HIV/AIDS Newsroom: August 24, 2000
Double Blind Randomized Placebo Controlled Trial of Adjunctive Prednisolone in Treatment of Effusive Tuberculous Pericarditis in HIV Seropositive Patients
Heart Online (heart.bmjjournals.com)
08/00 Vol. 84, No. 2, P. 183; Hakim, J. G.; Ternouth, I.; Mushangi, E.; et al.
Researchers from Zimbabwe conducted a study to determine how adjunctive prednisolone affects the morbidity, pericardial fluid resolution, and mortality of HIV-seropositive patients with effusive tuberculous pericarditis. The study involved 58 patients between the ages of 18 and 55. Following a short course of antituberculous chemotherapy, the patients received treatment with prednisolone or placebo for six weeks. After 18 months, five patients who took prednisolone and 10 patients who took placebo had died. According to the researchers, patients randomized to receive prednisolone achieved a significantly quicker resolution of increased jugular venous pressure, hepatomegaly, and ascites. However, they note that the rate of radiologic and echocardiographic resolution of pericardial effusion was comparable in both groups.
U.S. physician and clown Patch Adams, whose story was portrayed in a movie by actor Robin Williams, recently visited AIDS orphans and villagers in Romania in an effort to promote AIDS awareness. Approximately 9,000 children in Romania are infected with HIV -- many of whom contracted the virus as the result of poor sanitation, a lack of disposable syringes, and unscreened blood. However, while Adams' visit evoked laughter and dancing, many area residents are still reluctant to allow people with AIDS a place in the community. Indeed, some villagers prohibit their children from playing with HIV-positive youngsters, and, in one town, the local council barred teachers from going to the region's orphanage school for fear of accidental infection.
HIV Counseling for Marriage to End This Year [in Michigan]
Detroit Free Press (www.freep.com)
08/23/00; Hopgood, Mei-Ling
Starting next year, couples in Michigan will not need HIV counseling to receive a marriage license. This is the first time in many years that couples in the state will not have to be tested, counseled, or show proof that they have no sexually transmitted diseases (STDs) before marrying. Testing for venereal diseases stopped in 1985, but couples still had to show a doctor's certificate regarding STD health after that date. The AIDS counseling requirement was added in 1988. Critics of the change believe it reflects a growing complacency towards AIDS, and they note the counseling provided a good opportunity to teach people about the disease. Jean Brandt, the sexual health coordinator at the New Health Agency in Livonia, notes, "The greatest enemy we have in the age of HIV and AIDS is complacency and people who believe the epidemic is over. All we have to fight that is education and prevention." State health officials now plan to focus on higher-risk groups, including young people and drug users, and will distribute a brochure about HIV and AIDS to couples when they apply for their marriage license.
Vermilion County, Ill., has seen eight new cases of syphilis since June, the first month of a local outbreak. A total of 14 cases of syphilis have been recorded in the county over the past nine months. The Vermilion County Health Department is unsure what caused the outbreak, the worst seen in over 20 years. Health officials are studying factors like prostitution and drug use to see if they are related factors.
A case of a false-positive HIV test result is presented in the Archives of Internal Medicine (2000;160:2386-2388) by Dr. Eleftherios Mylonakis of Massachusetts General Hospital and colleagues. According to the researchers, the false-positive test shows the need for repeated HIV testing and follow-up to prevent unnecessary treatment. A screening of the 43-year-old male patient was reactive using ELISA but inconclusive under Western blot analysis; additional Western blot tests found positivity at gp160 and gp41 bands, while repeat ELISA was weakly reactive. Dr. Mylonakis stated it is important to take all factors into consideration for diagnosis, including CD4 cell count.
At an economic conference in Maputo, Mozambique, on Tuesday, Ugandan President Yoweri Museveni recommended using radio broadcasts to help educate people about AIDS. "This has been very successful in Uganda, where we had to eliminate misbeliefs among our population very quickly to prevent the pandemic from gaining more ground," Museveni said. He noted, however, that school AIDS programs were also needed for children who do not listen to the radio or read the newspaper. Museveni -- whose country is one of the few African nations to successfully stem the spread of HIV -- also said that politicians need to join the anti-AIDS fight, particularly because they "have a better chance of putting the message across and to a wider audience than an ordinary health ministry official."
Forty-five new cases of AIDS were recorded in Yemen during the first half of the year. According to Abdullah Habbabi of the AIDS department at the Yemeni central lab, 24 of the new infections were among Yemenis and 21 were among foreigners. Since July 1998, 605 people have been diagnosed with AIDS in Yemen.
Zambia's AIDS coordinator, Dr. Moses Sichone, announced Tuesday that over 200 HIV infections occur every day in the country. He estimated that nearly three-quarters of Zambian families care for at least one AIDS orphan. Dr. Sichone cited poverty as a factor leading to AIDS, as Zambia deals with external debts that hinder investment in the health sector. The AIDS coordinator was hopeful that new political commitment to fighting AIDS will render results. U.S. AID official Allan Reed also noted that AIDS is a development crisis, and they "must mobilize every part of society to respond."
Almost 10 percent of Nepal's deaths from AIDS take place in the district of Morang, which borders India. According to a report in the Kathmandu Post, 141 people died from AIDS in Nepal last year, including 10 people in Morang. In addition, of the estimated 1,500 HIV cases in the country, about 115 people are in Morang. Usha Koirala, chief of the HIV Coordination Section in Morang, attributed the rise in HIV cases to ignorance about safe sex, especially among people who visit prostitutes.
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.