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.
Lancet (www.thelancet.com) (04/01/00) Vol. 355, No. 9210, P.
1162; Smith, John H.F.
Participants at the International Consensus Conference on the
Fight Against Cervical Cancer, held in Chicago from March 18 to
22, focused on the need for greater screening for cervical
carcinoma throughout the world. Danish researcher Elsebeth Lynge
noted that cervical cancer incidence and mortality are twice as
high in developing countries as they are in developed regions,
linking the gaps to screening availability. But Eric Suba of
Kaiser Permanente Medical Center in Redwood City, California,
also reported that a smear-based population screening program in
Vietnam should reduce the incidence of invasive disease by 12
cases per 100,000 in 10 years. Other items discussed include
alternative programs such as direct visual inspection, which has
the advantage of not requiring a lab or trained technicians.
Ralph Richart of Columbia-Presbyterian Medical Center suggested
that human papillomavirus (HPV) testing be used in developing
countries; however, several participants voiced concerns about
the cost of HPV testing versus standard screening.
"Agencies Urge Use of Affordable Drug for HIV in Africa"
New York Times (www.nytimes.com) (04/06/00) P. A1; McNeil, Donald
G.
The World Health Organization and UNAIDS have recommended that
Africans infected with HIV be given regular doses of a common
antibiotic known as trimethoprim-sulfamethoxazole, or
cotrimoxazole. The drug, also sold as Bactrim by Roche
Pharmaceuticals, is used in the United States to treat urinary
tract infections and bronchitis. The groups have preliminary
evidence that the drug could add years to the lives of Africans
and delay complications associated with AIDS. Preventive use of
the drug, which is already widely available in Africa for the
treatment of childhood pneumonia and bacterial diarrhea, could
cost between $8 and $17 a year per patient. The Clinton
administration has already committed at least $100 million to
fight AIDS abroad; it may also contribute millions to help
distribute Bactrim, although it has not yet determined how much
it will spend. Dr. Helene Gayle, director of the National Center
for HIV, STD, and TB Prevention at the Centers for Disease
Control and Prevention, notes that the drug is "cost-effective,
it's ready to roll, and it may become an important component of
the program." The long-term effects of the drug are still
unknown; but a one-year study in the Ivory Coast found that
Bactrim reduced death rates by 50 percent, while another study in
the same country revealed that the drug cut the number of serious
complications such as pneumonia and diarrhea by half.
Reuters (04/05/00); Lovell, Jeremy
South Africa has stopped further testing of the AIDS drug
nevirapine after five women died in a trial run by Triangle
Pharmaceuticals. The country's health minister, Mantombazana
Tshabalala-Msimang, noted that so far the death rate for
participants in the trial is 1 percent, with a liver toxicity
profile of 11 percent. Clinical trials in Uganda have shown that
nevirapine, which is made by Roxane Laboratories, can
successfully prevent mother-to-child HIV transmission. While
advocates cite the drug's apparent efficacy and low cost when
compared with AZT, Tshabalala-Msimang said the Ugandan research
was inconclusive in terms of potential long-term adverse
reactions.
Kyodo News Service (04/06/00)
Health officials in China's Fujian Province report that they have
diagnosed HIV-2 infection, which has been found primarily in
western Africa, in a Chinese man. According to the Chinese News
Service agency, the man recently visited West Africa. This is
the first case of HIV-2 detected in China, the news service said.
"County Reports Sharp Rise in Hepatitis C Cases"
Los Angeles Times Online (www.latimes.com) (04/05/00); Blake,
Catherine
New statistics indicate a significant increase in hepatitis C
cases in Ventura County, California, although residents tend to
be healthier than most Southern Californians. In 1998, 228
hepatitis C cases were reported, compared to only 95 the year
before and only two cases in 1996. The figures can be found in
the county Public Health Department's "Community Health Status
Report," which notes that the area has wealthier residents who
can afford better medical care. The sharp increase in hepatitis
C cases could be a result of increased testing. In terms of
communicable diseases in the county, sexually transmitted
diseases (STDs) are the most common, with chlamydia the most
common STD. The number of chlamydia infections recorded in 1998
was up 18 percent from the previous year, for a total of 980
cases in 1998. Dr. Robert Levin, who oversees the county Public
Health Department, suggested that "the increase is partly because
people, especially young people, think HIV is not to be feared
and that has emboldened them to not use barrier protection."
More than 500 of the chlamydia cases recorded in 1998 were among
young people between the ages of 20 and 29.
"Needle Exchange Needed"
Washington Post--PG Extra (www.washingtonpost.com) (04/06/00) P.
M4; Fleming, Patricia S.
In a letter to the editor, Patricia Fleming--head of Prevention
Works, which runs a needle exchange program in Washington,
D.C.--rejects a recent article by Prince George's County,
Maryland, Council member Walter H. Maloney (D-Beltsville).
Fleming, the former director of the White House Office of
National AIDS Policy, notes that Maloney implied that the
programs promote drug use. However, she asserts that research
from several groups--including the Centers for Disease Control
and Prevention and the National Institutes of Health--have
"concluded that needle exchange significantly reduces HIV
transmission among injection drug users and in no way encourages
drug use." The need for a needle exchange program is based on a
health issue, Fleming says, and should be implemented as part of
an effective HIV prevention strategy.
Financial Times (www.ft.com) (04/06/00) P. 17; Bilefsky, Dan
Researchers from Virginia Tech have developed a gel, called Z-15,
that they hope will enable women to prevent pregnancy and reduce
the risk of infection from HIV, herpes, and other diseases. The
spermicide, developed with the U.S. Agency for International
Development, may be used to coat devices like diaphragms,
cervical caps, sponges, and condoms.
Africa News Online (04/05/00); Phiri, Brighton
Zambian officials said Tuesday that over 19 percent of the
nation's population has been infected with HIV since the
beginning of the epidemic, which is threatening the country's
economic development. Lusaka Province Deputy Minister Mulenga
urged more people to get tested for HIV and also to try to stay
healthy so they could donate blood, which is desperately needed.
Webster Mwape of the Community Based Tuberculosis Organization
reported that the number of tuberculosis cases in the country is
increasing, in part because of a lack of drugs.
Reuters (04/05/00)
Over 3 million people in Ethiopia have HIV, which is 9.3 percent
of the country's sexually active population, according to a new
report. Eduard Sanders, program manager of the Ethio-Netherlands
AIDS Research Project, also warned that rural areas of
Ethiopia--where the majority of the population lives--may have
more infections than reported. Sanders noted that research on
so-called low-risk groups indicates that the rate of HIV
infection ranged from 7 percent to 23 percent in urban areas.