The Associated Press; Thursday June 2, 1988

"Viewing HIV infection as a disease is important because it may eventually be amenable to treatment and patients will need to be diagnosed and treated as early as possible," the academy said in a report.

The report based its recommendation on what is now "scientifically conclusive" evidence that the human immunodeficiency virus, or HIV, causes AIDS.

"From a public health perspective, the important event is infection rather than full-blown disease because even asymptomatic infected persons are capable of infecting others," it said.

But the report also called for a federal law to prevent discrimination against people with the AIDS virus, a measure opposed by the Reagan administration.

Although it encouraged more voluntary testing to get better information on the magnitude of the epidemic, the report says mandatory testing "is currently appropriate only for blood, tissue and organ donations" and specifically says testing should not be a requirement for getting a marriage license.

Theodore Cooper, chairman of the committee, told a press conference the call for antidiscrimination legislation "might be the first among equals" of several recommendations because it is at the root of so many other objectives.

For example, he said, one thing holding back more voluntary testing is the fear of discrimination. And one of the results of limited testing is lack of accurate data to make good projections about the number of people infected with the virus.

Cooper, who also is chairman and chief executive officer of Upjohn Co., said the message calling for federal antidiscrimination must be brought to the "attention of both the president and Congress, reiterated and made strong enough."

He said such legislation is "fundamental to the success" of the overall AIDS fight.

The report also called for establishment of a new, semipermanent federal commission to oversee the nation's response to the epidemic after the present White House commission goes out of business this month.

The report was prepared by a joint committee of the academy and one of its operating arms, the Institute of Medicine, and was presented as "an update of and a supplement" to the academy's initial 1986 report on AIDS.

The new call for placing additional emphasis on the estimated number of people infected with the virus reflected what the committee said was a growing consensus that "the vast majority of persons" with the virus "will eventually progress to AIDS if no treatment is found to slow or halt the progression of the infection."

Moreover, the panel said many people infected with the virus suffer from "clinical syndromes and laboratory test abnormalities that signal the presence of disease but do not meet" technical guidelines for being listed as either AIDS or AIDS-related complex.

The symptoms for the latter-ARC for short-were incorporated in a definition by the Centers for Disease Control but never used for case reporting.

"The committee believes that the term ARC is no longer useful, either from a clinical or a public health perspective, and that HIV infection itself should be considered a disease," said the report.

However, the panel acknowledged that CDC estimates showing as many as 1.4 million Americans may be infected with the virus-as opposed to a little over 62,000 diagnosed with full AIDS-are based on epidemiological studies and projections rather than extensive data.

"The imprecision of those figures and others about prevalence, incidence, modes and efficiencies of transmission, and other crucial information, bespeaks the need for more facts," the report said. In the section calling for a new AIDS commission, the committee singled out Surgeon General C. Everett Koop for "continuing superb leadership" and cited biomedical researchers, the CDC and the Food and Drug Administration as "areas of progress" within the federal government.

"Nevertheless, the committee has concluded that the federal response has been too uneven," it said. "Inadequacies persist in the provision and financing of health care, in setting standards for antibody testing and antidiscrimination, (and) in addressing IV substance abuse . . . and in furnishing overarching direction for all components of the government and the private sector."

The report complimented the leadership of retired Navy Adm. James D. Watkins as head of the White House AIDS commission working toward a June 24 deadline for its final report.

880601
AP880601

Copyright © 1988 - Associated Press. Reproduction of this article (other than one copy for personal reference) must be cleared through the AP Permissions Desk.

AEGiS is a 501(c)3, not-for-profit, tax-exempt, educational corporation. AEGiS is made possible through unrestricted funding from Broadway Cares/Equity Fights AIDS, Elton John AIDS Foundation, National Library of Medicine, Pacific Life Foundation, and donations from users like you.

Always watch for outdated information. This article first appeared in 1988. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 1988. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .