PAGE 17 Q-Notes T July 1994
by David Prybylo
Q-Notes Staff
Interferon Gamma found
useful in treating HIV-related
infections
WASHINGTON,DC—Interferongamma
helped non-tuberculous mycobacterial infec
tions in patients who did not respond to
conventional therapies, according to research
reported in the May 12 issue of The New
England Journal of Medicine by scientists
from the National Institutes of Health (NIH).
“This research effort adds to our under
standing of mycobacterial infections, which
have become increasingly important as more
and more individuals suffer the immunosup
pression of HIV disease,” says Anthony S.
Fauci, M.D., director of the National Institute
of Allergy and Infectious Diseases (NIAID).
“It is an important step in our search for new
therapies against these serious mycobacterial
diseases.”
Mycobacteria are a diverse family of dis
ease-causing organisms including some that
cause tuberculosis. Non-tuberculous myco
bacteria occur in the environment and usually
affect only people with impaired immune
systems. They can cause serious, often life-
threatening diseases such as disseminated
Mycobacterium avium complex (MAC),
which affects up to 40 percent of people
infected with HIV.
The study reported by Steven M. Holland,
M.D., of the Laboratory of Host Defenses,
NIAID, and colleagues, involved seven pa
tients who were not HIV infected and had
severe non-tuberculous mycobacterial infec
tion of at least two organ systems. Six of the
patients had MAC
The patients had received the maximum
tolerated conventional treatment for at least
four months and had become drug-resistant
before enrolling in the current study. Treated
with interferon gamma, all patients rapidly
improved and many of their symptoms abated.
“Laboratory and animal studies have sug
gested that interferon gamma, a protein nor
mally secreted by the immune system’s T
cells, plays an important role in containing
and clearing mycobacterial infections in the
body,” says Dr. Holland. “We also noted that
patients in this study produced smaller
amounts of this protein than healthy people.
Once we added interferon gamma to their
therapy we saw dramatic improvement with
few side effects, which leads us to conclude
that the protein may someday be used in the
treatment of other mycobacterial infections,
including tuberculosis.”
Investigators injected interferon gamma
under the skin three times weekly for several
months in addition to providing the standard
antimycobacterial drugs.
This study builds on other interferon
gamma research by the same team of NIAID
investigators, led by John I. Gallin, M.D.,
director of the Warren Grant Magnuson Clini
cal Center and NIH associate director for
clinical research. Previously, researchers
found that interferon gamma could be suc
cessfully used to manage a disorder called
chronic granulomatous disease or CGD. CGD
is a group of rare, life-threatening diseases
caused by an inherited defect in any one of
several genes. “These findings have impor
tant implications for using interferon gamma
and related immune-boosting proteins in the
management of infectious diseases,” says Dr.
Gallin.
Physicians also use interferon gamma to
treat leprosy, a mycobacterial disease that
affects the skin, peripheral nerves and upper
airways.
DOD to stop demanding
repayment from ousted gay
servicemembers
WASHINGTON, DC—After concerted
efforts by Servicemembers Legal Defense
Network (SLDN) and Representative Gerry
Studds (D-MA), the Department of Defense
(DOD) has issued a new policy on
recoupment, ending the practice of requiring
servicemembers to repay scholarship mon
ies, bonuses and special pay if they are dis
charged for saying they are gay.
“This is a small, but significant step for
ward,” said C. Dixon Osbum, an executive
director of SLDN. “Servicemembers who
are involuntarily thrown out of the military
because of the gay ban will not be required to
repay scholarship monies and enlistment bo
nuses if they have been discharged only for
saying they are gay.”
The new recoupment policy came after
Studds pressed for clarification of the case of
Eric Fenner, 24 of Washington, DC, who was
discharged from the Navy last year after
serving only half of his six-year enlistment.
Since leaving the Navy last year, the Navy
has repeatedly demanded that Fenner repay
his enlistment bonus. Eventually, he re
ceived a notice from the Internal Revenue
Service, stating it had applied his federal tax
refund to satisfy a portion of this “debt.” In
addition, Fenner received a demand for re
payment from a collection agency for the
remaining balance plus a substantial collec
tion fee.
In a letter to Studds, Deputy Secretary of
Defense John Deutch said the decision to try
to make Fenner repay his enlistment bonus
was a “misinterpretation of recoupment poli
cies at the time of his separation in March
1993. Mr. Fenner will be permitted to keep
the unearned portion of his enlistment bonus.
We have taken action to effect this, and to
ensure future interpretations of recoupment
policy are correct.”
Studds noted that others forced to leave
the service are rarely required to repay the
unearned portions of their scholarships or
enlistment bonuses. Even the cadets recently
expelled from the U.S. Naval Academy for
cheating were told they would not be required
to reimburse the government for the educa
tions they had received.
Michelle Benecke, also an executive di
rector of SLDN, was cautious in her appraisal
of the new policy. “The new recoupment
policy still permits the military to seek repay
ment of scholarship and bonus monies from
servicemembers who are discharged for ho
mosexual acts, including private, consensual
sexual activity. The problem is that the
military selectively targets gay people for
discharge, even though 80%-90% of hetero
sexuals engage in sexual activity that is in
violation of military regulations. In fact,
SLDN knows of no cases where the military
has discharged heterosexuals for consensual
sexual activity in violation of military regula
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tions and then demanded repayment of schol
arships and bonus monies.
Osburn agreed. “It is ironic that the Pen
tagon will not seek recoupment for the Naval
Academy midshipmen who were discharged
for cheating on a final exam last year, but will
seek recoupment from gay servicemembers
who, in response to a direct question by a
commander or investigator, honestly reveal
their sexual relationships,” he said.
AIDS experts issue vaccine
testing recommendations
WASHINGTON, DC—The search for a
preventive HIV vaccine may depend as much
upon the implementation of extensive social
and behavioral research, social safeguards
and collaboration among government agen
cies as it does on scientific breakthrough, a
Washington conference concluded.
“The testing of an HIV vaccine presents
unprecedented challenges, and will test our
will, our creativity and our ability to reach
across our differences toward a common
goal,” said conference organizer Derek Hodel.
Hodel is the treatment issues director of AIDS
Action Council.
The May 9-10 conference, sponsored by
the Washington-based AIDS Action, drew
nearly 300 participants and issued a 40 page
report—HIV Preventive Vaccines: Social,
Ethical and Political Considerations for
Domestic Efficacy Trials—^with over 50 rec
ommendations.
“For communities at greatest risk of con
tracting HIV, we are as desperate for a vac
cine as we are for a cure,” says Hodel. “Our
recommendations will provide the founda
tion for a successful partnership among gov
ernment, industry, academia and the commu-
Continued on page 25
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