The Washington Blade; Friday, February 14, 1997
Lisa Keen

Gay men with HIV infection and a low level of vitamin B-12 in their blood are twice as likely to see their disease progress quickly than Gay men who have adequate levels of B-12. That conclusion comes in this month's issue of the Journal of Nutrition, a publication of the American Society for Nutritional Sciences.

Researchers at Johns Hopkins School of Hygiene and Public Health report that in a study of 310 men with HIV infection, 12 percent had low levels of vitamin B-12, 11 percent had low levels of vitamin B-6, and 8 percent had low levels of folate. Folate is a type of B vitamin that helps with the production of red blood cells.

Comparing the men with B-12 deficiency against those with adequate B-12 in the blood, the researchers noticed over the course of nine years that the men with deficiency were 87 percent more likely to have progressed to full-blown AIDS. The men with normal B-12 levels had four more years free from full-blown AIDS. Deficiencies in B-6 or folate did not appear to be associated with any difference in disease progression.

**CDC contemplates post-sex treatment

The Washington Post reported last week that the U.S. Centers for Disease Control and Prevention is working on a recommendation for whether intensive post-exposure treatment for HIV infection is warranted following sex. San Francisco General Hospital announced it will provide such treatment beginning this spring, and CDC is reportedly getting an increasing number of inquiries about the viability of the practice.

According to reports at last summer's International Conference on AIDS, 75 percent of health care workers who suffered accidental exposure to HIV-loaded blood (usually through a needlestick injury) and who immediately took 1,000-1,500 mg per day of AZT for two to four weeks have not become infected with HIV, at least not so far.

The success rate with this therapy, however, might not be so easily translated for post-sex exposure. That's because the health care workers were generally in situations where they could obtain antiviral drugs within one to two hours of their exposure. Charles Carpenter, a Brown University doctor who presented the post-exposure prophylaxis data to reporters at a pre-conference symposium, recommended the therapy for needlestick injuries begin within at least 12 hours.

"After 12 hours," he said, "the risk of side effects exceeds the benefit. ... We need data to recommend aggressive therapy after this."

One downside of the post-sex treatment approach is that people taking such aggressive therapy might not be infected with HIV and, thus, would be taking potent drugs they don't need and suffering their side effects, some of which can be quite serious. And if they are HIV-infected, they take the risk of losing AZT, or some other antiviral, from the arsenal of drugs they might need later, should the infection take hold and progress. But the hope is "eradication" -- hitting so hard and so early that the virus might be stopped completely from establishing infection.

In brief ...

STUDY ENROLLING: A California pharmaceutical company developing the antiviral adefovir dipivoxil, one of a new class of antivirals called nucleotides, is now enrolling more than 2,000 people with HIV in its study. Like nucleoside analogs, nucleotides inhibit an enzyme, called reverse transcriptase, in an early stage of HIV replication. People interested in participating should call Gilead Sciences at 1 (800) 445-3235.

LEGAL HELP: The ACLU has published a thick new legal guide for people with HIV infection. Written by the ACLU's National Lesbian and Gay Rights Project former director William Rubenstein and two D.C. area legal activists -- Ruth Eisenberg and Lawrence Gostin -- the 384-page book, The Rights of People Who Are HIV Positive, answers questions about insurance, federal benefits, public accommodations, and employment-related concerns. The book costs $13.95. For more information, call the ACLU at (212) 869-9065.

EYE CARE: The Better Vision Institute, a nonprofit group which educates the public about eye health issues, says patients with HIV who experience certain symptoms -- cloudy vision, multiple small "floaters," light flashes -- should consult an eye specialist immediately for diagnosis of possible cytomegalovirus (CMV) retinitis.

WEB SITES: The pharmaceutical SmithKline Beecham has launched an "interactive" Web site called "Boy Meets Boy" aimed at educating sexually active Gay men about hepatitis A and the company's vaccine Havrix. The site can be reached at http://www.boymeetsboy.com. And the U.S. Centers for Disease Control has launched a Web site to provide information to employers and employees about HIV and workplace issues. It can be reached at http://www.brta-Irta.org.

AMFAR GRANTS: The American Foundation for AIDS Research announced last week that it has awarded $819,902 to 12 AIDS research projects. Since 1985, it has awarded $83 million to 1,700 projects.

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