestall the tragedy even
though Lo reportedly made no effort to hide violent and hateful
attitudes towards such diverse groups as African Americans, Jews, AIDS
patients, homosexuals, and individuals with disabilities.  The students
say the college environment at the elite school fosters unimpeded
freedom of thought and freedom of expression.  "The most human reaction
is to say that someone should have known," said Saffron Kohler, the
mother of a sophomore at the college.  "Wouldn't it be wonderful if we
could tell that these idiots are going to go out and do these things?"
Student Joshua Faber said, "It's hard to tell at what point something is
intellectual and what point someone will put it into action."  Great
Barrington Police Chief Thomas Walsh told reporters that Lo threatened
to kill two student advisors prior to the murderous rampage on Dec. 14.
The Associate Press has reported that Lo received a package of 200
rounds of ammunition in the campus mail, which college officials knew
about but failed to confiscate because he told them he planned to give
the ammunition to his father for Christmas.  The college has issued a
statement claiming it "acted responsibly and conscientiously in the
events leading up to and following the incident."  Dean Bernard F.
Rodgers Jr. said in a letter to alumni and parents, "Part of the price
we are paying for our cooperation [in the investigation]...is that many
of the television and print reports...are inaccurate."

"Two Strides Toward a Workable AIDS Vaccine" Science News (12/19-26/92)
Vol. 142, Nos. 25 + 26, P. 422 (Ezzell, C.)
     Two recent studies have made significant progress toward the
development of an effective AIDS vaccine.  The first study used a
vaccine made of crippled but live virus to completely protect a group of
monkeys from simian immunodeficiency virus (SIV).  The second involved a
research team which determined that HIV picks up bits of the cells it
infects, perhaps as a means of improving their ability to latch onto and
attack new cells.  Ronald C. Desrosiers and his colleagues from the New
England Regional Primate Research Center in Southborogh, Mass., used a
strain of SIV by removing a gene called nef, which is believed to
regulate the virus' ability to reproduce.  They discovered that a single
immunization with live, weakened virus allowed each of the four monkeys
to fight infection following repeated injections of enough virulent SIV
to infect 10 animals--even though the vaccine was administered more than
two years previously.  The researchers claim their findings indicate
that a similar strategy involving live HIV "may also be the most potent,
effective vaccine for the prevention of AIDS" in humans.  Another study
conducted by Larry O. Arthur, director of the AIDS vaccine program at
the National Cancer Institute's Frederick Cancer Research and
Development Center in Frederick, Md., found on the surfaces of HIV
particles clusters of molecules that human immune system cells normally
use to communicate with one another.  They found that both SIV and HIV
selectively concentrate more major histocompatibility complex (MHC)
proteins, possibly to enable them to better adhere to and infect other
cells.

"Expression Directed From HIV Long Terminal Repeats in the Central
Nervous System of Transgenic Mice" Science (12/11/92) Vol. 258, No.
5089, P. 1804 (Corboy, John R. et al.)
     Differences in the nucleotide sequence of the long terminal repeats
(LTRs) of different HIV strains can alter the tissue-specific pattern of
gene expression directed from their LTRs, as has been observed for other
retroviruses, write John R. Corboy et al. of the Johns Hopkins
University School of Medicine in Baltimore, Md.  Infection with HIV is
often accompanied by the AIDS dementia complex (ADC).  The researchers
constructed transgenic mice that contained the LTRs of two CNS-derived
strains and a T cell tropic strain of HIV-1.  Only mice generated with
CNS derived LTRs directed expression in the CNS, particularly in
neurons.  The findings are unexpected because HIV-1 replication in the
CNS has not been detected in neurons. But the pathogenesis of the
neuronal cell loss seen in ADC is still uncertain.  In autopsy studies
of the brains of individuals with ADC, macrophages and microglia are the
cells most commonly infected with HIV-1.  Infrequently in autopsy and
biopsy studies, other CNS cells, including endothelial cells,
astrocytes, and oligodendrogli and neurons are found to be infected.  In
tissues other than those of the CNS, HIV-1 primarily infects T
lymphocytes and macrophages that express the surface molecule CD4.  But
CD4 may not be necessary for HIV-1 infection of neural-derived primary
or cultured cells, where the virus may use other molecules for entry
into cells.  If these CNS-derived strains are able to enter into the
cell, neurons can produce cellular transcription factors that interact
with and direct expression from LTRs, the researchers conclude.

"Men's Disclosure of HIV Test Results to Male Primary Sex Partners"
American Journal of Public Health (12/92) Vol. 82, No. 12, P. 1675
(Schnell, Daniel J. et al.)
     Although it is believed that undergoing HIV testing leads to
disruption of an important relationship and may discourage men  from
being tested, an encouraging rate of disclosure of  serostatus and a low
rate of relationship disruption has been  found, according to Daniel J.
Schnell et al. of the Centers for  Disease Control in Atlanta, Ga.  The
researchers examined disclosure of HIV antibody status to a main sex
partner and the impact on the relationship in men who have sex with men
and who are enrolled in the AIDS Community Demonstration Projects
cohorts.  Between 1987 and 1990, 1,684 participants had made an initial
visit and first return visit to one of four sites: Dallas, Texas;
Denver, Colo.; Long Beach, Calif.; and Seattle,  Wash.  It was found
that 89 percent of both seronegative and  seropositive men disclosed the
results to their main sex  partners.  In addition, 70 percent of the
seronegative men and 82 percent of the seropositive men who did disclose
their results reported that the relationship remained "as strong as
ever" after six months.  Most men who did not reveal their test results
to their main partner reported being "single" after six months.  The
findings indicate that more homosexual/bisexual men may get tested since
there was such a low rate of relationship disruption reported, conclude
Schnell et al.

"Fatal Hospital-Acquired Multidrug-Resistant Tuberculosis Pericarditis
in Two Patients With AIDS" New England Journal of Medicine (12/17/92)
Vol. 327, No. 25, P. 1816  (Horn, David L. et al.)
     Clinicians should be aware of Mycobacterium tuberculosis infections
involving both pulmonary and extrapulmonary sites, write David L. Horn
et al. of the Lincoln Medical and Mental Health Center in Bronx, N.Y.
Two patients at the medical center developed tuberculosis pericarditis.
The first patient had AIDS and was hospitalized with fever and
hypotention.  He had had two previous hospitalizations for possible
tuberculosis and had been treated with isoniazid, rifampin,
pyrazinamide, ethambutol, and streptomycin but had not complied with
therapy.  Antituberculosis therapy was reinstituted.  The patient became
hypodic and required mechanical ventilation.  Despite a pericardiotomy,
the patient had a cardiac arrest and died.  M. tuberculosis resistant to
isoniazid, rifampin, ethambutol, and streptomycin but moderately
susceptive to pyrazinamide was cultured from the sputum.  An autopsy
showed fibrinous pericarditis and miliary TB involving the lungs,
spleen, kidneys, thyroid, lymph nodes, and pericardial tissue.  The
second patient also had AIDS and was hospitalized with fever and weight
loss.  Acid-fast bacilli were found on sputum smears, and the patient
was treated with isoniazid, rifampin, pyrazinamide, and ethambutol.  A
pericardiotomy and biopsy were performed.  A smear of pericardial fluid
was negative for acid-fast bacilli.  Hypotension persisted, and the
patient died.  Microscopial examination of the pericardial tissue
revealed acid-fast bacilli, and M. tuberculosis was isolated from bone
marrow, sputum, blood, and pericardial fluid.  Multidrug-resistant TB
was not detected in these patients before they died, therefore
preventing effective therapy.

*  The AIDS Daily Summary will not published Friday, December 25, 1992
   due to the observance of the holiday.
   Have a safe and happy holiday!