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6 November 2001 Annals of Internal Medicine Tip Sheet

Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 internal medicine physicians and medical students. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656.

Aspirin Not a Substitute for Colorectal Cancer Screening

(See news release)

Hepatitis B Virus (HBV) Studies Provide New Information

Two reports on hepatitis B virus (HBV) infection shed new information on infection. One study looked at the results of a universal vaccination program against HBV started in Taiwan in 1984 (Article, p. 796). The study showed that the mass vaccination program has dramatically decreased both the HBV infection rate and the carrier rate. The second study followed 1,536 Alaska Natives with chronic HBV for a median of 12.5 years (Article, p. 759). This study found that about 70 percent of the carriers recovered from the infection within ten years, when measured by disappearance of a HBV viral protein in the blood.

An estimated 1.25 million people in the United States have chronic HBV infection, and an estimated 5,000 die from liver failure and liver cancer each year. The United States implemented routine vaccination of infants for HBV, an important cause of liver disease, in 1992. Today, most infections occur among older adolescents and young adults by sexual transmission. An editorial says that immunizing more infants "will ensure that future generations are protected from HBV infection and its consequences" (Editorial, p. 835). But the writer says that unless the United States institutes a nationwide program to vaccinate adults at risk for HBV, "acute disease will continue to occur and transmission of HBV will not be eliminated for decades."

Gene Variations May Slow Progression from HIV Infection to AIDS

This study showed that variations in genes (CCR5-?32 and CCR-641 alleles) were associated with decreased risk for progression from HIV infection to AIDS (Article, p. 782). Drugs that imitate the effect of these genetic variations might delay the progression of HIV infection.

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