HIV/AIDS Newsroom: December 13, 2000
Tuberculosis Among Foreign-Born Persons in the United States, 1993-1998
Journal of the American Medical Association (www.jama.com)
12/13/00; Vol. 284, No. 22, P. 2894; Talbot, Elizabeth A.; Moore, Marisa; McCray, Eugene; et al.
A new report from the Centers for Disease Control and Prevention shows that the number of tuberculosis (TB) cases among foreign-born persons in the United States rose 2.6 percent between 1993 and 1998. The proportion of U.S. cases that were foreign-born, meanwhile, increased from about 30 percent to 41.6 percent. The researchers note that nearly three-quarters of the foreign-born cases were reported in six states (California, New York, Texas, Florida, New Jersey, and Illinois). The majority of these infections were diagnosed in people from Mexico, the Philippines, Vietnam, India, China, Haiti, and South Korea. The researchers conclude, "Based on extrapolation and assuming that changes in the number of U.S.-born and foreign-born persons with TB continue to occur at the rate observed in 1993-1998, more than half of U.S. cases may occur in foreign-born persons by the year 2002."
Researchers from Mount Sinai Medical School in New York City compared the completion rate of hepatitis B vaccination among students who received primary care at two comprehensive high school-based health centers (SBHCs) and at a hospital-based adolescent health center (AHC). Using a retrospective chart review of patients seen between September 1997 and March 1998, the researchers attempted to identify predictors for successful immunization. The study revealed that the completion rate was 76 percent in on SBHC facility, versus 29 percent at the other SBHC site and 24 percent for AHC. The researchers concluded that adolescents with access to SBHC services that stressed outreach were much more likely to have been fully vaccinated against hepatitis B.
UNICEF: Start Kids Off Right
USA Today (www.usatoday.com)
12/13/00; P. 10D; Rayam, Sheila
UNICEF's new "State of the World's Children 2001" report highlights the benefits of early investment in children. Carol Bellamy, executive director of the organization, said, "We now know a great deal more . . . about the critical nature of the very earliest years in terms of intelligence, personality, and social behavior." The report notes that early childhood care is a human rights issue; is based on solid scientific and practical experience; and that it is a wise investment, as children who go to preschool and day care are not as likely to drop out of school and need remedial classes later. However, the report explains that there are three key challenges to early childhood care: poverty, conflict, and the AIDS epidemic. Bellamy said she hopes the findings will encourage countries to make children a greater priority.
A 47-year-old AIDS patient gained 15 pounds after six months of being treated with insulin injections, according to a new report. Researchers from the University of Arizona College of Medicine and the VA Medical Center in Phoenix found that the man, who had lost 20 pounds and was increasingly fatigued despite the fact that he was receiving antiviral drugs and receiving B12 and testosterone injections, weighed 140 pounds after three months of daily insulin shots and 147 pounds after six months. In addition, the patient's CD4 cell count rose while he received the insulin; his CD4 cell count dropped after the shots stopped. The researchers report in AIDS Patient Care and STDs (2000;14:575-579) that the patient reported no adverse effects from the insulin and he asked to resume treatment with the drug because he felt much better.
Injection drug use is the primary source of an alarming explosion of HIV cases in Irkutsk, Russia, where the number of HIV infections has soared from 37 to more than 7,500 in the past 23 months. That figure is expected to increase even further before this year is out. Dr. Yulia Rakina, who heads the team of researchers in charge of testing HIV incidence among the region's residents, said that the actual number could be six times higher because fear and self-denial among the drug users. UNAIDS' Tatyana Shoumilina noted that while officials in the region are spending a lot of their limited resources on testing, more needs to be spent on prevention efforts, including counseling young people on how to avoid HIV and other sexually transmitted diseases, providing drug users with clean needles, and distributing condoms.
Researchers at Quest Diagnostics and the Stanford University School of Medicine have identified an HIV-1 strain that has reduced susceptibility to reverse transcriptase inhibitors. Quest noted that the discovery of this new mutation will provide doctors with information to better select HIV-1 treatments for their patients. The company is using the findings, which are published in the November issue of the Journal of Virology (2000;74:10707-10713), to report lab results for its HIV-1 genotyping test.
A recent report in the journal AIDS Research and Human Retroviruses (2000;16:1797-1804) indicates that synthetic helical peptides derived from a part of the HIV glycoprotein gp41 can inhibit HIV infection. Researchers from the Korea Institute of Science and Technology note that the extracellular domain of the glycoprotein are key for oligomerization and virus-induced fusion. The authors tested a number of synthetic peptides designed to be highly helical in solution for their ability to inhibit HIV. The report points out that while adding helix-capping motifs to a 19 amino-acid wild-type peptide did not generate the desired helical conformation; however, changing eight residues to alanine or lysine did induce the desired changes.
The research head for Merck, the nation's second-leading drug maker, said Tuesday that he was encouraged by ongoing early-stage human HIV vaccine studies at the company. Dr. Edward Scolnick told Wall Street analysts that Merck's vaccine candidates use specific HIV genes that are common to the virus' many strains, stimulating antibodies to work against the virus and prompting cellular immune-system cells to attack. The International AIDS Vaccine Initiative's Wayne Koff noted that animal studies reported by Merck in October -- in which monkeys were given a gene-based vaccine containing SIV and HIV DNA -- were also promising, showing that the vaccine stopped the animals from developing symptoms of HIV infection, although it did not keep them from contracting the disease. Meanwhile, Greg Gonsalves of the Treatment Action Group praised Merck's researchers and history of designing AIDS treatments; however, he said he would like to see more details for the vaccine.
A $50 million interest-free credit has been approved by the World Bank to help Kenya boost its healthcare sector and expand its anti-AIDS activities. In a statement, the bank noted that AIDS is a "development crisis" in Kenya, where the prevalence of HIV infection among 15- to 49-year-olds has risen about 11 percent each year for the past decade, to 13.9 percent last year.
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.