HIV/AIDS Newsroom: November 21, 2000
Syphilis and Orthostatic Shaking Limbs
11/18/00; Vol. 356, No. 9243, P. 1734; Brotman, Daniel J.; Fotuhi, Majid
Researchers from the Cleveland Clinic Foundation and Johns Hopkins Hospital present the case report of a 65-year-old man who, in April 1999, was evaluated for possible seizures at Johns Hopkins' emergency room. The man had been diagnosed with syphilis more than a quarter century previously and was treated two times. The patient was experiencing uncontrollable shaking of his left arm and leg whenever he stood up, sensations that had increased in frequency over the past year and had caused falls. The blood pressure on his left arm was 162/54, while it was 73/56 on the right. Following a cerebrovascular accident (CVA) in the patient, the researchers suggested that the shaking may represent recurrent transient ischemic attacks (TIA). They warn that limb-shaking TIAs could serve as a warning sign for an upcoming CIA, and they also note that a diagnosis of postural limb shaking should be followed by a careful examination of the carotid arteries and the proximal aorta, particularly when the individual has risk factors like syphilis for aortic aneurysm.
In a study from the Montreal Chest Institute and McGill University, tuberculin skin testing (TST) was conducted on 529 close contacts or patients suspected of active tuberculosis (TB). The final diagnoses showed that 68 had active TB, 274 had inactive TB, and 213 had no abnormality related to TB. Patients who had TSTs of 5 mm or more were not significantly more at risk compared to subjects with similar size tests. However, TST reactions that were 5 mm or larger meant the patient was more likely to have active or inactive TB. In patients with suspected TB, reactions under 5 mm meant a lower likelihood of disease.
Protein's Role Traced in AIDS Infection
Boston Globe Online (www.boston.com/globe)
11/21/00; P. A4; Recer, Paul
New studies in the Proceedings of the National Academy of Sciences discuss the role of a group of proteins, called proteasomes, that HIV uses to assemble and spread new viral particles to uninfected cells. According to an author of one of the studies, Ulrich Schubert of the National Institute of Allergy and Infectious Diseases, test tube studies indicate that inhibiting the action of these proteins can decrease the spread of HIV by 98 percent. Schubert warned, however, that the tests were only done in test tubes, and the proteasomes inhibitors will be tested in monkeys before any human studies are conducted. Also, co-author Dr. Jonathan W. Yewdell noted that while the proteasome inhibiting strategy shows promise, "it is possible that it may not have any effect [against HIV] at all." The proteasome function, he explained, is critical for healthy cells, so a treatment that inhibits that activity could have an effect on all cells.
The Centers for Disease Control and Prevention has decided to extend an agreement with Apache Medical Systems that increases the firm's HIV/AIDS studies to include hepatitis and influenza in HIV-infected individuals. The CDC uses a database managed by Apache to assess HIV/AIDS patient data. Started in 1993, the cooperative agreement between the CDC and Apache will continue through mid-2001.
Kyrgyzstan, one of the poorest nations of the former Soviet Union, started focusing on HIV prevention in 1995, while many other countries in the region are only just beginning to address the epidemic. Larisa Bashmakova has played a key role in the battle, leading a joint United Nations-Krygyz government project that began three years ago. The program includes a free clinic; a needle exchange for drug addicts; and a local group called Tais-Plus, which recruits prostitutes and taxi drivers for condom-distribution and AIDS education efforts in the capital city, Bishkek. Official statistics show that only one person in the country has died from AIDS and there are only 11 cases of HIV recorded; however, tests of needles from heroin users earlier this year indicated that HIV-infection rates are between 18 percent and 50 percent, according to Sergei Gavrilin, head of the needle-exchange unit. The only Central Asian nation to help pay for HIV prevention efforts, Kyrgyzstan's government plans to allocate $1.2 million for several AIDS-related projects over the next two years, and it hopes the United Nations will extend the joint program.
In Vancouver, British Columbia, a new drug policy calls for safe-injection sites for drug users and providing free heroin for hard-core addicts. The new plan is to be unveiled today; however, a copy obtained by the Vancouver Sun shows that it also discusses drug courts, special treatment beds for young people, testing of street drugs to prevent overdoses, and increased police action against upper-level drug dealers. The new policy comes in response to the soaring rates of deaths and HIV and hepatitis C infections in Vancouver as a result of drug use. The plan focuses on a so-called four-pillar approach to fighting drug abuse, emphasizing prevention, treatment, legal enforcement, and harm reduction.
Two Massachusetts organizations are working to help AIDS patients in Haiti obtain medication. Cambridge Cares About AIDS has been collecting the drugs, which might otherwise be thrown out when a patient changes drug regimens. The group has already provided Partners in Health with about $200,000 in AIDS drugs, which are then taken to the Boston-based group's clinic in Haiti and distributed to HIV and AIDS patients. Michael Reich, acting chairman of the Department of Population and International Health at the Harvard School of Public Health, notes that the movement helps to draw attention to the problem of HIV drug access; however, he also points out that there is no agency overseeing the drug collection and it is not known whether all organizations are following World Health Organization guidelines for drug donations.
As the debate over the presidential election continues, U.S. Secretary of State Madeleine K. Albright urged whoever ends up as the new president to allocate more for diplomacy and State Department activities, pay U.S. debts to international groups, and keep participating in foreign peacekeeping maneuvers. Albright, who asserted that she had "all my political partisan instincts surgically removed on taking office nearly four years ago," said she hoped that if Texas Gov. George W. Bush did become president, his administration would continue to focus on key issues in the United States, including HIV, drugs, women's needs, and nonproliferation.
A report in the December issue of the Journal of Medical Virology (2000;62:410-415) indicates that the presence of Epstein-Barr virus (EBV) in cervical samples from HIV-infected women does not raise the risk for squamous intraepithelial lesions. Italian researchers tested 122 HIV-infected women for human papillomavirus (HPV) and EBV DNA. The results show that 60.9 percent of the women had cervical HPV and 10 percent had cervical EBV, with HPV detected in 84.7 percent of the participants with squamous intraepithelial lesions and EBV in 13.5 percent of the women with the lesions. According to the authors, the risk for the lesions was significantly increased in women with HPV but not in women with EBV.
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.