_______ ____________________F ebruary 14, 1996 • T he P ortland O bserver
Figures Update AIDS Growth Computers To Find Medicare Fraud
The world is grappling with sep­
arate epidemics of the HIV virus
with fresh cases no longer rising in
Western nations but increasing rap­
idly in Africa and Asia, an AIDS
expert said
“We have two HIV epidemics in
the world,” Professor Max Essex
of the Harvard AIDS institute told
a conference on infectious diseases
in the Indian capital.
“We have the epidemic in the
West, which has something of the
order of 2 million people infected
and is plateauing or decreasing.
“Conversely, if we look at the
other epidemic, the epidemic of
subSaharan Africa and Thailand,
India ... we see the number of peo­
ple infected is of the order of 15-20
million and rising, increasing rap­
idly,” Essex said.
Essex said AIDS contracted in
Western nations mainly through ho­
mosexual contact and intravenous
drug use was spread by HIV 1 -B, a
strain of the Human Immunodefi­
ciency Virus (HIV).
But AIDS in South Asia and
sub-Saharan Africa is caused by
other varieties of the virus, H IV I-
A, C and E, which are contracted
almost entirely by heterosexual con­
tact, he said.
"Ninety to 95 percent of the dis­
ease is not in heterosexuals in North
America and western Europe. Con­
versely, in virtually every other part
of the world, 90 percent of HIV cases
are associated with heterosexual con­
tact,” he said.
He said sex education in develop­
ing countries was practically non­
existent compared to AIDS aware­
ness among youths in the West, a
strong reason underlying unprotect­
ed sexual activity and the prolifera­
tion of HIV infection.
E ssex c a u tio n e d re search ers
against complacency, saying most
planned vaccines and therapy for
AIDS were developed in the West
and were consequently geared to
dealing with HIV I B alone.
“If other HIV subtypes take hold
in the West — and in my opinion that
is inevitable — a heterosexual epi­
demic of significantly greater mag­
nitude must be anticipated,” he told
the conference.
At least 22 million people have
been infected world-wide by HIV,
Essex said. More than a million peo­
ple contracted HIV in Thailand in
less than five years while nearly 2
million Indians were infected, he
said.
The World Health Organization
estimates there could be at least five
million people carrying the HIV
virus in India by the end of the
century.
“The m ost central q u estion
that concerns us both in p re v e n ­
tion and treatm ent is the high
rate o f genetic m u tatio n ," the
do cto r said. "In a hum an being
who lives 10 years, the virus
that do m in ates m ay be 10 p e r­
cent dif ferent from the virus that
entered — a huge d iffe re n c e .”
Essex said the m ainstay o f AIDS
research was sh ifting to p re v e n ­
tion rather than therapy due to
the g ro w in g co st o f tre a tin g
A ID S p atien ts w ith in c re a sin g ­
ly long lives.
“The huge expense o f tre a t­
ment is only in creasin g in the
U.S. w hich keeps p atien ts aliv e
for three or four years instead
of o n e ,” he said.
"T his m eans a $50-100 m il­
lion burden ra th e r than a $ IQ-
15 m illion burden for the U.S.
as a w h o le.”
New Drug Fights TB And Other Diseases
Scientists have applied biotech­
nology to create a stronger germ that
may more effectively fight tubercu­
losis (TB ) and other human diseases.
The researchers boosted the bacille
Calmette-Guerin (BCG) organism
commonly used for both TB vac­
cines and for bladder cancer immu­
notherapy by packaging inside it five
mammalian genes that stimulate the
immune system.
The proteins produced by these
genes, called cytokines, activate dis­
ease-fighting cells.
The work of the scientists from the
Whitehead Institute for Biomedical
Research in Cambridge and Boston ’ s
Children’s Hospital will appear in
the Proceedings of the National Acad­
emy of Sciences. "The efficacy of
BCG vaccines lor I B varies tremen­
dously from 0 to 80 percent,” lead
Whitehead researcher and co-author
Richard Young said.
"While we already have that safe
vaccine, which is widely used in hu­
mans against TB, it is not that effec­
tive. We are trying to lind a way to
soup it soup (boost it),” he said.
So far the researchers have tested
the improved BCG in mice and have
shown it can create an immune sys­
tem response 10 times greater than
normal BCG.
Y oung com pared the hum an
body’s immune response to many
batallions of white blood cells that
are armoured and ready to tight in­
fection. The new form of BSG gives
each battalion extra allotments of
ammunition.
BCG is the most common TB vac­
cine; more than 2 billion people
worldwide have taken it since it was
developed in 1914.
TB remains a major killer in many
societies. About one-third of humans
worldwide are infected with TB, and
I to 3 million people die from it each
year. There are 10,000-20,000 cases
annually in the United States.
Olestra Warning Label Wanted On Ads
A consumer group has asked the
Federal Trade Commission to re­
quire Procter & Gamble to put the
same warning label on its advertise­
ments for the fat substitute as is re­
quired on its package labels.
The Center for Science in the Pub­
lic Interest cited recent newspaper
ads headlined “No fat. No Compro­
mises,” but said there were compro­
mises.
It noted that when the Food and
Drug Administration approved the
fat substitute for some snack foods,
including potato chips and crackers,
it required a label to warn users that
olestra may cause abdominal cramp­
ing and loose stools.
The U.S. government is to deploy
powerful supercomputers, normally
used to analyze weapons systems and
nuclear stockpiles, to detect Medicare
fraud, officials recently announced.
The Department of Health and
Human Services has signed a $6 mil­
lion tw o-year contract with Los
Alamos National Laboratories to use
its computers to detect fraud and to
design systems to prevent errors and
cheating, they said.
M ed icare, a go v ern m en t-ru n
health insurance for those over age
65 no matter what their income, each
year handles more than 800 million
claims, worth around $180 billion.
That volume makes it hard to detect
fraud, a growing problem.
The Los Alamos National Labo­
ratory in New Mexico, operated by
the University of California for the
U.S. Department of Energy, is capa­
ble of searching vast amounts o f data
stored in different formats.
Medicare bills are handled by 70
dif ferent contractors, who in turn deal
with hundreds of thousands of doc­
tors, clinics, laboratories, hospitals
and other health facilities.
Vitam ins May Fight Eye Condition
Twice-a-day doses o f a dietary
supplement may help combat an eye
condition that often leads to blind­
ness in the elderly, according to new
research.
The finding was based on a study
of veterans in the United States who
were given non-prescription antiox­
idant capsules containing 14 compo­
nents, including zinc and vitamins C
and E.
Researchers at the Department of
Veterans Affairs writing in the cur­
rent issue o f the Journal o f the Amer-
ican Optometric Association said the
supplement appeared to prevent the
progression of age-related macular
degeneration.
'Hie condition is a leading cause of
blindness among older adults, affect­
ing nearly 37 percent of those over
the age of 75.
The report said recent studies have
indicated that a diet lacking in certain
vitamins, mineralsand othersubstanc-
escontributes to the condition, in which
central vision needed to see both near
and far is gradually destroyed.
The study said a lower fat diet
with high complex carbohydrates,
moderate protein and five to nine
portions a day of fruits and vegeta­
bles, including dark green leafy veg­
etables, is probably the best help for
aging eyes.
But since many people do not
follow such a diet, it said, attention
must be paid to supplements.
The study said there are more than
tw o-dozen an tio x id an t products
billed as helpful to the eyes currently
on the market.
New Drugs Give Hope In HIV Epidemic
New drugs to help control HIV
and a test that can predict how quick­
ly someone will develop AIDS give
some reason for hope in the battle
against epidemic, according to re­
searchers at a major scientific con­
ference.
Scientists are dubious about acure
for AIDS in the foreseeable future,
but believe that in the coming years
they will have more drugs capable of
controlling HIV, the virus that caus­
es AIDS, and prolonging lives.
The new test, which measures how
much actual virus is in an infected
person’s blood, accurately forecasts
whether someone is likely to develop
AIDS quickly or live for 10 or more
years without falling ill, Dr. John
Mellors of the University of Pitts­
burgh said Tuesday.
The test o f viral RNA plasma,
made by Chiron Diagnostics, is use­
ful both for helping doctors decide
when and how aggressively to treat
patients, and for scientists to evalu­
ate experimental treatments. It is a
more accurate prognosticator than
more common tests which measure
infection-fighting CD-4 blood cells,
Mellors said.
“There’s a real sense that w e’re
making progress. But progress is in
the eye of the beholder,” said Dr.
Douglas Richman of the University
of California at San Diego.
A cure is “unrealistic,” but many
smaller steps are being made in basic
science, testing and treatments, said
Richman and other organizers of the
Third Conference on Retroviruses
and Opportunistic Infections.
Researchers presented data about
more drugs — including some from
Bristol-Myers Squibb Co. and from
Abbott Laboratories — that are show-
ing promise.
Interim results from the Universi­
ty of Texas, testing Bristol-Myers’
drugs Zerit (stavudine, d4T) and
Videx (ddl, didanosine) on 75 pa­
tients, showed a substantial reduc­
tion in viral load which appeared to
be prolonged, and an increase in CD4
cells for as long as one year.
Abbott’s experimental protease in­
hibitor ritonavir, combined with two
other drugs AZT and ddC, also showed
a powerful antiviral response in a
French study of 21 patients, research­
ers told the conference. Abbott filed
for FDA approval last month.
After six months, HIV activity
was not detected in blood cells of six
patients, or in the plasma of five
patients taking the Abbott drug “cock­
tail,” researchers said.
On Monday Merck researchers
presented data from anotherprotease
inhibitor, indinavir, showing that it
wiped out almost all of the virus for
four to six months in most patients
tested. Merck hopes to get approval
to market the drug, which will be sold
as Crixivan. Many conference par­
ticipants said the protease inhibitor
studies were the most exciting devel­
opment yet against AIDS, although
they cautioned that the studies have
been small and fairly short-term. The
verdict is still out on how useful they
will be in the long haul, since AIDS
can mutate and develop resistance to
drugs.
In another developm ent, New
York Blood Center scientists recent­
ly reported that they had made a
compound from ordinary milk and
whey which can stop HIV transmis­
sion in a test tube.
The hope is that the finding could
lead to inexpensive foams or creams
that could be used with a condom to
stop viral infection through sex.
However, developments that have
looked promising in the laboratory
have often failed in tests on animals
and humans, which have not begun
on this compound yet.
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