| prevention-news@cdcnpin.org 2005-03-19, 5:18 pm |
| CDC HIV/STD/TB Prevention News Update
Friday, March 11, 2005
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. The following summaries were prepared without conducting any additional research or investigation into the facts and statements made in the articles being summarized, and therefore readers are expressly cautioned against re
lying on the validity or invalidity of any statements made in these summaries. 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 and
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tracted below for full texts of the articles.
HEADLINES
NATIONAL NEWS
UNITED STATES: "Digene Ads to Promote Company's HPV Test"
LOUISIANA: "Tulane Will Study Virus Resistance"
INTERNATIONAL NEWS
THAILAND: "Thais Protest Anti-AIDS Drug Trial"
UNITED KINGDOM: "Steady Rise in UK Heterosexual HIV Infections"
GLOBAL: "AIDS Experts Want Drug Addicts to Have Better Access to Clean Needles"
SOUTH AFRICA: "Durbanites Likely to Shun HIV Testing, Says Survey"
MEDICAL NEWS
UNITED STATES: "Hepatitis Outbreak Tied to Use of Test Devices"
UNITED STATES: "More Patients Got Wrong Syphilis Medication at Gay Center, CDC Says"
NEWS BRIEFS
UNITED STATES: "For the Record"
MOZAMBIQUE: "Brazil to Build AIDS Drugs Factory in Mozambique"
GLOBAL: "France Calls for Doubling of International AIDS Funds by 2007"
TEXAS: "AIDS Walk"
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NATIONAL NEWS
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UNITED STATES:
"Digene Ads to Promote Company's HPV Test"
Washington Post (03.10.05)::Michael S. Rosenwald
On Wednesday, Digene Corp. announced it has launched a print and TV ad campaign to promote its test for human papillomavirus (HPV). According to a survey sited by the company, most women do not know that HPV causes cervical cancer.
Despite the recommendation of a physicians' group that women over 30 be screened for HPV during their regular Pap test, sales growth of Digene's test has been below expectations.
This month, the company is debuting print ads in nine magazines, including Ladies Home Journal, Redbook, Woman's Day, and People. Last week, Digene began running TV commercials for the test during daytime programming in Philadelphia, Atlanta, and Bal
timore. The company said these cities have both reasonable ad rates and sizable populations of women over 30.
Digene said the campaign seeks to convey three key messages: HPV causes almost all cases of cervical cancer; abnormal, precancerous cervical cells are not detected by a Pap test alone; and using the HPV test with the Pap test can help doctors reduce
the chance that patients will develop cervical cancer.
The campaign's initial cost will be $3 million to $6 million, estimated Digene CEO Evan Jones.
LOUISIANA:
"Tulane Will Study Virus Resistance"
The Advocate (Baton Rouge) (03.10.05)::Joe Gyan Jr.
The National Institutes of Health's National Institute of Allergy and Infectious Diseases has awarded a five-year grant of more than $2 million to the Tulane National Primate Research Center. Scientists will use the money to study why some monkey spe
cies are able to resist developing AIDS when infected with the monkey equivalent of HIV. Ivona Pandrea, principal investigator of the study, said she hopes it will help researchers find ways to enhance the human immune system to delay the onset of AIDS in
people with HIV.
Scientists once thought that the natural hosts of simian immunodeficiency virus (SIV), such as African green monkeys, did not progress to AIDS when infected with SIV, Pandrea said, but recent research shows the natural hosts can progress to AIDS afte
r a prolonged period of asymptomatic SIV infection. "While a rhesus monkey typically develops AIDS two to four years after infection, and a human may not develop AIDS for five to 10 years after infection, the African [green] monkeys may not develop AIDS f
or 20 years, if ever," said Pandrea, who has studied infection in mandrills and African green monkeys.
"We discovered that these monkeys harbor high viral loads, but there are very few cases of AIDS in this species, which may occur only after a very long incubation period that generally exceeds the normal life span of these monkeys, as least in the wi
ld," Pandrea said.
The center, which is affiliated with Tulane University, is the largest of eight national primate research centers funded by NIH.
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INTERNATIONAL NEWS
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THAILAND:
"Thais Protest Anti-AIDS Drug Trial"
Associated Press (03.10.05)
On Thursday in Bangkok, activists protested plans, proposed by the US CDC and approved by Thailand's Public Health Ministry, to test the efficacy of Tenofovir on hundreds of volunteers. The Thai trial of the AIDS drug, also known as Viread D, will in
volve 1,600 intravenous drug users in Bangkok.
The drug is also to be tested at sites in the United States and Africa. In some countries, planned trials of Tenofovir have been cancelled amid allegations that its manufacturer, Gilead Sciences Inc., failed to take steps to prevent subjects from bei
ng infected and did not offer continuing care for those who might contract HIV. In August, Cambodia's premier halted a Tenofovir trial that would have involved hundreds of sex workers. A planned trial in Cameroon was cancelled this year.
The Thai Drug Users' Network and other AIDS groups issued a statement Thursday opposing Thailand's approval of the tests because of alleged ethical violations and the failure to consult the entire HIV community. Paisan Suwannawong, director of the Th
ai AIDS Treatment Action Group, alleged that Gilead has failed to provide subjects with injecting equipment. Seree Jintakanon, chairperson of the Thai Drug Users' Network, said there has been no promise of treatment for volunteers diagnosed with HIV when
seeking to join the trial or for those who might become infected during the three-year test.
Last year, Gilead responded to such concerns by saying all participants receive extensive counseling. The company said it is not compelled to provide lifetime health coverage for participants because they are being given prevention information that w
ill make them less likely to contract HIV.
UNITED KINGDOM:
"Steady Rise in UK Heterosexual HIV Infections"
Reuters (03.10.05)
HIV infections among British heterosexuals have increased steadily in recent years, though gay men still account for 80 percent of newly diagnosed UK cases, according to a Health Protection Agency report.
More than 21,000 of the 56,308 adults diagnosed with HIV in England, Wales and Northern Ireland between 1985 and 2003 were infected through heterosexual sex. HPA warned that cases are likely to continue to increase, especially among ethnic minorities
. "The number of people becoming infected with HIV through heterosexual intercourse in the United Kingdom is rising steadily," HPA's Sarah Dougan and colleagues said.
Around 75 percent of newly diagnosed HIV cases among heterosexuals were female, and 62 percent had a partner who acquired the virus outside Europe. Nearly 80 percent of those partners were likely infected in Africa, which has the highest rates of HIV
/AIDS, said Dougan.
According to health experts' estimates, 53,000 people are infected with HIV/AIDS in the United Kingdom but about one-fourth of them do not know their status.
The full report, "HIV Infections Acquired Through Heterosexual Intercourse in the United Kingdom: Findings from National Surveillance," was published online in the British Medical Journal (doi:10.1136/bmj.38393.572188.EB).
GLOBAL:
"AIDS Experts Want Drug Addicts to Have Better Access to Clean Needles"
Associated Press (03.10.05)::Susanna Loof
At the UN Commission on Narcotic Drugs meeting Thursday in Vienna, several AIDS experts said thousands of lives could be saved through the harm reduction strategy of giving IV drug users access to clean needles.
About 10 percent of new HIV infections are acquired through the sharing of tainted needles, according to the World Health Organization. These infections could be prevented by the universal implementation of harm reduction, said Joanne Csete, executiv
e director of the Canadian HIV/AIDS Legal Network. However, harm reduction remains controversial, with some opponents, including the United States, arguing that it promotes drug use. The commission is "too timid in its support for drug users' rights to pr
otect themselves from HIV," said Csete.
In Brazil, needle-exchange programs have proven effective, said Cristina Pimenta, chief of HIV/AIDS prevention in its National AIDS Program. In 1995, a quarter of new HIV infections in Brazil were through injection drug use; by 2004, that proportion
had fallen to 13 percent. "This decrease is directly related to harm reduction measures implemented during that period," Pimenta said. Responding to program critics, she said, "the Brazilian policy does not support or stimulate drug use in any way."
Earlier in the week, Commission Director Antonio Maria Costa said needle-exchange programs were appropriate if they were part of a broader drug-control strategy. The commission ought to support harm reduction measures more strongly, said Jonathan Coh
en, an HIV/AIDS researcher with the New York-based Human Rights Watch.
SOUTH AFRICA:
"Durbanites Likely to Shun HIV Testing, Says Survey"
Business Day (03.07.05)::Tamar Khan
A recent survey by Khulisa Management Services indicates people living in Durban, located in the KwaZulu-Natal province, are less likely to take an HIV test than residents of Cape Town and Johannesburg. KwaZulu-Natal has South Africa's highest HIV pr
evalence.
"We don't know what the underlying reasons are," said Scott Billy of New Start VCT [Voluntary Counseling and Testing] Center, which commissioned the study. Working with the US CDC, the South African government is setting up walk-in testing centers to
target people who prefer not to use public health testing facilities.
KMS surveyed 892 Durban households and found that 72 percent of respondents had no intention of getting tested for HIV in the next 12 months, compared with 42 percent of Cape Town residents and 53 percent of people in Johannesburg. Overall, 33 percen
t of respondents ages 18-35 have taken an HIV test, and 43 percent intended to go for testing in the next 12 months, KMS reported.
The survey also found that South Africans recognize that HIV testing provides an opportunity to change their behavior and adopt a healthier lifestyle whether they test positive or not, said Billy. Women make up the majority of South Africans seeking
HIV tests at public clinics, he added.
According to treasury estimates of expenditure for 2005, 3,368 public health facilities are already offering voluntary HIV counseling and testing. That figure is expected to rise to 5000 by the end of March 2006.
New Start VCT Centers in the country's three largest cities are aimed at men ages 25-29, as they are the group most reluctant to use public clinics, Billy added.
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MEDICAL NEWS
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UNITED STATES:
"Hepatitis Outbreak Tied to Use of Test Devices"
Reuters (03.10.05)::Paul Simao
Improperly used blood sugar testing devices likely contributed to a string of hepatitis B virus (HBV) outbreaks in nursing homes in Mississippi and North Carolina and an assisted living center in California, CDC officials said Thursday. CDC's finding
followed an investigation into about three-dozen HBV cases, including two deaths, that surfaced in 2003 and 2004.
The HBV cases in the long-term care facilities initially raised suspicion because they occurred largely among elderly diabetics, according to CDC's report. Around 70,000-80,000 Americans contract HBV each year, but most cases are found in young adult
s who have unprotected sex with an infected partner or shared contaminated needles while injecting drugs. Investigators soon learned that the nursing home patients were sharing some of the equipment used to monitor blood sugar, including parts of fingerst
icks and glucometers, allowing for the possibility of cross-contamination. In addition, some nursing staff were not wearing gloves or disinfecting their hands when administering the tests.
Since 1990, CDC and the Food and Drug Administration have recommended that fingersticks, which draw a trace amount of blood with a single prick, be limited to a single use. CDC also advises against the sharing of glucometers.
Dr. Anthony Fiore, a CDC epidemiologist and co-author of the report, said he suspects that other long-term care facilities are falling short of the federal guidelines, increasing the risk for HBV outbreaks. "These facilities looked perfectly nice and
probably provided the same standard of care than many others provide," said Fiore. "I think it's a problem that could potentially exist elsewhere."
Fiore noted that the three recent outbreaks were not reported or investigated in a timely manner, complicating efforts to contain the spread of HBV, which is sometimes asymptomatic.
The full report, "Transmission of Hepatitis B Virus Among Persons Undergoing Blood Glucose Monitoring in Long-Term-Care Facilities - Mississippi, North Carolina, and Los Angeles County, California, 2003-2004" was published in CDC's Morbidity and Mort
ality Weekly Report (2005;54(09):220-223).
UNITED STATES:
"More Patients Got Wrong Syphilis Medication at Gay Center, CDC Says"
Los Angeles Times (03.11.05)::Eric Malnic
On Thursday, CDC reported that the Los Angeles Gay & Lesbian Center inadvertently administered the wrong kind of penicillin to more than 650 patients between January 1999 and March 2004 who either had syphilis or reported sexual contact with someone
known or believed to have syphilis. When the mistake was discovered a year ago, it was thought that only 300 people were affected. The mistake was discovered after a patient read a package insert stating that the medicine was not intended to treat syphili
s, said CDC.
Penicillin is a main treatment for syphilis, but different formulas exist, said county health authorities. LAGLC clients received Bicillin C-R, which contains only half the dose of CDC's recommended penicillin formula for treating syphilis, Bicillin
L-A (benzathine penicillin G).
Based on data compiled on Jan. 26, investigators were able to contact 282 of the 429 male patients with confirmed syphilis infections. Of the 282 patients, 255 were re-treated with the correct penicillin formula, eight await evaluation, and 19 refuse
d to be re-treated. Investigators contacted another 116 of 234 patients - all but five of them male - who were treated after reporting sexual contact with someone with the STD. Of the 116 patients, 98 were tested and 22 showed evidence of previous infecti
on. Of those 22 patients, 19 were re-treated and three refused re-treament.
As an outcome of the investigation, King Pharmaceuticals, whose subsidiary, Monarch Pharmaceuticals, markets Bicillin, has agreed to packaging and label changes to reduce the chance of future mix-ups.
A report on the case, "Inadvertent Use of Bicillin C-R to Treat Syphilis Infection - Los Angeles, California, 1999-2004," is published in Morbidity and Mortality Weekly Report (2005;54(09):217-219).
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NEWS BRIEFS
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UNITED STATES:
"For the Record"
Washington Post (03.11.05)::David Brown; Dana Priest
Sens. Rick Santorum (R-Pa.) and Richard J. Durbin (D-Ill.) said they will seek to more than double the Bush administration's proposed contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria. Santorum and Durbin want to boost the US co
ntribution to the fund to $800 million in fiscal year 2006; the White House requested $300 million. The fund has provided a total of $3.1 billion to 313 programs in 127 countries since late 2002,.
MOZAMBIQUE:
"Brazil to Build AIDS Drugs Factory in Mozambique"
Agence France Presse (03.10.05)
Wednesday in Maputo, Brazilian Foreign Minister Celso Amorin said his country plans to build a pharmaceutical plant in Mozambique to produce generic AIDS drugs. "We already have the financing to carry out feasibility studies for this factory," Amorin
said as he wrapped up his one-day visit to the country. Mozambique, like Brazil, was once a colony of Portugal. "Health ministry officials will come to discuss the final details," said Amorin. No date has been set for construction. According to UNAIDS, s
ome 12.2 percent of adults in Mozambique, or 1.3 million people, are living with HIV/AIDS.
GLOBAL:
"France Calls for Doubling of International AIDS Funds by 2007"
Agence France Presse (03.09.05)
The French government on Wednesday called for doubling international AIDS funding to $15 billion by 2007. The money could be acquired through a tax on airplane fuel, as proposed earlier by President Jacques Chirac at the Davos World Economic Forum, s
aid Xavier Darcos, the French Minister for Cooperation. "Even to attain this figure, the international aid budgets will not be enough," Darcos said on the sidelines of an international conference in London. "France thinks that we have to find other innova
tive sources of finance to fight against AIDS." A French proposal to add a one-dollar surcharge to airline tickets has met US opposition.
TEXAS:
"AIDS Walk"
Houston Chronicle (03.10.05)
AIDS Foundation Houston Inc. and J.P. Morgan Chase & Co. will host the annual AIDS Walk Houston on Sunday, March 13, at Sam Houston Park. Registration begins at 8 a.m. The walk starts at 10 a.m. For more information, telephone 713-403-WALK or visit t
he Web site www.aidswalkhouston.org.
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