| prevention-news@cdcnpin.org 2004-11-05, 7:13 pm |
| CDC HIV/STD/TB Prevention News Update
Friday, November 05, 2004
The CDC National Center for HIV, STD and TB Prevention provides the follo=
wing information as a public service only. Providing synopses of key scie=
ntific articles and lay media reports on HIV/AIDS, other sexually transmi=
tted diseases and tuberculosis does not constitute CDC endorsement. The f=
ollowing summaries were prepared without conducting any additional resear=
ch or investigation into the facts and statements made in the articles be=
ing summarized, and therefore readers are expressly cautioned against rel=
ying on the validity or invalidity of any statements made in these summar=
ies. This daily update also includes information from CDC and other gover=
nment agencies, such as background on Morbidity and Mortality Weekly Repo=
rt (MMWR) articles, fact sheets and announcements. Reproduction of this t=
ext is encouraged; however, copies may not be sold, and the CDC HIV/STD/T=
B Prevention News Update should be cited as the source of the=20
information. Contact the sources of the articles abstracted below for ful=
l texts of the articles.
HEADLINES
NATIONAL NEWS
UNITED STATES: =93CDC: Hepatitis B Cases Down 89 Percent Among Children, =
Adolescents in 1990s=94
UNITED STATES: =93New HIV Drug Guidelines=94
OREGON: =93OHSU Gets Grant for TB Research=94
INTERNATIONAL NEWS
UNITED KINGDOM: =93Hepatitis B Jab Urged for Babies=94
GLOBAL: =93Urgent Need for Health-Care Workers in Poor AIDS-Afflicted Cou=
ntries: WHO=94
CANADA: =93University Don, 21, Fired for Dispensing Condoms=94
MEDICAL NEWS
MEXICO: =93Disease Associations: Less Morbidity/Mortality from Opportunis=
tic Infections in Mexico Since HAART=94
LOCAL AND COMMUNITY NEWS
CONNECTICUT: =93Changes Made in Sex Education=94
NEWS BRIEFS
SOUTH AFRICA: =93South Africa AIDS Activists March over Drugs Timetable=94
KAZAKHSTAN: =93Over 4,500 People HIV-Positive in Kazakhstan=94
RUSSIA: =93Over 450 HIV-Infected Registered in Chechnya=94
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NATIONAL NEWS=09
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UNITED STATES:
=93CDC: Hepatitis B Cases Down 89 Percent Among Children, Adolescents in =
1990s=94
Associated Press (11.04.04)=20
On Thursday, CDC reported that the incidence of hepatitis B cases am=
ong US children and adolescents dropped by 89 percent between 1990 and 20=
02 due to childhood vaccination against the disease. In 1991, the governm=
ent recommended all infants receive hepatitis B vaccination, a vaccinatio=
n program that was expanded in 1995 to cover 11- and 12-year-olds and in =
1999 to cover all children. =20
Between 1990 and 2002, 13,829 cases of hepatitis B were reported amo=
ng US children and adolescents. Hepatitis B incidence dropped from 3.03 c=
ases per 100,000 people in 1990 to 0.34 cases per 100,000 in 2002.
Hepatitis B attacks the liver, and can cause liver scarring, liver c=
ancer, liver failure and death. Hepatitis B can be transmitted by contact=
with blood or other body fluids, as well as through sex or shared needle=
s, or from an infected mother to her infant during birth.
The full report, =93Acute Hepatitis B Among Children and Adolescents=
=97 United States, 1990-2002,=94 was published in CDC's Morbidity and Mo=
rtality Weekly Report (2004;53(43):1015-1018). =20
UNITED STATES:
=93New HIV Drug Guidelines=94
Gay City News (11.04.04)::Duncan Osborne
On Oct. 29, the US Department of Health and Human Services issued ne=
w recommendations on when HIV-infected persons should begin taking antivi=
ral drugs.=20
The guidelines suggest that patients who have not previously taken H=
IV drugs and who have a viral load of more than 100,000 should consider s=
tarting drug therapy =97 even if their T-cell count exceeds 350. The guid=
elines recommend that a patient with a T-cell count below 200, or who is =
experiencing AIDS-related symptoms, begin treatment regardless of his/her=
viral load.=20
Greg Gonsalves, director of treatment and prevention advocacy at Gay=
Men's Health Crisis, was a member of the federal panel that drafted the =
new recommendations. Patients as well as doctors will find the guidelines=
useful, he said.
When highly active antiretroviral therapy was introduced in 1996, th=
e prevailing treatment practice was =93hit early, hit hard,=94 in the bel=
ief that starting HIV treatment upon diagnosis might eliminate the virus =
from the patient's body. =93People have beaten a retreat from that and th=
ere is a much more conservative view, conservative in a good way, about w=
hen to start treatment,=94 Gonsalves said. =93They used to say that if pe=
ople go above 55,000 viral load they should start treatment. Now, the bar=
for starting is a little higher. It is moving further away from hit earl=
y, hit hard.=94
The recommendations also discuss which drugs to take first and how t=
o treat HIV-infected special populations =97 including adolescents, injec=
tion drug users, and people co-infected with TB, hepatitis B or hepatitis=
C =97 that may need help in complying with complex treatment regimens. P=
hysicians and patients are urged to consider interactions among HIV drugs=
, and between HIV drugs and other drugs =97 legal and illegal =97 that pa=
tients may be taking.
=93Use the drugs when you need them. It's not like there is an unlim=
ited supply of regimens people can take,=94 Gonsalves said. HIV drugs are=
expensive, some have side effects, and HIV can become resistant to them =
over time.
To access the full recommendations, visit www.aidsinfo.nih.gov.
OREGON:
=93OHSU Gets Grant for TB Research=94
Associated Press (11.03.04)
A $4 million federal grant targeted for bioterrorism research has be=
en awarded to researchers at Oregon Health & Science university to help f=
ind a vaccine for tuberculosis. It is the largest bioterrorism grant in O=
SHU's history and was presented to the husband-and-wife team of Dr. David=
Lewinsohn and Dr. Deborah Lewinsohn. =20
Working with scientists from the university of Washington, Colorado =
State university and Case Western Reserve University, OSHU researchers wi=
ll focus on diseases terrorists might use, as well as diseases such as tu=
berculosis, influenza and West Nile virus. The study is part of a $73 mil=
lion initiative by the National Institutes of Health to identify small st=
rings of amino acids, displayed by diseases, that stimulate the body's im=
mune system.=20
Strains of multi-drug resistant TB, severe acute respiratory syndrom=
e, influenza and rabies are among the list of third-tier, or less deadly,=
diseases that researchers will tackle. Though the grant does not require=
the OHSU team to create a vaccine, the researchers hope to define diseas=
e building blocks that drug companies could use to develop vaccines.=20
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INTERNATIONAL NEWS=09
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UNITED KINGDOM:=20
=93Hepatitis B Jab Urged for Babies=94
The Guardian (London) (11.05.04)
Doctors writing in today's issue of the British Medical Journal reco=
mmend that every child in Britain receive vaccination against hepatitis B=
.. While 150 countries now immunize their populations from the virus, Brit=
ain is one of the few developed countries that do not universally immuniz=
e babies, the doctors wrote.=20
One potential concern with childhood vaccination might be that the v=
irus is usually associated with at-risk groups such as IV drug users, gay=
men and prisoners. =93Because the burden of hepatitis B was low and indi=
vidual rights were considered paramount, a policy of selective immunisati=
on of newborns of carrier mothers and in high-risk groups has been follow=
ed. This policy fails to identify a large proportion of those at risk,=94=
wrote Rakesh Aggarwal and colleagues of the Sanjay Gandhi Postgraduate I=
nstitute of Medical Sciences in Lucknow, India. =93The magnitude and clin=
ical consequences of chronic hepatitis B make a strong case for its preve=
ntion and treatment.=94=20
The full article, =93Preventing and Treating Hepatitis B Infection,=94=
was published in British Medical Journal (2004;329(7474):1080-1086). =20
GLOBAL:
=93Urgent Need for Health-Care Workers in Poor AIDS-Afflicted Countries: =
WHO=94
Canadian Press (11.04.04)::Helen Branswell
On Thursday, World Health Organization Director Dr. Lee Jong-wook wa=
rned that AIDS-ravaged sub-Saharan Africa is suffering from a critical la=
ck of health-care workers. Lee met with Aileen Carroll, the minister resp=
onsible for the Canadian International Development Agency, and said Canad=
a's pledge of $100 million toward WHO's effort to get antiretroviral drug=
s to 3 million people by the end of 2005 will help close this gap. =93We =
will ensure that you get value for the money,=94 Lee said at a news confe=
rence following the meeting.
With a population of 682 million, sub-Saharan Africa has just 600,00=
0 health-care workers, said Lee. In contrast, Canada, with a population t=
otaling less than 5 percent of sub-Saharan Africa's, has 500,000 health-c=
are workers.=20
While an additional 85,000 health workers will be trained in the nex=
t 18 months, retaining them in areas where they are needed presents a cha=
llenge. =93These are very, very complex issues,=94 Lee said of doctor sho=
rtages. Canadian doctors are lured to the United States by lower taxes an=
d better working conditions; Canada responds by advertising for doctors f=
rom South Africa and other countries, and poorer nations end up losing th=
e most. Lee noted the migration often stems from the desire of doctors to=
relocate for lifestyle reasons.=20
Lee said many African nations are concerned about the flight of doct=
ors, and WHO has responded by establishing a commission on the issue to s=
earch for solutions.=20
The WHO =933 by 5=94 initiative must address women and young girls, =
who make up the majority of new HIV/AIDS infections, said Carroll. =93Thi=
s disease is incredibly female in nature,=94 she noted.=20
Canada is the largest contributor to WHO's =933 by 5=94 program. Sin=
ce Canada announced its funding, Britain and Sweden have also committed m=
oney.=20
CANADA:=20
=93University Don, 21, Fired for Dispensing Condoms=94
Toronto Star (11.05.04)::Louise Brown
King's university college has fired a third-year student as residenc=
e supervisor because he would not agree to stop providing condoms to stud=
ents. Publicly funded KUC is affiliated with the university of Western On=
tario but operates on Catholic principles. Daniel Grace said he pinned an=
envelope of condoms outside his door so students could have easy, anonym=
ous access to condoms to practice safe sex.
=93I'm a Catholic myself, but the reality is, if condoms aren't avai=
lable, students will have sex anyway and risk getting pregnant, risk gett=
ing sexually transmitted disease, risk getting HIV,=94 said Grace. =93Thi=
s is a health and safety issue, not an attack on the church. Catholic bis=
hops in Africa hand out condoms to fight AIDS. The needs of the community=
must come first,=94 the social justice scholar said. Losing his job mean=
s Grace no longer receives free accommodation and so must find an off-cam=
pus apartment.
=93We are a Catholic institution built on land owned by the Diocese =
of London, and while we have full academic freedom and students from dive=
rse religious backgrounds, we absolutely could not officially distribute =
condoms,=94 said Mary Carol Watters, dean of students. =93We know student=
s have condoms and we are quick to tell them where they're available and =
we encourage peer health education =97 but the decision has been made tha=
t we will not actively distribute them or make them available through was=
hroom vending machines.=94
Dons had been discreetly providing condoms for years at King's Colle=
ge without repercussions, but the college stopped that after a complaint =
was made this fall to the college chaplain and the local bishop was consu=
lted. On three occasions, the chaplain met with Grace but failed to persu=
ade him to follow church doctrine, said Watters. Neither the chaplain nor=
the bishop could be reached for comment.
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MEDICAL NEWS=09
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MEXICO:
=93Disease Associations: Less Morbidity/Mortality from Opportunistic Infe=
ctions in Mexico Since HAART=94
AIDS Weekly (09.27.04)
=93Opportunistic infections (OIs) complicate the outcome of HIV-posi=
tive patients. There have been observed regional differences in the incid=
ence and the prevalence of OIs in AIDS patients secondary to immunologica=
l deficiencies, environmental factors and socioeconomic and sanitary cond=
itions,=94 wrote L.E.M. Delcampo-Rodriguez and colleagues.=20
Global incidence of OIs at the beginning of the HIV/AIDS epidemic wa=
s 60-100 percent. But pharmacological prophylaxis, enhanced medical care =
and the introduction of antiretroviral therapy have decreased the inciden=
ce of tuberculosis, intestinal pathogens, Pnuemocystis jiroveci and Mycob=
acterium avium in the Western hemisphere. The researchers noted this phen=
omenon has been more evident in the United States, in Western Europe and =
in most Latin American countries.=20
=93At the beginning of the HIV epidemic the frequency of the differe=
nt OIs in Mexico was similar among all the clinical reports; the majority=
of the cases showed mucocutaneous or esophagic candidiasis, followed by =
P. jiroveci pneumonia, and Cryptosporidium sp. enteritis,=94 said the res=
earchers. They went on to report an increase in =93the number of episodes=
of CMV retinitis and M. avium disseminated infection as evidence of a pr=
olonged survival of the HIV-positive patients.=94
Thus, =93the morbidity and mortality rates in the HIV-positive patie=
nts have diminished as a result of the improvement of the medical care, t=
he application of specific OIs prevention measures and more recently to t=
he introduction of HAART.=94
The full report, =93Opportunistic Infections in the Acquired Immunod=
eficiency Syndrome: the History in Mexico 20 Years After the Beginning of=
the Epidemic,=94 was published in Revista de Investigacion Clinica (2004=
;56(2):169-180).
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LOCAL AND COMMUNITY NEWS=09
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CONNECTICUT:
=93Changes Made in Sex Education=94
Hartford Courant (11.04.04)::Don Stacom
Hartford's middle schools began a new sex education program on Thurs=
day, created in response to parent complaints that the old curriculum was=
too explicit. But prior to the school board's approval of the new curric=
ulum on Wednesday, some parents objected to it as well, saying some conte=
nt is inappropriate for pre-teenagers and abstinence, rather than safe se=
x or birth control, should be the focus.=20
=93This is sending mixed messages to children,=94 Suzanne LaFrance s=
aid at the meeting. Board member Jane Anastasio agreed with complaints th=
at two videos in the new program were too explicit, but she and board mem=
ber Michael Uchalid praised most of the program, saying it addressed most=
of the parents' concerns. The videos address topics such as condoms and =
STD and HIV/AIDS prevention.
One parent argued that the board had rushed through a program revisi=
on and did not allow parents enough opportunity to get involved. Anastasi=
o rejected this complaint. =93A lot of work went into this,=94 she said. =
=93We did rush this, but it was because parents wanted something in place=
for this year. And they've been notified of exactly what we're doing.=94
The new curriculum was unanimously approved after the board voted 7-=
1 to accept Anastasio's recommendation to drop the two videos. Board memb=
er Christopher Wilson cast the sole dissenting vote, saying the videos pr=
esented useful information. Administrators said that information could st=
ill be discussed, and that the overall curriculum would not be harmed by =
dropping the videos.=20
Last spring, a group of parents petitioned the board to change the s=
ex education program for sixth-, seventh- and eighth-graders. Parents can=
opt their children out of the program.
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NEWS BRIEFS =09
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SOUTH AFRICA:
=93South Africa AIDS Activists March over Drugs Timetable=94
Reuters (11.04.04)
On Thursday across South Africa, thousands of activists took to the =
streets to support the Treatment Action Campaign's renewed fight with hea=
lth authorities over plans to provide free HIV drugs. In Cape Town, hundr=
eds of TAC supporters marched on parliament to demand that the state pay =
the group's legal costs for litigation seeking a timeline for the drug pr=
ogram's launch. Similar actions were held in Pretoria and other cities. M=
any protesters wore T-shirts proclaiming their HIV-positive status. In Oc=
tober, TAC dropped its lawsuit demanding that the government release its =
plans after the Department of Health revealed that no cabinet-approved do=
cument existed. In a statement, TAC said, =93We are asking the High Court=
to hold [the health minister] to account by making her pay our wasted le=
gal costs.=94=20
KAZAKHSTAN:
=93Over 4,500 People HIV-Positive in Kazakhstan=94
Xinhua News Agency (11.05.04)
As of Oct. 1, 4,531 people in Kazakhstan were registered as HIV-posi=
tive, of whom 206 had developed AIDS, Zamzagul Zhamagulova, a senior epid=
emiologist, told a national seminar on HIV/AIDS and drug abuse on Thursda=
y. The actual number of HIV-positive could exceed 20,000, Zhamagulova add=
ed. Seventy-seven percent of HIV cases are males, and drug use is the maj=
or cause for infection (78 percent), she noted. Two-thirds of those infec=
ted are ages 15-29. The country's HIV prevalence is attributable to the t=
rafficking of heroin from nearby Afghanistan. Kazakhstan has the fifth-la=
rgest number of HIV patients among the Commonwealth of Independent States=
, said Zhamagulova.
RUSSIA:
=93Over 450 HIV-Infected Registered in Chechnya=94
ITAR-TASS News Agency (11.04.04)::Sergei Ovsienko
There are now 457 people registered as HIV-positive in Chechnya, inc=
luding 32 children, and the number of AIDS patients over the last two yea=
rs has risen to 306, Kheda Aidamirova, head doctor of the republic's AIDS=
center, said Thursday. =93The official number of registered patients is =
only the tip of the iceberg,=94 said Aidamirova, adding she expects HIV/A=
IDS rates to continue to rise. Chechen medical facilities, especially in =
the countryside, are under-prepared for HIV testing, she said. The republ=
ic lacks a specialized blood-transfusion center to test for the presence =
of HIV. Aidamirova said Chechnya is grappling with a growing drug problem=
, with unofficial data estimating 10,000 drug addicts. She noted the Chec=
hen Public Health Ministry has approved a program to fight the spread of =
HIV/AIDS in the republic.
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