The Chicago Tribune, 435 North Michigan Avenue, Chicago, IL 60611 - Monday, September 1, 1997 Edition: NORTH SPORTS FINAL Section: METRO CHICAGO Page: 1 Word Count: 1,119
Sue Ellen Christian, Tribune Staff Writer.

The decline in mortality, according to new city health figures for 1996, is attributable to the benefits of protease inhibitors and the emergence of "drug cocktails," in which various medications are taken in an attempt to attack the virus at different points in its growth cycle, authorities said.

But the findings are not all positive: Though the number of deaths among men has dropped, the mortality figures for women increased.

Last year, 777 Chicagoans died of causes relating to HIV and AIDS compared with 968 in 1995, according to the Chicago Department of Public Health.

The new data, to be released Monday, represent the first significant drop in AIDS deaths since the epidemic began in 1980. Until last year, the number of deaths had steadily risen, city figures show; the only other decline occurred in 1994, when there were 931 deaths compared with 961 a year earlier.

"This is really a historic moment," said Steven Whitman, the department's director of epidemiology. "For the first time, there is some hope, apparently, in staving off death from AIDS. Everybody is holding their breath that this will continue."

If anything, the decline is more extraordinary because the number of people living with AIDS is continuing to increase, said Whitman.

Mortality figures for 1996 are not yet available for Cook County or Illinois. But roughly 75 percent of all HIV/AIDS cases are in Chicago, so statewide mortality numbers are expected to indicate a similar decline.

However, the good news is not enjoyed equally among all groups of Chicagoans--and it comes with a hefty dose of caution.

"With all this great news, people can't let their guard down and say, 'This is a cure.' These drug regimens are very complicated and very expensive, and it's not like taking an aspirin. It's allowed some people to let their down guard down in terms of prevention," said Robert Rybicki, Chicago's assistant commissioner for HIV/AIDS.

Also, while the number of men dying of AIDS last year declined sharply, deaths among women rose to 125 last year from 121 in 1995.

Though roughly 75 percent of AIDS cases are among men, there has been a steady increase in the number of African-Americans, particularly women, with the disease.

"It's not a gender issue, it's a race issue," said Whitman.

For African-Americans, the legacy of the infamous Tuskegee experiment, in which black men with syphilis went untreated by government doctors even though treatment was available, influences their attitude toward the new HIV/AIDS drugs, said many experts.

Cathy Christeller, executive director of the Chicago Women's AIDS Project, said, "

Most of these women do not automatically trust the medical experts," she said.

"Women are aware and interested in the new drugs, but they are waiting to be convinced of their effectiveness."

Christeller and officials of other Chicago-based HIV/AIDS programs say low-income and minority women in particular face a range of obstacles, from child-rearing responsibilities that make getting to a clinic difficult to following the dietary guidelines necessary to make the drugs effective.

Minority women also are not benefiting from the newest drugs because of problems with access to primary health care and with the medications.

For example, GiGi Nicks, an African-American woman with AIDS, wanted to begin taking one of the new protease inhibitors, but she could not find it anywhere in her predominantly black community of Maywood last spring.

"So, I went from pharmacy to pharmacy, and I ended up finding it in Berwyn," said Nicks, 45, who receives her treatment at Cook County Hospital. "I took it upon myself to call the makers of the drug, and each month since, I've had to call the company in California to get it air-shipped to my pharmacy just for me. That shouldn't be."

Protease inhibitors are aimed at neutralizing a key enzyme of the AIDS-related virus and thwart its reproduction.

The practice of combining various medications is aimed at lowering "viral loads," which indicate the level of activity of the virus in the body, and boosting the T-cell level, which indicates the strength of the immune system response.

The Food and Drug Administration hurriedly approved the protease inhibitors last year based on early studies showing patients' health improved dramatically and quickly after taking the medications. However, researchers cannot say what the long-term effects, whether good or bad, of the drugs will be.

Phillip Matthews, who has been HIV-positive for 15 years, began taking protease inhibitors last winter. He takes seven drugs and more than 20 pills daily, but it has paid off.

Matthews' T-cell count is up and his viral load is undetectable. He has put weight on his 6-foot-2-inch frame and goes to the gym four times a week.

"The benefits for me have been noticeable. I'm probably in the best shape I've been in my life," said Matthews, who is executive director of the Test Positive Aware Network, a Chicago education and information organization.

"It's done wonders for a lot of people; I've seen people down to five T-cells, who were very, very sick, and now they are back going to the gym, gaining weight and thinking about returning to work," Matthews said. "But I've also seen people on these drugs who died."

For about 30 percent of AIDS and HIV patients, the cocktail medications are ineffective.

Unfortunately, that seems to be the case for Nicks, who was diagnosed with AIDS in 1994.

"It hasn't worked for me," Nicks said. "It's like you're being fooled, like you're opening up a gift and the box is empty."

But the new drugs also mean that people such as Patty, who did not want her real name used, now must plan for a future they never expected to come.

The 45-year-old North Sider is HIV-positive and transferred the virus at birth to her now-teenage son. Both are on a mix of drugs, including protease inhibitors. For Patty, the drugs have not done much, though she has never been seriously ill from her disease. But for her teenage son, the cocktails have substantially improved his health.

"Six years ago, I said, 'What will I have to save money for? Who knows if I'll be here in 10 years?' " Patty said. "And now it's a totally different story. Now we've got to talk about college for my kid."

Copyright 1997/The Chicago Tribune. Reproduced with permission. Reproduction of this article (other than one copy for personal reference) must be cleared through the Permissions Desk, The Chicago Tribune, 435 North Michigan Avenue, Chicago, IL 60611.
970901
CT970901

Always watch for outdated information. This article first appeared in 1997. 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, 1997. 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. .