The Associated Press; 50 Rockefeller Plaza, New York, NY 10020 - Sunday, September 28, 1997; 12:13 p.m. EDT
Daniel Q. Haney, AP Medical Editor

Researchers from the U.S. Centers for Disease Control and Prevention estimate that about 775,000 Americans carry HIV, and at least 500,000 have been tested and know their status.

The CDC research is the first careful attempt to arrive at this figure using infection data collected by the states. Until now, many experts had guessed that about half of all HIV-infected Americans were aware of it.

"This is encouraging, because it suggests that the majority of persons with HIV have been tested," said Dr. Patricia Sweeney, who directed the study. "We need to continue to work to ensure these people have access to recommended treatment."

Some experts are pushing for more widespread AIDS testing now that treatments exist that can delay and perhaps stop HIV's destruction of the immune system. Doctors believe that the sooner treatment starts, the better the chance of controlling the disease.

The new data suggest the problem of undiagnosed infections may be smaller than previously believed. Nevertheless, they also mean that roughly 275,000 Americans are unaware of their HIV infections and are not getting early treatment.

Sweeney presented her findings at an infectious disease conference sponsored by the American Society for Microbiology. Another CDC study presented Sunday demonstrates the importance of the new treatments for prolonging lives.

Sweeney's figures were based on the cases of infection reported to the CDC through June from 25 states where doctors are required to report the names of patients who carry the virus.

In these states, 240,000 people were known to be living with AIDS, and another 76,000 were infected but not sick. The researchers used these data to estimate the number of diagnosed infections in the states without mandatory reporting of HIV infections.

The researchers say their two-thirds estimate is conservative, since it does not include people who learned of their HIV status through anonymous testing. Among those whose infections are known to authorities, 80 percent were diagnosed in hospitals, doctors offices and clinics.

"We need to continue to stress the need for early testing to maximize the potential benefits of new therapies to extend people's lives," Sweeney said.

Nationally, AIDS deaths fell 23 percent last year. Combinations of AIDS drugs that include a new class of medicines called protease inhibitors are generally credited with this turnaround. However, until now, this belief was based more on anecdotes than on hard data.

Dr. Scott Holmberg analyzed the records of 2,957 AIDS patients who were seen in 10 HIV clinics. He linked their death rates with their use of combination therapy.

The first weak protease inhibitor became available in late 1995, and two stronger ones that are now mainstays of treatment arrived in the spring of 1996.

Through 1995, the death rate among these patients averaged 7 percent every three months. By the third quarter of 1996, this had fallen to 3 percent, and in the final quarter of last year, it was just 2 percent.

Those who survived were also healthier. Every three months in 1995, 18 percent of AIDS patients fell sick with infections that are common complications in this disease. By the end of last year, just 3 percent got these infections.

The declining toll of AIDS among these patients was matched by their increasing use of combination therapy, including combinations of AIDS drugs that were available before the advent of protease inhibitors.

During the first quarter of 1994, 15 percent took combinations. This increased to 29 percent in the first three months of 1995 and 87 percent in the first quarter of 1996. By the end of last year, 92 percent of AIDS patients were getting the combination treatment.

"This is an important step in winning the war against AIDS," Holmberg said.

Copyright 1997/The Associated Press. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Associated Press, 50 Rockefeller Plaza, New York, NY 10020.
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