AIDS falls on list of top killers but transmission rates stay high

Thursday, October 15, 1998

AIDS falls on list of top killers but transmission rates stay
high

FINDINGS: Drugs work at prolonging life but virus can develop
immunity

By Matt Grace

Daily Bruin Contributor

After catapulting into the nation’s list of top 10 killers, AIDS
has started to fall – and that’s a good thing.

For now.

"It’s exciting that it has dropped from the list of top
killers," said Jerome Zack, associate director for the UCLA AIDS
Institute, "but the drugs are not a panacea."

Although the discovery of powerful new multi-drug combinations
in the past has made it difficult for the AIDS virus to replicate,
regimented pill-scheduling and high costs have counteracted the
drugs’ effectiveness.

And the barrage of drugs – known as protease inhibitors –
doesn’t work for everyone.

Strains of HIV have become immune to three drugs used in these
cocktails, protecting the virus from the "three-pronged attack,"
and making this good news a little more sobering.

"There will probably be an upswing in the next five years in the
number of AIDS-related deaths," Zack said.

"People feel that this is a treatable disease, but it is
difficult to take all the pills and deal with the side effects," he
said. "As far as we know, people need to be on the therapy for the
rest of their life."

According to the Center for Disease Control and Prevention’s
(CDC) National Center for Health Statistics, the death rate from
AIDS has dropped almost 50 percent since 1996.

As a result, the disease moved from eighth to 14th on the CDC’s
list of common causes of death in the U.S.

In 1995, 43,115 people died from AIDS, compared to 16,685 in
1997, according to the CDC.

This decline reflects the drugs’ success in extending the lives
of the newly infected – but that doesn’t mean the number of HIV
transmissions has been reduced, said Roger Detels, professor of
epidemiology in the UCLA school of public health.

In fact, the infection rates continue to climb in heterosexual
populations.

Approximately 40,000 new infections occurred last year, despite
the fact that infection rates for intravenous drug users and
homosexuals reached a plateau over the last seven to eight
years.

Specifically, new drug therapies have extended the lives of
infected individuals who would have otherwise died. This increases
the reservoir of infected individuals, who, in turn, have the
potential of infecting other people.

The problem escalates in communities where HIV education is not
mainstream.

"Communities of color always play the catch-up game in terms of
being diagnosed and treated,"said Gil Mangaoang, director of client
services and a treatment of advocate for Asian Pacific Intervention
Team. They have a tendency to be secretive about the disease and
ignore HIV as a health risk, he said.

"We will see the drop in the death rate much sooner in the white
population than in minority populations," said Mangaoang. Infected
individuals, as a result, will not always be identified.

"For communities of color, the death rate will be much greater
than the mainstream white population."

In addition to shadowing the plight of minorities, the recent
announcement of the drop in HIV-related deaths has eclipsed the
AIDS epidemic in the rest of the world.

The HIV infection rate is increasing worldwide. Treatments are
not available in developing countries because they are far too
expensive and the strict drug schedules are too difficult to
follow.

"The price of these drugs needs to be knocked down so that the
majority of infected people have access," Detels said."This
involves a change in economics, profit motivation and
politics."

In the meantime, researchers will to continue the search for new
drug alternatives and simplify the use of multi-drug cocktails.

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