HIV/AIDS Newsroom: January 11, 2001
HIV/AIDS Surging in Eastern Europe
Journal of the American Medical Association (www.jama.com)
12/27/00; Vol. 284, No. 24, P. 3113; Stephenson, Joan
Health officials from the Joint United Nations Program of HIV/AIDS (UNAIDS) and the World Health Organization have reported that cases of HIV have increased dramatically in Eastern Europe. The group's annual report said there were approximately 700,000 people in Eastern Europe living with HIV, versus just 420,000 one year ago. The report noted, however, that underreporting could mean that the actual number of infections in Eastern Europe may be significantly higher. Calling the figures "alarming," Dr. Peter Piot, executive director of UNAIDS, said the increase in HIV cases in the region can be attributed primarily to injection drug users. Adding to that problem, warn health experts, is the potential for HIV to spread even further among drug users and their sexual partners, particularly in Russia, where the estimated number of people living with HIV more than doubled from year-end 1999 to year-end 2000.
Researchers studied hospitals and clinics in the rural regions of Colorado and found evidence of inconsistent policies regarding hepatitis B virus (HBV) vaccination for newborns. According to the authors, the study was designed to evaluate specific hospital policies regarding the administration of the HBV vaccination in rural Colorado, communication to clinicians directing the administration of the vaccine, the scope of undervaccination as evidenced by ineffective communication to primary care physicians, and the resources clinicians utilized to determine neonatal HBV vaccine status. The study revealed that most of the rural Colorado hospital nurseries surveyed do not have either standing orders for HBV vaccination or policies for communicating vaccine administration to clinicians. Standing orders, the authors explain, can be an effective method of promoting vaccination for neonates, as evidenced by an Australian study which found that a hospital with standing orders for neonatal shots used the HBV vaccine 20 percent more than a hospital without the orders.
The High Cost of Selling Blood
Washington Post (www.washingtonpost.com)
01/11/01; P. A1; Pomfret, John
In China, thousands of people have contracted HIV after selling blood to dealers who reused needles, mixed blood products, and reinjected infected blood back into their veins after the plasma was separated out. Many poor farmers in China's central plains have tried to alleviate their poverty by routinely selling their blood. In Chenglao, for example, some farmers report that before government intervention about five years ago, they earned about $250 annually for approximately 80 blood sales, about the same as their income from farming. Also, in 1993, a Health Ministry plan to export blood products helped increase the blood market. In many cases, middlemen, called blood heads, bought farmers' blood and sold it to hospitals and blood banks. To enable sellers to give more blood sooner, the blood heads would use a technique that involved removing the plasma from the blood and then returning the rest of the blood to the seller. However, sellers of the same blood type were often connected to the same machine, and the blood returned to them came from a number of people. While injection drug use is responsible for the majority of the HIV cases in China and sexual transmission is on the rise, as many as 20 percent of the infections stem from blood sales. Statistics on HIV and AIDS in the country are sketchy, but Health Ministry data indicate that, as of late September, more than 20,000 Chinese were infected with HIV and over 700 had AIDS. Most experts, though, believe the actual numbers are much higher -- as many as 1 million HIV infections, according to some estimates.
In a commentary in the New York Times, Bob Herbert discusses the spread of HIV through African-American communities in this country. Statistics show that AIDS is the No. 1 cause of death for African Americans between the ages of 25 and 44. Furthermore, over 50 percent of all new HIV cases are among African Americans, even though they represent just 13 percent of the American population. Given these and other alarming statistics, Herbert questions why the epidemic is not receiving more attention. Dr. Helene Gayle, head of the Centers for Disease Control and Prevention's National Center for HIV, STD, and TB Prevention, notes that AIDS is "an overwhelming problem in the African-American community. It has continued to increase along a trajectory that we had talked about for a long time." Herbert points out that while African-American religious leaders and politicians are starting to do more, "voices here and there are not enough. Nothing less than a mighty chorus is needed to cope with this overwhelming tragedy."
According to a report published in the December issue of the American Journal of Respiratory and Critical Care Medicine (2000;162:2238-2240), sputum induction is safe and effective for diagnosing pulmonary tuberculosis (TB). The study noted that the results and diagnostic yield of this test are on a par with those obtained using bronchoalveolar lavage. Tests performed on 251 patients with suspected pulmonary TB but who could not generate sputum spontaneously or who were smear-negative for acid-fast bacilli showed that 57 percent were diagnosed with pulmonary TB, including those who were infected with HIV. Brazilian researchers note that there was no major difference in acid-fast bacilli smear or culture yields based on the technique used to collect them.
New research suggests that children who had previously been treated with nucleoside reverse transcriptase inhibitors (NRTIs) and then received a combination of abacavir, lamivudine, and zidovudine saw increased antiretroviral activity. Researchers from Hospital del Nino in Panama City studied 205 children between the ages of three months and 13 years. The patients were randomized to receive either abacavir or a placebo; all participants received lamivudine and zidovudine twice a day. According to their report in the journal Pediatrics (2001;107(1)), 29 percent of the children taking abacavir attained HIV-1 RNA levels of less than 10,000 copies/mL, compared to just 12 percent of those receiving the placebo. In addition, patients in the abacavir group saw their CD4 cell counts increase by a median 99/mL, while the median CD4 level of those in the placebo group dropped 14/mL.
Dr. Bruce Walker, head of the Partners AIDS Research Center at Massachusetts General Hospital, will partner with Genzyme Molecular Oncology to study and identify novel peptides that could be used as HIV vaccines. Dr. Walker is known for his work in the AIDS arena, discovering the cytotoxic T(CTL) cell response to HIV-infected individuals and identifying how both the T helper cell responses and CTL responses are present in individuals capable of controlling HIV without drug treatments.
South Africa has abandoned its plans to make AIDS a reportable disease, fearing the infected individuals would be treated as social outcasts or become the target of violent retribution. The decision also reflects the government's hope that South Africans will voluntarily seek HIV testing without the fear of losing their anonymity. Originally, health officials hoped to use mandatory reporting as a means to track the disease throughout the country; however, concerns about privacy and the stigma surrounding the disease in South Africa were too strong.
Strong criticism from local churches and some government circles has prompted Zambian officials to pull new safe sex advertisements off the air. Church groups argued that the advertisements -- intended to stem high rates of HIV infection, especially among young people -- encouraged sexual promiscuity. One ad showed teenage girls discussing sex and condoms, while another illustrated how to use a condom. Minister of Health Enoch Kavindele said the suspension of the ads was only temporary until their contents were completely reviewed and re-edited.
In Zambia, former president Kenneth Kuanda is planning to set up two radio stations to increase awareness and understanding about AIDS. According to a report in the government-owned Times of Zambia, the stations will be launched via the Kenneth Kaunda Children of Africa Foundation, a group he established to help AIDS orphans. The two stations, situated in the Western and Northern provinces of the country, should cover the entire southern African region, Kuanda said.
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.