HIV/AIDS Newsroom: October 18, 2000
Influence of Follicular Dendritic Cells on Decay of HIV During Antiretroviral Therapy
Proceedings of the National Academy of Science Online
09/26/00; Vol. 97, No. 20, P. 10966; Hlavacek, William S.; Stilianakis, Nikolaos I.; Notermans, Daan W.; et al.
Investigators from the United States, Germany, and the Netherlands evaluated the role of HIV-1 on follicular dendritic cells in the process of decay of plasma virus as the result of antiretroviral therapy. Using a mathematical model for HIV-1 dynamics in lymphoid tissue, the researchers analyzed data for the decay of HIV during treatment. The model showed that viral clearance and death of short-lived productively infected cells could be faster than previously thought. The study also indicated that the second stage of decay may not be caused by long-lived or latently infected cells.
Health policy expert Lawrence Gostin of Georgetown University Law Center has stated that the government should not require HIV-positive doctors to tell their patients they are infected. Gostin, whose proposal is published in today's Journal of the American Medical Association (2000;284:1965-1970), noted that as the rules stand now, they "pose significant human rights burdens" and are not supported by data regarding the risk of doctor-patient transmission. The Centers for Disease Control and Prevention is currently undertaking a routine review of the guidelines, which state that HIV-positive healthcare workers should reveal their status to patients undergoing invasive procedures. The debate over informing patients stems from the case of Kimberly Bergalis, who contracted HIV from her dentist and died nine years ago.
Prince George's Council Rejects Needle Program for Addicts [in Maryland]
10/18/00; P. B1; Schwartzman, Paul
In Maryland, the Prince George's County Council has rejected with a vote of five to three a proposal to provide a needle exchange program to drug addicts. The needle exchange was cited as a way to prevent the spread of HIV; however, critics expressed concern that the program might send a message of tolerance regarding drug use. Commenting on the bill's defeat, council member Thomas Hendershot (D-New Carrollton), who sponsored the measure, said that his colleagues ended a chance to help save lives in a county that has the state's second-highest number of AIDS cases. Hendershot first introduced the measure in February. County health officers testified that needle exchange programs stop disease from spreading, as seen in Baltimore, where HIV cases have fallen 35 percent after a needle exchange program began six years ago.
Dr. Frederick Hecht and colleagues, of the University of California at San Francisco, have concluded that name-based reporting policies for HIV infection do not appear to deter HIV testing, although they could be related to delays in testing. According to their report in the journal AIDS (2000;14:1801-1808), a total of 2,404 subjects were interviewed, including men who have sex with men, intravenous drug users, and heterosexuals who attended a sexually transmitted disease clinic. The study found that 20 percent of the subjects had never had an HIV test, while 17 percent of patients from states with name-based reporting said concern over the reporting led them to not get tested, versus 14 percent from states that did not have name-based reporting. Of the patients already tested, 26 percent of gay men and 26 percent of drug users in states with name-based reporting stated that concern over HIV reports delayed their testing, versus 19 percent of gay men and 13 percent of drug users in states without name-based testing.
Thousands of refugees with HIV await entry into the United States, many denied after U.S. Health and Human Services health workers test them for the virus. A change in immigration policy has allowed 14 HIV-positive refugees to enter and settle in Boston this year. Many of the refugees contract HIV during torture or in crowded cells created for demonstrators in Africa who oppose the government. All refugees admitted into the United States must be tested for diseases like tuberculosis, leprosy, sexually transmitted infections, HIV, and mental problems. Thus far, 123 HIV-infected refugees have been allowed to enter the country. The Immigration and Naturalization Service test program allows a small number of these HIV patients to enter and get treatment through Medicaid or the Refugee Medical Assistance Program.
A new report published in the journal Sexually Transmitted Diseases (2000;27:545-550) shows that the Internet may encourage faster and easier transmission of sexually transmitted infections. Dr. Sheana Bull of Denver Public Health and Dr. Mary McFarlane of the Centers for Disease Control and Prevention visited 175 Internet chat rooms targeting men who have sex with men, heterosexuals, or couples seeking partners. Bull and McFarlane found that safer sex or risk-reduction behaviors were not often mentioned in the rooms, although sometimes they were noted in searches for drug-free and disease-free partners.
A new bill in New Jersey would require teachers to stress abstinence in sex education and HIV prevention classes. The bill, sponsored by Assemblywoman Marion Crecco (R-Essex), would promote abstinence as "the only completely reliable means" of avoiding pregnancy and sexually transmitted infections. Opponents of the bill believe abstinence is already part of sex education. The bill, which was approved Monday by the Education Committee, has now been sent to the full Assembly.
Optima Worldwide Ltd., an Arizona company, stated in Chinese advertising campaigns that its contraceptive gel Surete could prevent HIV infection, promising the Chinese public something that was not backed by the U.S. Food and Drug Administration (FDA). However in interviews with the San Jose Mercury News, the company has admitted its claims are false, as the gel has never been approved for anti-AIDS properties in any nation. The FDA recently stated that Surete is an "unapproved new product," and it ruled invalid the export certificates the company had obtained for Surete as a contraceptive. Optima will recall the product in China, but researchers fear the damage has been done to women who used the product instead of condoms. Polly Harrison, director of the nonprofit Alliance for Microbicide Development, said the claims about Surete are "irresponsible . . . it's false security for women." Surete was labeled as an American scientific breakthrough in China, effective against such diseases as hepatitis B, HIV, chlamydia, gonorrhea, and syphilis. Optima President Stephen Drake defended Surete's marketing, saying that tests reveal encouraging results about the gel. Local health authorities in Beijing conducted studies that showed Surete was a disinfectant, but did not study any anti-HIV claims. Dr. Gustavo Doncel, director of contraceptive research at the Arlington, Virginia-based Contraceptive Research and Development Program, which is supported by the U.S. Agency for International Development, performed lab tests on the gel and found it "did inactivate the HIV virus, but not in a more potent way than our standard controls." Optima plans to reintroduce the gel in China as a "vaginal disinfectant."
The number of AIDS-related deaths in South African prisons increased 300 percent between 1995 and 1999, and will likely only continue to rise, a new report claims. There have been over 1,000 natural deaths in South African prisons this year, with about 90 percent suspected to be from AIDS, according to Gideon Morris, secretary of the Office of the Inspecting Judge. A growing number of inmates with HIV infection and a high incidence of rape in prison have contributed to the steep rise in deaths. Morris told The Star newspaper that up to 80 percent of arrested suspects are robbed and raped by other prisoners before they are officially charged. Because of massive overcrowding, prisoners are not segregated for safety.
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.