ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Friday, February 28, 1997 TAG: 9702280075
SECTION: NATIONAL/INTERNATIONAL PAGE: A-1 EDITION: METRO
DATELINE: WASHINGTON
SOURCE: From The Washington Post and The Associated Press
Deaths from AIDS in the United States last year fell significantly for the first time since the AIDS epidemic began in the early 1980s, federal health officials reported Thursday.
The decline in AIDS deaths occurred in all regions of the country and in all racial and ethnic groups. However, the trend was not seen among women or among people infected with HIV through heterosexual contact - two demographic groups in which the epidemic is still growing.
Epidemiologists at the national Centers for Disease Control and Prevention, which made the announcement, believe deaths from AIDS are falling for two reasons: The number of infected people who are progressing to AIDS - the advanced, often-lethal stage of the disease - is leveling off; at the same time, better medical therapies are prolonging the survival of patients who are already at that stage.
The total number of deaths from AIDS in the first six months of 1996 was 22,000, compared with 24,900 deaths during a similar period in 1995 - a 13 percent decrease, according to the data compiled by the CDC. Although there had been slight declines for short periods earlier in the epidemic, last year's was by far the largest.
``I think this speaks to the success of the dual approach of counseling, testing and treating people with HIV,'' said Patricia Fleming, the CDC's chief of HIV/AIDS reporting and analysis.
The trend appears to have begun in 1995. Only some of the fall can be attributed to the growing use of protease inhibitors, a potent new class of antiviral drugs that didn't become widely available until last spring. Protease inhibitors are now commonly used in combination with two other antiviral drugs in what's become known as ``triple therapy.''
``AIDS deaths began to plateau in 1995, and that really suggests that something began to happen before protease inhibitors were licensed by the [Food and Drug Administration],'' said John Ward, CDC's chief AIDS epidemiologist.
Two forces, in particular, appear to have preceded the arrival of the first protease inhibitor in December 1995. One was the use of two-drug antiviral combinations, which prolonged survival among AIDS patients even though they are less effective than triple therapy. The second is more widespread use of an anti-infective pill that helps prevent Pneumocystis carinii pneumonia, the most common ``opportunistic'' infection in AIDS patients, whose immune systems are severely damaged.
In Virginia, AIDS deaths fell from 443 during the first half of 1995 to 345 during the same period in 1996, a 22 percent decrease, according to the Virginia Department of Health.
Worldwide, AIDS deaths continue to rise. Last year, more than 1.5 million people died from the disease, which amounted to about 25 percent of all AIDS deaths since the start of the epidemic.
``Like much in recent AIDS news, this news is mixed,'' said Christine Lubinski, deputy executive director of the AIDS Action Council, which represents hundreds of AIDS service organizations in the country. ``It's good to see that AIDS deaths declined. However, the deaths are increasing for women, and the infection rates are increasing for people of color. What we now need to do is to ensure that everyone at risk for HIV, or living with HIV, has access to good prevention and health care.''
``In my view, this decline is unfortunately only a lull,'' said Dr. Irvin Chen, director of the AIDS Institute at UCLA. ``Not all patients are responding as effectively as the majority of patients. There are some patients for whom the drugs are not effective.''
And some advocates point out that AIDS patients, as they live longer, will need more help, not less.
``It's still difficult for a person to walk into a doctor's office and be treated for AIDS,'' said Christopher Portelli, executive director of the National Lesbian and Gay Health Association in Washington. ``We are concerned that people will misinterpret this news. We would hope to see more money and support for better access to medical services. New drugs are not all we need.''
The drop in mortality nationwide was not evenly distributed among groups of AIDS patients.
AIDS deaths among men infected by sexual contact with other men fell by 18 percent. Deaths in people exposed through intravenous drug use fell by 6 percent. People exposed through heterosexual activity had a 3 percent rise in deaths.
Blacks accounted for more cases of AIDS than whites for the first time in 1996 - 41 percent to 38 percent. Hispanics accounted for 19 percent, and other races 2 percent.
The magnitude of the trend also varied by region. AIDS deaths fell 16 percent in the West, 15 percent in the Northeast, 11 percent in the Midwest, and 8 percent in the South.
Epidemiologists estimate that, in all, 600,000 to 900,000 Americans are infected with with human immunodeficiency virus, the virus that causes AIDS.
LENGTH: Medium: 92 lines KEYWORDS: FATALITYby CNB