HIV/AIDS Newsroom: December 7, 2000
Classification of Drug-Resistant Tuberculosis
12/02/00; Vol. 356, No. 9245, P. 1930; Sonnenberg, Pamela; Godfrey-Faussett, Peter; Glynn, Judith R.; et al.
In response to two letters to the editor regarding their recent Lancet article about the classification of drug-resistant tuberculosis (TB) in an epidemic area, Aventis Pasteur researchers agree that discussions about the classification of drug resistance should not affect efforts to make sure patients complete their treatments. After finding high transmission rates of multidrug-resistant TB among new and previously treated individuals, the authors concluded "that infection or reinfection with a multidrug-resistant strain of tuberculosis was important in the area studied," and thus, further research is needed. Various factors -- including differences in study design, TB prevalence, multidrug-resistant outbreaks, and the virulence of the circulating strains -- may produce different results. One key finding of this research, however, is "that surveillance data based on history of previous treatment are insufficient to predict drug resistance, to predict transmission of multidrug resistance, and to correctly assess a tuberculosis control programme."
Speaking at a conference in Addis Ababa, Ethiopia, United Nations Secretary-General Kofi Annan said African leaders must make fighting AIDS their top priority. Annan noted that the disease has taken the lives of millions of people, and it is also a key impediment to fighting poverty in the developing world and could affect political stability. The official called for concerted, comprehensive action against AIDS; however, he pointed out that while the world is prepared to spend billions of dollars battling the disease, African officials must work to make sure the money goes where it is needed most. Annan also said that while the majority of AIDS cases are in Africa, the disease is also spreading rapidly in Eastern Europe, Russia, and India, and these regions could face a situation like the one in Africa unless aggressive steps are taken.
High Marks for Hepatitis Drug
Washington Post (www.washingtonpost.com)
12/07/00; P. A16
Hoffmann-La Roche's new Pegasys product, a longer-lasting version of interferon alpha fights hepatitis C much better than its predecessor, according to two new reports. The current issue of the New England Journal of Medicine includes two reports from the drug maker, which compared Pegasys and the company's standard interferon, Roferon-A. An estimated 4 million Americans are infected with hepatitis C, and treatment for the disease involves interferon injections or a combination of interferon and ribavirin.
Toronto health officials announced that approximately one-third of the refugees identified by immigration officials for follow-up tuberculosis (TB) treatment did not report to area clinics. According to Sharon Pollock, manager of Toronto's TB program, while 1,000 refugees did show up for treatment, 500 did not, and their names are being sent to immigration to help locate them. Pollock suggested that some of the individuals who failed to show may have left the province, changed their address, have language difficulties, or may be afraid of authorities.
Two hundred students and staff members at North Toronto Collegiate were tested for tuberculosis (TB) earlier this week after a teenager was diagnosed with the disease late last month. Health officials said it was not necessary to test all 1,150 students at the school, because most were not considered at risk for infection. The officials noted that the case is not related to the outbreak in Hamilton, where hundreds of people were exposed to a Caribbean man and his wife who were both infected with a multidrug-resistant strain of TB.
Approximately 400 patients who were treated at a Charleston, West Virginia, hospital over the past year are being warned that they may have been exposed to tuberculosis (TB). "There has been an exposure in our acute-care setting, and as a precaution we sent letters to patients asking them to come in for a TB test," explained St. Francis Hospital's chief nursing officer, Jeanne Reeves. Due to confidentiality concerns, Reeves would not say whether it was a patient or hospital employee who was infected, nor would she reveal what part of the hospital was involved. Reeves said the letters were sent, per Centers for Disease Control and Prevention recommendations, to individuals in the primary circle of exposure." According to the CDC, the primary circle includes individuals at highest risk of developing TB because of the length of time they were exposed to the TB bacterium.
Health officials in Alaska said Tuesday that Gov. Tony Knowles intends to increase the state's 2002 operating budget by $3 million for health care. The "Back to Basics" initiative was announced at the Alaska Health Summit in Anchorage. Included among the proposed changes is new funding for 11 public health nurses, two microbiologists, and three food safety inspectors. Two months ago, health officials in Alaska had recorded 54 cases of tuberculosis, and they said that nearly 800 others were exposed to the disease. In addition, four cases of TB were recently reported at the Spring Creek maximum-security prison in Seward. Karen Perdue, commissioner of the Department of Health and Social Services in the state, said that while Alaska has met many of its health objectives for the year, tuberculosis, deaths from stroke, suicide, and prenatal care are still key issues that need to be addressed.
OraSure Technologies' OraQuick HIV test is being tested in Planned Parenthood clinics in Anchorage and Soldotna, Alaska, joining other testing sites around the United States and in Africa. For taking the rapid test, participants will receive $20; however, they will not be given results because the test has not yet received Food and Drug Administration (FDA) approval. Participants will be interviewed, and then receive an oral swab, a finger prick, and have a blood sample taken. The OraQuick test will analyze the first two samples, while the blood sample will be tested with an approved HIV screen. OraSure spokesman Richard George explained that the company did not want to highlight test results in the study because it wanted to include a variety of people in its research, not just people who think they are infected. Anna Franks, executive director of Alaska's Planned Parenthood, noted that if people are concerned they are infected, they should be screened with an FDA-approved test.
Watertown, Massachusetts-based V.I. Technologies reportedly has designed a chemistry-based product that can inactivate viruses, bacteria, and other pathogens in red blood cells without affecting blood components. "Despite reductions in the risk of pathogen transmission by blood transfusion, there remains a residual risk of disease transmission from known and as-yet undiscovered pathogens," noted Dr. James P. AuBuchon, acting chairman of the Department of Pathology at the Dartmouth-Hitchcock Medical Center in New Hampshire. AuBuchon, who reported V.I. Technologies' latest findings at the annual conference of the American Society of Hematology in San Francisco, said that the inactivation product, called Inactine, did not negatively affect the oxygen carrying capabilities of the red blood cells. V.I. Technologies will soon launch a phase II study of Inactine-treated red blood cells stored for 42 days, versus 28 in the last test, and administered by pints to 24 individuals.
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.