Faculty Bibliography

The overwhelming majority of these, 500,000, live in high-income countries where combinations of anti-HIV drugs have prolonged the lives of many people. In these countries, in 2001, fewer than 25,000 people died of AIDS. But in Africa, fewer than 30,000 of the 28.5 million infected people were receiving anti-HIV treatment at the end of 2001. Preparation of the forecast was aided in large part by development of improved scientific methods to create models of epidemic patterns as well as the collection of large amounts of recent information about AIDS and patterns of sexual behavior from affected countries, said Peter Piot, the director of the U.N. AIDS program. Earlier five-year projections underestimated the extent of the spread of HIV, the AIDS virus, in Africa by one-third to one-half, Piot and Neff Walker, a U.N. epidemiologist, said

The overwhelming majority of these, 500,000, live in high-income countries where combinations of anti-HIV drugs have prolonged the lives of many people. In these countries, in 2001, fewer than 25,000 people died of AIDS. But in Africa, fewer than 30,000 of the 28.5 million infected people were receiving anti-HIV treatment at the end of 2001. Preparation of the forecast was aided in large part by development of improved scientific methods to create models of epidemic patterns as well as the collection of large amounts of recent information about AIDS and patterns of sexual behavior from affected countries, said Dr. Peter Piot, the director of the U.N. AIDS program. Earlier, five-year projections underestimated the extent of the spread of HIV, the AIDS virus, in Africa by one-third to one-half, Piot and Dr. Neff Walker, a U.N. epidemiologist, said in news conference conducted by telephone

A more aggressive effort would focus on providing accurate information about how to prevent infection, because only one in five people at risk of acquiring the virus now has access to such information. For example, in China, which is on the verge of an explosive epidemic, most people do not know what causes AIDS, Dr. Peter Piot, the director of the United Nations AIDS program, said in an interview. The reports emphasized that conquering AIDS requires combining prevention with treatment programs. A more aggressive effort to prevent the spread of AIDS would be far less expensive than treating those infected in an epidemic. In Zambia, an AIDS victim was visited yesterday by a health worker. Reports that modest steps could greatly reduce global H.I.V. were issued in advance of an AIDS conference opening on Sunday in Barcelona, Spain. (Reuters)

The findings 'provide a beacon of hope' for extending Thailand's success to women and infants in other countries, said Dr. R.J. Simonds, an epidemiologist from the U.S. Centers for Disease Control and Prevention. Simonds worked on the project in Thailand from 1998 to 2001 and is a co-author, with Thai health officials, of a report to be published in The Journal of the American Medical Association

Thai and U.S. health officials reported that the first nationwide program in a developing country to prevent transmission from a mother to her newborn of the virus that causes AIDS has proved highly successful in Thailand. In the Thai program, after pilot studies showed the benefits of the drug AZT in preventing such transmission in certain areas, the Thai government mounted a program in October 2000 to reach the more than half-a-million women each year who give birth and the 10,000 infants a year who are born at risk of contracting HIV. The rising incidence of resistant HIV strains 'is not desirable, but it is not necessarily the death knell for treatment,' because anti-HIV drugs can 'prolong life significantly even when there is resistance,' Dr. Richard E. Chaisson, an AIDS expert at Johns Hopkins University, said in an interview

Thai officials collected information each month from 822 public health hospitals in the country, with 9 of every 10 women who gave birth from October 2000 through September 2001 volunteering to be tested for H.I.V. infection. Most mothers paid for the test. AZT was given to 5,682 newborns, 88 percent of all babies born to infected mothers. Dr. Merle A. Sande, an AIDS expert at the University of Utah, said the findings had important implications for Africa, where 25 million people are infected and where relatively small but growing numbers of people are beginning to be treated with combinations of powerful anti-H.I.V. drugs. Dr. Sande, who also teaches doctors in Uganda how to use anti-H.I.V. drugs, said doctors and African governments must adapt and change strategies to deal with the resistant strains. The rising incidence of resistant H.I.V. strains ''is not desirable but it is not necessarily the death knell for treatment'' because anti-H.I.V. drugs can ''prolong life significantly even when there is resistance,'' Dr. Richard E. Chaisson, an AIDS expert at Johns Hopkins University, said in an interview

The findings 'provide a beacon of hope' for extending Thailand's success to women and infants in other countries, said R.J. Simonds, an epidemiologist from the U.S. Centers for Disease Control and Prevention. Simonds worked on the project in Thailand from 1998 to 2001 and is a co-author, with Thai health officials, of another report to be published in the Journal of the American Medical Association. In the report, to appear in the Journal of the American Medical Association, researchers examined changes in the rate of drug resistant infections among 225 newly infected HIV patients from 1996 to 2001. At the end of the study, 7.7% of newly infected patients showed resistance to protease inhibitors, compared with 2.5% at the start. More than 13% of new cases were resistant to non-nucleoside drugs by 2001, compared with none in 1996

A new smallpox vaccine will be provided free to Americans who want it if the vaccine, now being manufactured, passes licensing tests as expected in 2004, Tommy G. Thompson, the secretary of health and human services, said yesterday. As long as there are no smallpox cases, the vaccine is unlikely to be given to children, even if parents request it, because it has not been tested on them, said Dr. Anthony S. Fauci, the director of the National Institute of Allergy and Infectious Diseases. Researchers had hoped to conduct such studies in children, but ethics panels at medical centers refused to allow them, citing federal regulations banning human experiments in which risks outweigh benefits, he said. Plans are still being worked out to provide vaccine for Americans who want it now. Dr. Fauci said that one way was for people to enroll in clinical trials being conducted to study smallpox vaccine

Instead, Mr. [Bush] authorized a voluntary program to vaccinate about 450,000 doctors, nurses and emergency workers who would be the first to respond to any effort by terrorists or hostile nations to use smallpox as a weapon. The vaccinations are expected to be given from late January through March. In recent months, an advisory panel on immunization policy, many public health leaders and infectious disease experts have expressed deep concern that smallpox vaccination, the most dangerous human immunization, posed too great a risk for the public because no case of smallpox has occurred anywhere since 1980. Dr. E. Stephen Edwards, president of the American Academy of Pediatrics, urged the Bush administration to ''consider the devastating effects'' smallpox vaccinations could have on children. ''No trials have been conducted on children,'' who may have a higher incidence of injury from the vaccine than adults, Dr. Edwards said

The initial phases of the vaccination plan would cover about 500,000 military personnel and 500,000 civilians, mostly health care and emergency workers who would most likely be exposed if someone contracted smallpox, officials said. Eventually, as many as 10 million people in law enforcement, health care and emergency response could be offered the vaccine. Defense officials said troop vaccinations could start today. [C. Mack Sewell] and other experts said doctors need time to build up experience in administering the smallpox vaccine while avoiding danger. People at risk of complications include those whose immune systems have been weakened by cancer, AIDS or other diseases. The vaccine, made of a live virus closely related to smallpox, known as vaccinia, can cause death or injury in susceptible people. Such people could presumably decline to be vaccinated, but would remain vulnerable to infection with vaccinia virus shed by those who had taken the vaccine