HIV/AIDS Newsroom: October 12, 2000
Twice Weekly Isoniazid and Rifampin Treatment of Latent Tuberculosis Infection in Canadian Plains Aborigines
American Journal of Respiratory and Critical Care Medicine Online (www.ajrcc.atsjournals.org)
09/00; Vol. 162, No. 3, P. 989; McNab, Brian D.; Marciniuk, Darcy D.; Alvi, Riaz A.; et al.
A study from the University of Saskatchewan investigated six months of twice weekly directly observed isoniazid and rifampicin treatment for latent tuberculosis (TB) infection. A total of 591 aborigines never treated before received the therapy for six months. The outcome was compared to 403 others who self-administered isoniazid for one year. Eighty-two percent completed the twice weekly regimen, while 19 percent completed the daily year-long regimen. Side effects were more common among those receiving directly observed treatment. The program was well-tolerated overall and improved the outcome for latent TB in a population that had a high rate of default for self-treatment.
A report from the European Children's Trust shows that 50 million children or more in Eastern Europe and Russia live in poverty, exposed to tuberculosis (TB) levels usually found in the developing world. The study, titled "The Silent Crisis," asks the West to help through debt relief, noting that poverty in the region has soared since the fall of Communism. "Since the breakup of the Communist system," the study said, "conditions have become much worse -- in some cases catastrophically so." According to the report, there were an average 67.6 TB cases per 1,000 Eastern European people in 1997, versus 49.6 in Arab states and 35.1 percent in eastern Asia. Within Eastern Europe, TB rates ranged from 20 per 1,000 in the Czech Republic to 150 per 1,000 in Georgia.
South Africans Criticize Leader's Views on AIDS
Washington Post (www.washingtonpost.com)
10/12/00; P. A18; Jeter, Jon
The people of South Africa are no longer quietly enduring President Thabo Mbeki's questioning of the HIV-AIDS link, and some are now displaying bumper stickers that say "HIV Does Cause AIDS." Clerics, labor unions, and former leader Nelson Mandela have called for a consensus that HIV causes AIDS, urging Mbeki to offer antiretroviral drugs to pregnant women with HIV. Although initially hesitant to knock the president, the country's newspapers write daily stories that criticize Mbeki's decision. Mbeki recently acknowledged that HIV was one of several factors that could play a role in AIDS; however, he maintained that "a virus cannot cause a syndrome." According to a recent poll, over 82 percent of all South Africans believe that HIV causes AIDS.
The Centers for Disease Control and Prevention has announced a $19 million award to 24 community health programs, as part of an effort to help end racial and ethnic health disparities. CDC Director Dr. Jeffrey Koplan said the CDC wants to eliminate such health disparities by 2010. The grants are part of the agency's Racial and Ethnic Approaches to Community Health (REACH 2010) initiative, which targets HIV/AIDS, infant mortality, breast and cervical cancer, heart disease, immunization coverage, and diabetes. The funds will be distributed to programs in 15 states that assist African American, American Indian, Asian American, Hispanic American, and Pacific Islander populations.
Negotiators in the House and Senate have agreed to pay $25 million in federal funds for a Metro station on New York Avenue, but the District of Columbia's spending bill once again ran into hurdles over a needle exchange program. Conservative House Republicans wanted to restrict the city's only privately financed needle exchange, which health experts say can help stem the spread of HIV. As part of a compromise, the legislators decided that Prevention Works could not hand out needles within 1,000 feet of a school, although the program would not be prevented from operating near public housing, as had been suggested. The deal would force Prevention Works to end or move four of its 10 needle distribution points in the District of Columbia and would also require the D.C. public housing authority to send regular reports to Congress on drug activity at the public housing sites where needles are distributed. Paola Barahona, executive director of Prevention Works, said the prohibition will hinder the program's effectiveness, while Fred Johnson, the group's outreach coordinator, said he expects to see higher HIV infection rates because some people who now get needles at the four locations in question will not leave their neighborhoods to obtain clean drug paraphernalia.
A team of scientists led by John Glass of the University of Alabama and the pharmaceutical firm Eli Lilly report in the current issue of Nature that they have sequenced the genome for a sexually transmitted bacteria called Ureaplasma urealyticum. The parasite -- which lurks in the urogenital tract -- is the cause of a variety of ailments among newborns, including infant pneumonia and blood poisoning. According to the National Institute of Allergy and Infectious Diseases, about 60 percent to 80 percent of adults carry the parasite; however, most remain healthy. The researchers found that the bacterium is circular and made up of 652 genes.
A study from Adelaide University in Australia has found that gay men with long-term depression are nearly twice as likely to have unsafe casual sex as other gay men. The study of over 400 gay men found that 40 percent of the men with long-term, low-grade depression (dysthymia) said they engaged in unsafe casual sex in the past six months, versus 22 percent of the men who did not have dysthymia. Dr. Gary Rogers, program director of a care and prevention program at Adelaide University, suggested, "It may be that the low self-esteem that is part of long-term depression leads to men not caring enough about themselves to stay safe."
Dr. Kholoud Porter of the Medical Research Council Clinical Trials Unit in London has analyzed how HIV survival changes over time. Porter and colleagues studied data from 19 European seroconverter cohorts in the Concerted Action on SeroConversion to AIDS and Death in Europe study. The researchers note that of the more than 5,400 at risk as of January 1991 or later, 24.2 percent died, and there were significant reductions in mortality from 1997 to 1999. The researchers, who report their findings in the journal AIDS (2000;14:1899-1906), said their findings indicate that knowledge of the duration of HIV infection is necessary to obtaining accurate estimates of survival changes over time.
Zambia's government has reportedly rejected a $3.8 billion loan offer from the World Bank to help fight HIV. Health Minister David Mpamba said Zambia "cannot obtain any external loans because the country is failing to service the existing debt problem of the country." Mpamba told the Zambia Daily Mail that the government would, however, accept World Bank loans for programs it has already agreed to implement.
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.