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National News
International News
Medical News
Local and Community News
News Briefs
Tuesday, May 03, 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 relying 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 announcements. Reproduction of this text is encouraged; however,
copies may not be sold, and the CDC HIV/STD/TB Prevention News Update
should be cited as the source of the information. Contact the sources of
the articles abstracted below for full texts of the articles.
National News
UNITED STATES: "FDA Approves Once-Daily Version of Abbott's
Kaletra Drug for HIV"
Wall Street Journal (05.02.05):: Down Jones Newswires
The US Food and Drug Administration has approved a once-daily
formulation of Abbott Laboratories' protease inhibitor Kaletra.
Once-daily Kaletra will offer patients and physicians more flexibility
than the current twice-daily dosage, the company said.
Once-daily Kaletra will be offered in both liquid and softgel
capsule forms. Abbott said a Health and Human Services panel has
recommended a combination of Kaletra with zidovudine or stavudine plus
lamivudine as the preferred protease inhibitor-based treatment regimen
for patients starting HIV therapy. Kaletra is the most-prescribed
protease inhibitor in the United States, Abbott said.
Abbott said the new approval was based on data from a clinical
study of 190 treatment-naïve HIV patients. The 48-week study compared
the once-daily and twice-daily Kaletra doses. Both doses were given with
once-daily tenofovir and emtricitabine. Comparable virologic responses
were found between the two groups, and once-daily Kaletra was generally
well-tolerated. The most common side effects reported by both groups
were nausea and diarrhea. Reports of diarrhea were more common in the
once-daily group.
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NEW JERSEY; NEW YORK: "Advocates Fear Loss of AIDS Funds"
The Record (Bergen County, N.J.) (04.28.05):: Tom Meagher
The supervision of AIDS funding for North Jersey could be placed
under New York City purview, potentially removing funds from local
providers and stakeholders.
As a result of the 2000 Census, the federal government
re-crafted the statistical boundaries of metropolitan areas.
Consequently, with respect to federal legislation and funding, the
Office of Management and Budget grouped Bergen, Passaic, and Hudson
counties in the same area with New York City. In addition, two national
AIDS advocacy groups are proposing placing North Jersey's estimated $5
million annual Ryan White funding under New York City's planning
jurisdiction.
"Twenty-five percent of the people in the state of New Jersey
who are infected would now be under the control and the whims and wishes
of New York City," said Karen Walker, Paterson Counseling Center's
director of HIV services. Walker just completed 10 years as a member of
the Paterson-Passaic County-Bergen County HIV Health Services Planning
Council, which decides the local distribution of federal HIV funds.
Putting North Jersey under New York City oversight will just add
a layer of bureaucracy that costs more money to maintain, said Catherine
Correa, Paterson's Ryan White program director.
The legislation that created Ryan White CARE Act, which is up
for reauthorization, asks Congress to allocate AIDS funds by
metropolitan statistical area designations, said Robert Cordero, a board
member of Communities Advocating Emergency AIDS Relief (CAEAR), which
supports joining the North Jersey-New York City funding areas. "They
will continue to receive their proportionate share," said Cordero, a
former director of New York City's Ryan White planning council.
However, Passaic-Bergen's planning council representation would
decrease from the current 33 members to one or two on a New York City
council. Correa said local organizations would meet with a CAEAR
representative to voice their surprise. Rep. Bill Pascrell Jr.
(D-Paterson) also released a statement opposing the proposed change and
offered to organize New Jersey's congressional delegation to fight it.
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International News
UNITED KINGDOM: "UK Response to Global HIV Epidemic Is
Condemned for Lack of Coordination"
British Medical Journal (04.16.05):: Zosia Kmietowicz
Britain's response to the global HIV/AIDS epidemic has been too
slow, and efforts to control how the money it donates is spent remain
insufficient, according to a critical report by the House of Commons
Public Accounts Committee.
The United Kingdom is the second-largest donor to global
HIV/AIDS programs behind the United States. But in its report, the
public spending watchdog group said the Department for International
Development (DfID), which disburses aid money, supports many
international organizations that devote little of their budgets to
HIV/AIDS. For instance, of the ?1.4 billion (US$2.6 billion) provided to
multilateral groups in 2002-2003, only an estimated ?57 million
(US$107.8 million) actually went toward HIV/AIDS. Likewise, roughly ?19
million (US$35.9 million) of the nearly ?1 billion (US$1.9 billion)
given to the European Union annually is spent on the disease.
DfID should "exert more pressure through its funding to
influence priorities," said MP Edward Leigh, chairperson of the
committee. "DfID needs to give higher priority to tackling the wider
social and economic impacts of the epidemic, including household
poverty."
The report said DfID has responded too slowly in tackling
HIV/AIDS, while conceding that the international community in general
has been slow to address the epidemic. The committee also said the
government's HIV/AIDS strategy was unclear.
DfID must take a closer look at the key issues affecting
AIDS-ravaged countries, said the report. These include the impact of
recruiting health workers from poor nations to the National Health
Service, which in turn threatens those countries' own health
infrastructure; the cost of antiretroviral drugs; and the inequitable
distribution of money among affected countries.
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Medical News
UNITED STATES: "Cervical Cancer Virus Reactivates Sometimes:
Study"
Reuters (04.20.05)
Human papillomavirus (HPV) - the main cause of cervical cancer -
can be reactivated after lying latent in the body for years, providing a
clue as to why HIV-positive women are vulnerable to the cancer,
according to a new study.
Dr. Howard Strickler of New York's Albert Einstein college of
Medicine and colleagues at eight other institutions studied 2,500 women
who were examined every six months for an average of seven years. Most
of the women became infected with HPV at some point, though it
eventually became undetectable due to the immune system's ability to
control it. But in 29 HIV-infected women, HPV infection cleared and then
reactivated - despite the women being celibate for 18 months or longer.
According to the researchers, this fits "a stringently defined
pattern highly consistent with HPV reactivation." "That is, an initially
detected HPV type was subsequently not detected for at least two
sequential visits and then was detected a second time, in a subject who
had remained sexually inactive from the time the HPV type became
undetectable and then detectable again (minimizing the possibility of
new sexual transmission)."
"Our data suggest that undetectable HPV infections become active
much more frequently in HIV-positive women, which helps explain the
extremely high rates of HPV infection in these women," said Strickler.
The findings appear to support regular Pap exams in women with HIV and
those with suppressed immune systems, like cancer or transplant
patients, the researchers said.
The study also noted that women are much more likely to become
infected with HPV after a recent sexual encounter. "Even one male sexual
partner among married women (presumably a monogamous relationship with
the subject's husband) was associated with risk of incident HPV
detection," wrote the authors.
The full study, "Natural History and Possible Reactivation of
Human Papillomavirus in Human Immunodeficiency Virus-Positive Women,"
was published in the Journal of the National Cancer Institute
(2005;97(8):577-586).
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Local and Community News
PENNSYLVANIA: "Retest Clears Child of HIV in Needle Stick"
Philadelphia Inquirer (05.03.05):: Vernon Clark
Last Wednesday, a student at Bayard Taylor Elementary School in
North Philadelphia brought a blood-testing needle to school and used it
to injure 19 students. Because one of the students tested HIV-positive,
all were prescribed HIV drugs as a precaution.
But on Monday, St. Christopher's Hospital for Children notified
the parents of the 19 that a subsequent, more comprehensive test had
cleared the student of HIV. "We have good news about the incident last
week at your child's school," said a letter sent to the parents. "We
have completed our testing and have found that the results of a second,
more specific test for HIV was negative. This means your child should
stop taking the preventive medications that you have been giving them."
The letter said results on hepatitis tests will be released when
available.
Marla J. Gold, dean of the Drexel university School of Public
Health, said that putting the injured students on post-exposure
prophylaxis was proper under the circumstances and the drugs should not
cause the students any long-term side effects.
School district spokesperson Fernando A. Gallard called the
latest results "very good news for the students and their families." The
district will continue to provide support services, including
counseling, for the affected students and their families, he said.
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MARYLAND: "Lawsuit Filed over Sex-Ed; Video on Condoms Among
Objections in Montgomery"
Washington Post (05.03.05):: Lori Aratani
Two groups say they are seeking a temporary injunction in US
District Court today to stop Maryland's largest public school system,
Montgomery County, from teaching a new health curriculum that includes
instruction on condom use and permits discussion of homosexuality. The
semester-long health curriculum, which includes instruction on peer
pressure, safety, and injury prevention, has been piloted at six county
schools this month and will expand to all schools next year.
"We tried to put off this as long as possible," said Steve
Fisher, spokesperson for Citizens for a Responsible Curriculum (CRC),
which, along with the Virginia-based Parents and Friends of Ex-Gays and
Gays (PFEG), is seeking the injunction.
In November, Montgomery's Board of education incorporated
changes to the eighth- and 10th-grade health curriculum. Eighth-grade
teachers can now initiate discussion about homosexuality, whereas before
they could only respond to student-initiated questions on the subject.
Changes to the 10th-grade curriculum include a seven-minute video that
discusses abstinence and condom use, during which a woman uses a
cucumber to teach how to properly put on a condom.
Parents must grant permission for their children to participate
in these particular segments, and they can sit in on the courses if
space is available. The district also allows families to choose an
alternative abstinence-only program.
PFEG and CRC contend the opt-out provision discriminates against
these children by forcibly segregating them and unfairly does not allow
ex-homosexuals to present their viewpoints. Fisher said the curriculum
also fails to emphasize abstinence.
"In general, parents have been supportive of the curriculum,"
said Brian Edwards, the school system's spokesperson. Parent
participation has been low at schools that have held informational
meetings regarding the new curriculum, he said.
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NEW YORK: "Chlamydia Is Top Communicable Disease in County"
Journal News (White Plains) (05.01.05):: Jane Lerner
Chlamydia topped the list of infectious diseases reported to the
Rockland County Health Department in 2004, with 369 residents diagnosed.
The STD has remained the most commonly reported infectious disease in
the county since health officials began tracking cases in 2001. Chronic
Hepatitis C came in second in 2004 with 248 cases recorded. Tick-born
Lyme disease came in a distant third with 172 county residents affected.
Gonorrhea was next, with 89 cases, followed by shigella, a food-borne
bacteria that struck 33 residents.
County Health Commissioner Dr. Joan Facelle said chlamydia
education and treatment efforts are not as visible as those for other
diseases. "You don't necessarily see the efforts to prevent and treat
sexually transmitted diseases," said Facelle.
Public health workers often diagnose chlamydia, a bacterial
infection most commonly found in people younger than age 25. "Chlamydia
is quite prevalent, especially in younger people," said Jennifer
Leonardi, acting vice president of medical services for Planned
Parenthood of Hudson Peconic. "The concern here is that the infection is
mostly asymptomatic - you don't feel anything that makes you think
something is wrong, which is why it's so important that we test for it."
The Rockland Health Department tests all women who utilize its
Women's Health Center for annual exams. In addition, it offers chlamydia
testing to men and women using the county's STD clinic.
Judi Doherty, a public health nurse and a health department
educator, said she frequently talks to high school students about the
consequences of unprotected sex, including chlamydia and other STDs.
"Kids are desperate for this information," said Doherty. "If they don't
get the right information they will talk to each other and make it up.
They have to understand the risks and how they can protect themselves."
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News Briefs
CHINA: "Chinese Region Aims to Provide Free AIDS Treatment for
up to 20,000"
Agence France Presse (05.02.05)
China's impoverished Guangxi Zhuang region bordering Vietnam
plans to offer antiviral treatment for up to 20,000 people with HIV over
the next five to 10 years, the state Xinhua News Agency reported Monday.
However, the news agency did not indicate how the program would be
financed. A local health official was quoted as saying that more people
with HIV had sought treatment at hospitals in recent years. But most
patients wait to seek medical care until they are already very ill,
Xinhua reported.
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OHIO: "Cleveland Charter School Students Tested for TB"
Plain Dealer (04.29.05)
Almost 700 students and staff at Cleveland's Life Skills Center
charter school are being tested for TB after an active case of the
infection was diagnosed three weeks ago. The Cuyahoga County TB Clinic
said the patient's family members have already been tested. Just 44
cases of TB were recorded in the county last year, compared to the usual
yearly average of 70 cases, said the clinic. Anyone testing positive for
TB will have a chest X-ray to confirm an infection, and those who test
negative will be retested again in July.
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FLORIDA: "Center to Ease Hispanics' Transition"
St. Petersburg Times (04.30.05):: Saundra Amrhein
On Friday, community leaders celebrated the opening of the
Multicultural Family Center in Town 'N Country. From it, the Florida
Institute for Community Studies Inc. will operate Proyecto Prevencion
(Project Prevention), whose mission is to fight HIV/AIDS and substance
abuse among local Hispanic teens and their parents. The Florida
Department of Health has designated the center as a site for free,
confidential HIV testing. The center occupies a former dollar store at
6704 Hanley Rd.; its rent will be paid through a $1 million, four-year
grant from the Substance Abuse and Mental Health Services Administration
to the institute. An institute survey of 200 youths and adults found
that one-third of teens do not recall receiving instruction on sex
education or HIV prevention. In the Town 'N Country ZIP codes, HIV/AIDS
cases among Hispanics are five times greater than elsewhere in the
county.
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