News in brief - Dec. 1, 2003

Hepatitis A outbreak - Substance abusers more likely to have other disorders - Hepatitis C vaccine study announced - AIDS vaccine fails in phase III trials - Diabetes hits all-time high

Hepatitis A outbreak

By mid-November three people had died and more than 400 were sickened in a hepatitis A outbreak in western Pennsylvania that originated in a Mexican chain restaurant.

The outbreak began in late October, and the Pennsylvania Dept. of Health recommended that everyone who had eaten at the restaurant after Oct. 22 receive an injection of immune globulin, an antibody treatment that greatly lessens the chance of acquiring the disease. The health department has screened more than 6,000 people at a special clinic set up at a community college and administered about 5,800 injections.

Substance abusers more likely to have other disorders

People with substance abuse disorders often have accompanying medical or psychiatric conditions that can include bone fractures, muscle injuries, pain disorders, depression, anxiety and even psychoses, according to studies in the November issues of the Archives of Internal Medicine and Archives of General Psychiatry.

The Archives of Internal Medicine researchers found that people who entered a Kaiser Permanente substance abuse program had a significantly higher prevalence of injuries such as fractures, sprains, strains and burns, depression and anxiety disorders. They studied 747 people enrolled in the program and matched them to a control group not diagnosed with substance abuse.

The second study found that a large number of children ages 10 to 18 interviewed at a juvenile detention facility had a substance abuse disorder as well as a mental disorder or episodes of mania or depression.

"These studies provide more evidence that substance abuse does not occur in a vacuum, but rather often exists together with a number of conditions that have serious health consequences and may influence the success of substance abuse interventions provided alone," said National Institute on Drug Abuse Director Nora D. Volkow.

Hepatitis C vaccine study announced

Saint Louis University will be conducting the first human trials of a potential hepatitis C vaccine, according to a statement issued by the institution last month. The study will test the safety and efficacy of three dosage levels and is funded by the National Institutes of Health and Chiron Corp, an international pharmaceutical company based in Emeryville, Calif.

More than 170 million people are infected with the virus worldwide, including 4 million in the United States. The virus is responsible for nearly half of all liver transplants and causes 10,000 deaths annually. The disease also costs $600 million annually in lost work and medical costs.

"A vaccine to prevent the infection would be an important breakthrough in controlling the spread of the hepatitis C virus," said Sharon Frey, MD, principal investigator and associate professor of internal medicine.

AIDS vaccine fails in phase III trials

AIDSVAX B/E, the first AIDS vaccine to make it to phase III trials, failed to prevent infection or slow disease progression in those who did become infected, according to preliminary results of a trial in Thailand. The vaccine was tested in more than 2,500 injection drug users. The results were released in November by VaxGen Inc., the company funding the studies.

The vaccine was tested in more than 2,500 injection drug users in Bangkok. There were no serious adverse events. The vaccine, however, did not appear to work.

The company released data in February from its U.S. trial also finding that the vaccine was not effective, although a subset analysis showing some efficacy in ethnic minorities gave researchers hope that it might work in a few. That suggestion has been widely discounted, and this trial in an Asian population has further refuted the subset analysis.

"The outcome of this trial is one more reminder of how difficult it is to combat HIV and how important it is for the international public health community to redouble the effort to develop an effective vaccine," said Donald P. Francis, MD, DSc, VaxGen president.

Diabetes hits all-time high

More than 18 million people will have diabetes in 2003, according to estimates released by the Dept. of Health and Human Services last month.

"These new estimates show we are diagnosing more people who live with diabetes, and the overall prevalence of this disease continues to increase," said HHS Secretary Tommy Thompson.

Other data released by the agency in honor of World Diabetes Day on November 14 evidenced that 13 million are diagnosed but that another 5 million have the disease but don't know it. Nearly 15% of American Indians and Alaska Natives older than the age of 20 are diabetic and are more than twice as likely as Caucasian to have the disease.

The Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report also published several papers suggesting that diabetics suffer significantly from their disease. More than 60% of people who have a lower limb amputated are diabetics, although most people with the disease still are not receiving the recommended foot examinations. Also, those with diabetes are nearly four times as likely to have a history of coronary heart disease or stroke.