Faculty Bibliography

Today the best that doctors can offer are combinations of drugs known as cocktails that can drive the amount of virus in a person's blood below levels detectable in laboratory tests. But that does not mean the virus has been eliminated from the body. Scientists have recently discovered that although the virus could not be detected in the blood, it was still hiding in certain cells to produce what is known as a latent reservoir of H.I.V., the virus that causes AIDS. Two years ago, Dr. David Ho and his team from the Aaron Diamond AIDS Research Center in New York City first discussed the possibility of eradicating H.I.V. At the World AIDS Conference in Vancouver in 1996, they announced an experiment of purposely asking a patient to stop the medication to determine whether H.I.V. returned. Today, Dr. Ho, Dr. (Roberto) Siliciano and others said they had gone back to the drawing board to map new strategies to eliminate the latent reservoir. In pursuing that goal, scientists are moving into uncharted waters. Although vaccines can prevent viral infections, drugs do not cure any viral disease the way antibiotics can cure some bacterial infections

Tuesday, [David Ho], [Roberto Siliciano] and others said that they have gone back to the drawing board to map new strategies to eliminate the latent reservoir. In pursuing that goal, scientists are moving into uncharted waters. Although vaccines can prevent viral infections, drugs do not cure any viral disease the way antibiotics can cure some bacterial infections. When a person gets over a viral infection, recovery is due to the body's natural immune defenses. In the case of HIV, one strategy is to find new drugs to rid the body of the last cell of the reservoir. Another is to use one drug to flush HIV out of hiding so that another drug might kill the escaping virus. Normally, young uninfected CD4 cells emerge from the thymus gland in the chest and circulate throughout the body in its lymph system. When such cells meet a foreign invader like HIV, they turn into a different cell (known as a lymphoblast) and begin to proliferate. HIV kills many CD4 cells. But some survive in a resting state in which HIV does not replicate unless something stimulates it to do so

Consecutive single-patient methicillin-resistant Staphylococcus aureus (MRSA) isolates (270) from 12 hospitals (8217 beds) in metropolitan New York City were collected during May 1996. In 11 of 12 hospitals, MRSA was most frequent in the general medical services. DNA typing ('fingerprinting') revealed that mecA:Tn554:PFGE (pulsed-field gel electrophoresis) type I:A:A accounted for 113 (42%) of 270 isolates, was detected in all hospitals, and was the predominant clone in 9. Thirteen of 15 I:E:F isolates were from 1 hospital, and the remaining 2 were from another hospital of the same health system. Type V:NH:E was isolated from 22 (79%) of the 28 patients with AIDS, including 8 of 9 patients from an additional hospital. Subtype V:NH:E2 was recovered from 11 patients, 9 of whom had AIDS, including all 5 AIDS patients from one floor of a nursing home affiliated with a third hospital. By using both mecA:Tn554 probes and PFGE, MRSA clusters and outbreaks may be detected and provide a rationale for appropriate infection control intervention

OBJECTIVE: To investigate possible cross-contamination of laboratory specimens, as suggested by an increased incidence of newly diagnosed patients with tuberculosis, many of whom had all negative smears for acid-fast bacilli and only one positive Mycobacterium tuberculosis culture referred to as 'negative smears, one positive' or NSOP. METHODS: Medical-record reviews were performed for all patients with NSOP results diagnosed at this facility within a 9-month period. Laboratory logbooks were reviewed for all isolates processed; DNA fingerprinting was performed on available isolates. RESULTS: Of 80 patients with NSOP results, 45 (56%) were found to have false-positive cultures resulting from laboratory contamination with H37Ra, an avirulent stock strain of Mycobacterium tuberculosis. CONCLUSION: Laboratory cross-contamination resulted in the false diagnosis of tuberculosis in at least 45 individuals. Use of the Mycobacteria Growth Indicator Tube may have contributed to these contamination incidents by detecting small numbers of contaminating mycobacteria that may not have been detected with less sensitive media

In a new effort to slow the transmission of AIDS from mothers to their babies, the United Nations is starting a pilot program to treat 30,000 pregnant women infected with H.I.V. in 11 countries where the infection is spreading rapidly, United Nations officials said at the 12th World AIDS Conference here today. The program, which will focus on developing nations, mainly in Africa, will offer testing to pregnant women and short-term therapy with the drug AZT during late pregnancy and delivery. Several studies have shown that short-term AZT therapy can sharply reduce the risk of a woman's transmitting H.I.V. to her baby. Each year an estimated two million H.I.V.-infected women worldwide become pregnant, officials of the United Nations AIDS program said. About 680,000 babies were born with AIDS last year, thrusting mother-to-child transmission to center stage at the conference. But as the United Nations program was announced at a news conference, Actup-Paris, a French advocacy group, strongly attacked it as unethical. Protesters argued that the program was far too limited, because it will provide treatment to women only during pregnancy and not afterward. They also criticized organizers for not addressing the fate of the children who will be born free of H.I.V. but whose mothers may soon die of AIDS. About 1.6 million children worldwide lost their mothers to the disease in 1997

Pleas for national leaders to muster the political courage to carry out strong prevention programs to stop the global epidemic of AIDS were sounded at the opening of the 12th World AIDS Conference on Sunday. The world is facing a runaway epidemic and 'it is time to embrace a new realism and a new urgency in our efforts' to overcome complacency about the human immunodeficiency virus that causes AIDS, Dr. Peter Piot, the head of the United Nations AIDS program, said at the conference

Pleas for national leaders to muster the political courage to carry out strong prevention programs to stop the global epidemic of AIDS were sounded at the opening of the 12th World AIDS Conference here today. Saying that the world is facing a ''runaway epidemic'' of AIDS, Dr. Peter Piot, the head of the United Nations AIDS program, told the conference that ''it is time to embrace a new realism and a new urgency in our efforts'' to overcome complacency about human immunodeficiency virus, which causes AIDS. The condom for women, speakers said, was giving women more choice in protecting themselves against H.I.V. More than 18 million such condoms have been sold since 1992. The United Nations has negotiated a program in which four million condoms for women were sold in developing countries last year at a cost of 50 to 90 cents, compared with $2 to $3 in the United States

Pleas for national leaders to muster the political courage to carry out strong prevention programs to stop the global epidemic of AIDS were sounded at the opening of the 12th World AIDS Conference in Geneva, Switzerland, on Sunday

"The Unfinished Presidency: Jimmy Carter's Journey Beyond the White House" by Douglas Brinkley is reviewed