Faculty Bibliography

Countering decades of promoting 'breast is best' for infant nutrition, the United Nations is issuing recommendations intended to discourage women infected with the AIDS virus from breast-feeding. The much-debated step aims at preventing transmission of HIV, the AIDS virus, from mothers to babies in what U.N. officials say is 'a runaway epidemic' in many developing countries. U.N. officials said they were reluctant to issue a blanket warning because the decision should be left to each mother and because no simple message could encompass the diversity of environments in which women live. Women may become stigmatized for not breast-feeding in some cultures, and in some places alternatives such as formula can be unaffordable or unsafe, but the United Nations wants that to change. In its directive, the United Nations said it was deeply concerned that advising infected mothers not to breast-feed might lead many mothers who are not infected to stop breast-feeding. To reduce that possibility, it is advising governments to consider bulk purchases of formula and other milk substitutes and to dispense them mainly through prescriptions

Dr. (Peter) Piot's team quickly showed that the Zairian patients had developed AIDS through heterosexual sex -- a finding that was initially met with disbelief by medical experts. But Dr. Piot (pronouced PEA-ott) knew his work was important. The leader, whom Dr. Piot declined to name, contended that his country's blood supply was safe. But Dr. Piot, fresh from a visit to a blood bank, knew better because the bank had no laboratory kits to screen blood before transfusions. The skeptical leader called the blood bank and learned that the blood was in fact dangerous. He summoned his health minister and ordered him to adopt the United Nations AIDS Program's recommendations. That country's program now works well, Dr. Piot said. ''Go to Zaire tonight,'' Dr. Piot was told. Earlier, the same Belgian officials had opposed sending a team to investigate the epidemic in Yambuku, Zaire, from which Dr. Piot's team in Antwerp had isolated the new virus. Suddenly, Dr. Piot's presence in Zaire was needed because American, French and South African scientists were there and the Belgians did not want to be embarrassed by not being represented

In certain areas of Africa, one in four adults is infected with the virus that causes AIDS, and around the world the disease now rivals the greatest epidemics of history, according to a United Nations report issued recently. One is that more women of childbearing age are HIV-infected in Africa than elsewhere. A second is that African women have more children on average than those on other continents. Thus, one infected woman may pass the virus onto a higher average number of children. A third reason is that nearly all children in Africa are breast-fed. But breast-feeding is thought to account for between a third and a half of all HIV transmission from mother to child

Troubling questions like these have filled medical history when promising new therapies have gone sour. The questions come up now in a dramatic way in AIDS because of a recently recognized constellation of findings known as the lipodystrophy syndrome. It produces a different pattern from the wasting syndrome long known as a part of AIDS. Several published reports have linked the syndrome to the drug cocktails that contain one of the powerful protease inhibitor drugs that were introduced in the last two and a half years. Many discussions at the 12th World AIDS Conference that ended here last week focused on the syndrome as experts from several countries reported new cases. Dr. David A. Cooper of Sydney, Australia, an international leader in AIDS research, and Dr. Andrew Carr expanded on their earlier published findings that 74 out of 116 or about 64 percent of patients taking protease inhibitors developed the syndrome, compared to 1 out of 132 who did not

A series of reports about new problems with anti-AIDS drugs and setbacks in vaccine trials left many participants thinking that their best hope against the epidemic is the strategy they have had since it began: prevention. The mood was a sharp contrast to the euphoria at the last AIDS meeting, in Vancouver, British Columbia, two years ago. There, scientists reported that combinations of new drugs, called protease inhibitors, had allowed many people infected with HIV, the AIDS virus, to leave their deathbeds, even to return to work. As Dr. Hoosen Coovadia, of Durban, South Africa, explained it, AIDS affects 40 percent of the children he treats in a large black hospital there. Yet, Coovadia, who is chairman of the next World AIDS Conference in 2000 in Durban, said that he had never used any anti-HIV drugs. His hospital cannot afford them, he said

Reports about new problems with anti-AIDS drugs and setbacks in vaccine trials left many participants thinking that their best hope against the epidemic is the strategy they have had since it began prevention. The mood was a sharp contrast to the euphoria at the last AIDS meeting, in Vancouver, British Columbia, two years ago. There, scientists reported that combinations of new drugs, called protease inhibitors, had allowed many people infected with HIV, the AIDS virus, to leave their deathbeds, even to return to work. Reports like these lead inexorably to the conclusion that the best hope for easing the epidemic still is prevention, speakers said. Yet 'over 100 times more money is being spent on therapeutics now than on the development of prevention technologies,' said Catherine Hankins, an epidemiologist at Montreal General Hospital in Canada. Among them are chemicals that could be inserted into the vagina before sexual intercourse to kill HIV. Hankins left the meeting saying she did not feel 'terribly optimistic.'

GENEVA -- Speaker after speaker at the 12th World AIDS Conference said that sex education, needle exchanges and other prevention programs can save millions of people from AIDS. The conference ended Friday with little of the euphoria of the last AIDS meeting, in Vancouver, British Columbia. There, scientists reported that combinations of new drugs, called protease inhibitors, had allowed many people infected with HIV, the AIDS virus, to leave their deathbeds, even to return to work. Dr. Hoosen Coovadia, of Durban, South Africa said that AIDS affects 40 percent of the children he treats in a large black hospital there. Yet, Coovadia, who is chairman of the next World AIDS Conference in 2000 in Durban, said that he had never used any anti- HIV drugs. His hospital cannot afford them

A series of reports about new problems with anti-AIDS drugs and setbacks in vaccine trials left many participants thinking that their best hope against the epidemic is the strategy they have had since it began: prevention. The mood was a sharp contrast to the euphoria at the last AIDS meeting, in Vancouver, British Columbia, two years ago. There, scientists reported that combinations of new drugs, called protease inhibitors, had allowed many people infected with HIV, the virus that causes AIDS, to leave their deathbeds, even to return to work. Even when the drugs offered hope, still other speakers said, it is hope beyond the reach of the vast majority of the 34 million people infected with the AIDS virus. Those patients cannot afford the treatment. It can cost about $15,000 to provide the drugs to one person a year, a sum greater than the entire health budget of many a Third World village

A series of reports about new problems with anti-AIDS drugs and setbacks in vaccine trials left many participants thinking their best hope against the epidemic is the strategy they have had since it began -- prevention. The mood was a sharp contrast to the euphoria at the last AIDS meeting, in Vancouver, British Columbia, two years ago. There, scientists reported that combinations of new drugs, called protease inhibitors, had allowed many people infected with HIV, the AIDS virus, to leave their deathbeds, even to return to work. As Dr. Hoosen Coovadia, of Durban, South Africa, explained it, AIDS affects 40 percent of the children he treats in a large black hospital there. Yet, Coovadia, who is chairman of the next World AIDS Conference in 2000 in Durban, said he had never used any anti-HIV drugs. His hospital cannot afford them, he said

The mood was a sharp contrast to the euphoria at the last AIDS meeting, in Vancouver, British Columbia, two years ago. There, scientists reported that combinations of new drugs, called protease inhibitors, had allowed many people infected with HIV, the AIDS virus, to leave their deathbeds, even to return to work. Dr. Hoosen Coovadia, of Durban, South Africa, said AIDS affects 40 percent of the children he treats in a large hospital there. Yet, Coovadia, who is chairman of the next World AIDS Conference in 2000 in Durban, said that he had never used any anti-HIV drugs. His hospital cannot afford them, he said. Reports like these lead to the conclusion that the best hope for easing the epidemic is still prevention, speakers said. Yet 'over 100 times more money is being spent on therapeutics now than on the development of prevention technologies,' said Dr. Catherine Hankins, an epidemiologist at Montreal General Hospital in Canada. Among them are chemicals that could be inserted into the vagina before sexual intercourse to kill HIV. Hankins left the meeting saying she did not feel 'terribly optimistic.'