NetNews Usenet Archive 1992 #31/NN_1992_31.iso/spool/sci/med/aids/2174

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Subject: CDC Summary 12/30/92
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                          AIDS Daily Summary
                          December 30, 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

 "U.S. Patents Are Granted for 3 Laboratory Mice" Washington Post
(12/30/92), P. A4
     The federal government granted three patents yesterday to strains
of genetically altered mice.  Researchers consider the patents critical
for biotechnology.  They are the first since 1988 to recognize ownership
of a genetically altered animal species.  The U.S. Patent and Trademark
Office (PTO) notified its Official  Gazette that it was issuing patents
for laboratory mouse strains  to Harvard University, GenPharm
International of Mountain View,  Calif., and Ohio University.  GenPharm
was granted a patent for a mouse strain that has been altered so that it
naturally fails to  develop a fully functional immune system.  The
GenPharm mouse was genetically altered by the addition of aJgene that
prevents the  rodent from developing fully mature lymphocytes.  The new
mouse  will be used in the study of immune-system diseases such as AIDS,
or in research on autoimmune diseases, said Jonathan MacQuitty,  chief
operations officer of GenPharm.

"AIDS Groups Refine Strategies as Many Court Same Donors" Wall Street
Journal (12/30/92), P. 1  (Sebastian, Pamela)
     More and more AIDS groups are searching for a better fund-raising
foothold as the epidemic moves into its second decade.  "Heart Strings,"
a Broadway-style touring musical produced by New York's Design
Industries Foundation for AIDS (DIFFA), has been popular in the past but
may be rewritten.  When "Heart Strings" played in New York, it was
received warmly, but didn't even raise a third of the $989,000 generated
in Houston.  The road show fared poorly in Washington, San Francisco,
and Chicago.  "Heart Strings has been touring since 1990, each year with
a different theme.   Approximately 400 private grant-making foundations
give money to  AIDS and more than 18,000 programs offer a range of
medical and  personal services for AIDS patients.  Therefore, it is
inevitable that disputes about priorities emerge as some AIDS fund-
raising  groups mature, new ones form, and there is more concentration
on  the efforts of the incoming Clinton administration.   Consequently,
DIFFA is considering taking a scaled-down  production of "Heart Strings"
to high-school and college  campuses, stressing its educational benefits
and de-emphasizing  the fund raising for the time being.  This would
allow DIFFA to  work on a new version of the show to go on the road,
raising  money for AIDS, in 1995.

"Teacher With AIDS Virus Invited to Clinton Inaugural" United Press
International (12/29/92)
     Worcester, Mass.--An HIV-positive teacher will speak about
compassion for AIDS patients at President-elect Bill Clinton's
inauguration on Jan. 18.  Michael Quercio, a teacher at the  Worcester
Academy in Massachusetts, was selected to join 53  Americans in offering
their personal experiences at an inaugural  event entitled, "Faces of
Hope."  Quercio met Clinton in October  at a fund-raiser and said that
Clinton showed understanding and  compassion for people affected by the
disease.  At the academy,  Quercio works to educate high school students
about AIDS.  He  tells them to "leave their brains at the door and bring
their  hearts to class."  Quercio will discuss what it is like to live
with HIV infection at the inaugural event.  "I want to bring more
anecdotal experience of friends I've lost and people I know  living with
AIDS."  Quercio said he will not talk about  government policy or
statistics, but will focus on people and  life.  "People need to stop
the judgment of people living with  AIDS," he said.  "To be considered
as a 'face of hope' in this  country is a tremendous honor and a feeling
of tremendous  responsibility.  All I want to do is bring home the
message of  people living with it," Quercio added.

"AIDS Prevention" Associated Press (12/30/92)  (Dixon, Jennifer)
     Washington--Despite the spread of the AIDS epidemic, local and
state health departments nationwide may have to cut back their  AIDS
prevention and education programs.  Last month, state  officials were
told to expect cuts in the amount of federal funds available to finance
state and local health department programs  for AIDS prevention,
education, counseling, and testing.  Kent  Taylor, spokesman for the
Centers for Disease Control, said that  every dollar spent on AIDS
prevention equals $30 saved in health  care costs.  He said the agency
will actually grant the same  amount of money to states for prevention
programs in fiscal 1993  as in 1992--$143.7 million.  However, states
will have less money left over from 1992 to use this fiscal year than
they had left  from 1991.  He said the amount of so-called carryover
money has  dropped from $20.8 million in 1991 to $15.8 million in 1992
to  about $9.7 million in 1993.  Taylor said states have less money  to
carry over because they are using their grants more  effectively.
Congress established overall funding for AIDS  prevention and
surveillance in fiscal 1993 at $498 million, an  increase from $477
million in fiscal 1992.  But Congress also  designated $27.7 million of
the 1993 total to be used for  community-based minority programs, for
people with hemophilia,  for HIV and multidrug-resistant tuberculosis
prevention, and for  programs addressing HIV among women.  This forced
the CDC to take $7 million out of other AIDS programs to make up the
difference,  said Taylor.

"Advantage Life Products Inc. and Nestle Corp." Business Wire (12/30/92)
     Laguna Hills, Ca.--Advantage Life Products Inc. of Laguna Hills,
Ca., said Wednesday that it will provide its BE SAFE program free of
charge to separate high-school assemblies in Portland, Ore.,  and
Atlanta, Ga., as part of its continuing partnership with  Nestle Corp.
The two companies are working together to bring  necessary information
about HIV and AIDS to students.   Advantage's education program
encourages AIDS awareness and  prevention through the distribution of BE
SAFE, the company's  book and audio cassette program, at school
assemblies.  The  assemblies involve students, professional athletes,
and medical  experts who discuss the implications of HIV in the 1990s.
The BE SAFE program aims to enable parents, teens, and couples to freely
communicate the facts about HIV infection and help establish  strong
communication skills and self-esteem to prevent the spread of the virus.
Among those attending some of the assemblies will  be National
Basketball Association stars, including Kiki  Vandeweghe, Clyde Drexler
and Dominique Wilkins.  The Johns  Hopkins School of Public Health will
receive a portion of the  proceeds from BE SAFE for its continuing HIV
education and  research efforts.

"Cryptosporidial Disease in the Adult HIV-Infected Patient" Journal of
the Association of Nurses in AIDS Care (10-12/92)  Vol. 3, No. 4, P. 11
(Fegan, Christine)
     Caring for AIDS patients with cryptosporidial disease is a tough
challenge nurses must face because as the disease weakens and
transforms the body, independence is lost, writes Christine  Fegan, RN,
BSN, et al. of the University of California--San  Diego. Cryptosporidial
diarrhea is considered an AIDS-defining  diagnosis if there is also a
history of four weeks of chronic  diarrhea.  The condition is generally
experienced in individuals  with a CD4 cell count below 200.  It is an
illness that affects  15 percent of HIV-positive patients in the United
States.  The  disease is a protozoan parasite that can infect any
vertebrate.   Cryptosporidiosis is a self-limiting illness in the
immunocompetent host, usually lasting 5 to 21 days.  However, in  HIV-
positive patients, the onset may be more gradual, but the  symptoms
worsen as immune functions deteriorate.  The organism  infects the
epithelial cells that line the digestive tract.   Symptoms of
cryptosporidium in HIV-positive patients may vary  from asymptomatic
carriage to voluminous life-threatening  diarrhea.  The main complaint
of most patients is profuse watery  diarrhea, from 5-20 stools per day.
A fluid loss ranging from  1-17 liters per day may result.  Other
symptoms include nausea,  vomiting, abdominal pain and cramping, weight
loss, anorexia, and low-grade fever.  The oocysts shed in the stool are
highly and  immediately infectious.  Most likely, transmission will
occur via fecal-oral route, and can be spread from animal to person as
well as person to person.  Cryptosporidium can also be transmitted  from
contaminated food and water, concludes Fegan.

"Moving Home to Live: Migration of HIV-Infected Persons to Rural
States" Journal of the Association of Nurses in AIDS Care (10-12/92)
Vol. 3, No. 4, P. 42  (Davis, Kristine A. et al.)
     Rural nurses need to be prepared to treat both indigenous and
returning AIDS patients and their families, and to provide  professional
and community education, write Kristine A. Davis,  RN, MA, et al. of the
University of Iowa in Iowa City.  Migration of HIV-positive persons into
rural areas may present challenges  to both health-care workers and
patients.  A cross-sectional  survey was administered to a convenience
sample of 54 rural  HIV-clinic patients in Iowa to determine the
percentage of  patients who had moved back to the state after
contracting HIV  and the problems they experienced after moving.  The
authors  found that 46 percent of their patients reported moving to or
back to Iowa from a different state.  About 61 percent of the 54
patients said they had lived outside Iowa during the past 10  years.
Also, 21 percent of patients described problems after  moving.   Among
the patients moving back, 61 percent had not been tested for HIV and 52
percent were not experiencing symptoms.   The percentage of patients who
reported moving with an AIDS  diagnosis (27 percent) was higher than
determined using their  physician-reported data (17 percent).  The
researchers conclude  that many HIV-positive patients who move from
urban to rural  areas are not terminally ill.

"Mobile HIV Testing Attracts Clients--Even in Bars" AIDS Alert (12/92)
Vol. 7, No. 12, P. 186
     A mobile HIV testing and counseling program was begun in New York
State to address high-risk populations who would otherwise shun  the
services found at the sexually transmitted diseases clinic  (STD).
Sondra Pruden, RN, is team leader for the New York State  Health
Department's outreach program on HIV, STDs, and  tuberculosis.  The
program is a mobile education, counseling, and testing effort that takes
its services to homeless and battered  women's shelters, alcohol and
drug rehabilitation centers, and  gay bars.  Since the beginning of the
program in May 1990, Pruden and her team of four public health
representatives have educated  about 3,000 people in Broome County, a
community of 200,000 in  south-central New York.  Among those 3,000,
about 1,050 agreed to be tested for HIV infection, and approximately 25
tested  positive--a 2 percent rate in a county where only one in every
1,000 pregnant mothers tests positive for HIV.  The program is  funded
by the Centers for Disease Control's grant of $28,000.  It pays for five
part-time positions, a public health nurse for two  days a week, a
public health representative at half time, and  three additional public
health representatives with varying  hours.  Pruden's team visits about
12 agencies on a regular basis during a given year.  The team
establishes itself just about  anywhere it's invited, provided members
have access to a room  large enough for a general presentation and
smaller rooms for  counseling and testing.  A visit usually entails a
90-minute  educational talk on HIV infection and private counseling
sessions that last about 20 minutes.  During the sessions, counselors
assess the client's risk of infection.

"A Controlled Trial of Aerosolized Pentamidine or  Trimethoprim-
Sulfamethoxazole as Primary Prophylaxis Against  Pneumocystis Carinii
Pneumonia in Patients with Human  Immunodeficiency Virus Infection" New
England Journal of Medicine (12/24/92) Vol. 327, No. 26, P.  1836
(Schneider, Margriet M.E. et al.)
     For primary prophylaxis against pneumocystis carinii pneumonia
(PCP), trimethoprim-sulfamethoxazole is the drug of choice,  despite the
higher incidence of adverse events among patients  administered the
drug, write Margriet M.E. Schneider et al. of  the University Hospital
Utrecht in Utrecht, Netherlands.  The  researchers conducted a
multicenter trial involving 215  HIV-positive patients with no history
of PCP but with CD4 cell  counts below 200 per cubic millimeter.  The
patients were  randomly assigned to one of three regimens: aerosolized
pentamidine once a month; 480 mg of trimethoprim-sulfamethoxazole once a
day; or 960 of trimethoprim-sulfamethoxazole once a day.   The
cumulative incidence of PCP was estimated by Kaplan-Meier  survival
analysis.  After a mean follow-up of 264 days, 6 of the  71 patients in
the pentamidine group had a confirmed first  occurrence of PCP (11
percent), but none of the patients in the  two trimethoprim-
sulfamethoxazole groups had PCP.   Discontinuation of the drug due to
side effects was much more  frequent in the trimethoprim
sulfamethoxazole groups than in the  pentamidine group.  The adverse
reactions occurred significantly  sooner in the group given 960 mg of
trimethoprim-sulfamethoxazole than in the group given 480 mg.  The
researchers conclude that  trimethoprim-sulfamethoxazole taken once a
day is more effective  as a primary prophylaxis against PCP than
aerosolized pentamidine given once a month, even though adverse drug
reactions are more  common with trimethoprim-sulfamethoxazole.