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CDC HIV/STD/TB Prevention News Update

Monday, March 13, 2000
The CDC National Center for HIV, STD, and TB Prevention provides the following information as a public service only. Providing synopses of key scientific articles and lay media reports on HIV/AIDS, other sexually transmitted diseases and tuberculosis does not constitute CDC endorsement. This daily update also includes information from CDC and other government agencies, such as background on Morbidity and Mortality Weekly Report (MMWR) articles, fact sheets, press releases, and announcements. Reproduction of this text is encouraged; however, copies may not be sold, and the CDC HIV/STD/TB Prevention News Update should be cited as the source of the information. Contact the sources of the articles abstracted below for full texts of the articles.

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Drug-Resistant Tuberculosis Strains Are Found at High Levels in Mexico

Wall Street Journal (www.wsj.com) (03/13/00) P. B16; Chase, Marilyn
Drug-resistant strains of tuberculosis (TB) are overcoming Mexico, threatening progress made against the disease. A team of Mexican and U.S. researchers found that over 28 percent of TB cases in Orizaba were resistant to rifampin or isoniazid, and over 10 percent were resistant to both drugs. The World Health Organization recommends DOTS, or directly observed treatment, short-course, for the treatment of TB. However, resistant strains take much longer to cure. Another study in the Mexican states of Baja California, Sinaloa, and Oaxaca, indicates that between 3 percent and 50 percent of cases resisted at least one of three drugs: isoniazid, rifampin, and pyrazinamide. While ethambutol could help in the fight, the drug would increase treatment costs by about 30 percent, according to the study led by Jordan Tappero of the U.S. Centers for Disease Control and Prevention. The two studies are published in today's issue of the Archives of Internal Medicine (2000;160:630-636,639-644). A new program joining the four U.S. border states and six Mexican states aims to cure TB patients who may migrate across the border.

AIDS, HIV Going Uncounted Faulty Figures Leave States With Inadequate Funding

Columbus Dispatch (www.cd.columbus.oh.us) (03/12/00) P. 1D; Somerson, Mark D.
Ohio health officials believe that thousands of people with HIV or AIDS are not being counted by the state because they do not know they are infected or have not told a hospital or health provider. Although HIV status is tracked confidentially by the state, many people are reluctant to let others find out. Inaccurate counts mean the loss of federal funding, which is based on AIDS incidence. While the number of newly diagnosed AIDS cases in the state dropped from 1,300 in 1993 to 542 in 1998, HIV incidence has increased, from 733 cases in 1996 to 924 in 1998. As of December 31, Ohio officials estimated there were 10,000 to 18,000 people living with HIV or AIDS statewide; however, only 9,716 cases have been reported. It can take years for some people to seek treatment or be tested. People with HIV may not be aware they can seek services as easily as those with AIDS.

Unsafe Sex in Age of Viagra; Rising HIV Rates Show Seniors Often

"Unsafe Sex in Age of Viagra; Rising HIV Rates Show Seniors Often" Austin American-Statesman (www.Austin360.com/news/newstop.htm) (03/12/00) P. A19; Palmer, Louise, D.
The impotence drug Viagra has many health officials concerned about the spread of HIV and sexually transmitted diseases among older Americans. Older people are less likely to practice safe sex and rarely get tested for disease. R.H. Keller of the Biodorn clinic in Florida said, "The fastest-growing AIDS rate is among the geriatric population, and this is somewhat attributable to Pfizer (Viagra's manufacturer)." Health officials are concerned that as some older men become more sexually active, they may not realize that prevention efforts are necessary. Cultural stereotypes that people over 50 do not have sex are also problematic. Older women are very vulnerable to HIV and trust their partners more readily. In addition, older Americans tend not to ask their partners about possible diseases and may feel they do not need protection.

City Helping Fight Teen Pregnancy, AIDS

Miami Herald Online (www.herald.com) (03/12/00); Vazquez, Annie
The South Miami City Commission has decided to spend $30,000 to help prevent teen pregnancy and raise AIDS awareness. The money will be given to the Teen Pregnancy Prevention Center, which provides counseling and referral services and HIV testing for South Miami. Mayor Julio Robaina said more teens and senior citizens are contracting HIV and need counseling. The Miami-Dade Department of Human Services has found that South Miami's African-American community has one of the highest HIV/AIDS concentrations in the county.

Nigerian Sharia State Has Highest Rate of Syphilis

Reuters (03/12/00)
The highest rate of syphilis in Nigeria can be found in Talata Marafa. Located in the northwestern state of Zamfara, the town reported a 16.8 percent prevalence of syphilis among pregnant women, compared to a national average of 2.3 percent, according to the 1999 Federal Ministry of Health study of sexually transmitted diseases. Under sharia law, which Zamfara adopted last October, hands are cut off for theft and death is prescribed for adultery. Reports in Nigerian newspapers indicate that brothels have since become increasingly popular in non-sharia states that border Zamfara.

HIV Infection Accelerates Onset of Smoking-Induced Emphysema

Reuters Health Information Services (03/10/00)
Researchers at Ohio State University in Columbus have found that as more patients are living longer with HIV, the rate of emphysema related to smoking in HIV patients is on the rise. In their study, the scientists identified emphysema in 17 of 114 HIV-seropositive subjects without pulmonary complications, versus one case in 44 HIV-seronegative controls. The report, published in the Annals of Internal Medicine (2000;132:369-372), found that the incidence of emphysema in HIV-seropositive individuals with a smoking history of 12 pack-years or more was higher than that for persons in the HIV-seronegative group (37 percent versus O percent). According to the researchers, the findings show that young HIV patients--the median age in the study was 33--are developing emphysema at striking rates, and smoking-related respiratory symptoms may play an increasingly larger role in the natural history of HIV.

Long Exposure to Diesel Exhaust May Cause TB: Researchers

Kyodo News Service (03/11/00)
A team of Japanese researchers has concluded that long-term exposure to diesel exhaust may weaken resistance to tuberculosis (TB). The study included two groups of mice, one of which inhaled diesel gas from one to nine months, and a control group that did not inhale the gas. After injecting both groups of mice with TB germs, the lungs of those mice exposed to exhaust for six- and nine-month periods had 10 times more granulomas. There were no significant differences between the mice that inhaled the gas for one or three months compared to the gas-free mice; however, the authors reported that the mice that inhaled diesel exhaust particles had less active macrophages.

Syringes Reused on Hospital Patients

Australian Broadcasting Corp. News (03/12/00)
Twelve patients at the Frankston hospital in Victoria, Australia, received anesthetic from reused syringes, according to a new report. Although the hospital claims the needles were replaced, the patients are being offered HIV and hepatitis tests as well as counseling. An official from Frankston Hospital said the risk of infection is very small, but the patients are being warned as a precaution.

Tuberculosis: Developing a Breath Test

"Tuberculosis: Developing a Breath Test" Business Week (www.businessweek.com) (03/13/00) No. 3672, P. 93; Crockett, Roger O.
Researchers from the Illinois Institute of Technology in Chicago have developed prototypes of an electronic nose that could allow doctors to detect tuberculosis (TB) by its odor. The prototypes include a cylinder with electronic sensors and a vibrating crystal that absorbs bacteria from the air. Although the "e-nose" still must be made more sensitive, researcher Bill Penrose notes that it could reduce the amount of time needed to diagnose TB from six weeks to just minutes.

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