November 3, 2000
Since 1995 the number of deaths from AIDS in the United States has dropped from nearly 50,000 per year to less than 17,000. Deaths have dropped in Europe and Canada too. Doctors and scientists believe that fewer people are dying because many have been helped by new treatments which work against HIV, the virus that causes AIDS.
But some people claim that HIV doesn't really cause AIDS. These people, called "AIDS deniers," "denialists" or "AIDS dissidents," say the new drugs haven't reduced AIDS deaths. Some even claim that the medicines actually make people get sick and die.
After rising every year since 1981, 1996 was the first year that AIDS deaths ever dropped. The number of deaths dropped again in 1997 and 1998.
Second, doctors learned more about how to treat AIDS. Even before HAART, doctors were learning to combine anti-HIV drugs and got better at preventing or treating many of the infections that kill people with AIDS.
These better treatments were already starting to slow down the increase in AIDS deaths. But HAART dramatically added to that improvement.
In a cohort study, scientists try to learn as much as they can about people's daily experiences in order to see what helps them. The volunteers come in regularly to have blood tests, and at the same time the scientists ask about things that may affect their health -- like what they eat, whether they smoke, drink alcohol or take any medicines.
These studies can be very large, with many thousands of people, and often go on for many years. All the information from these thousands of people helps doctors learn what things help or hurt people over a long period of time.
One of the largest HIV/AIDS cohorts began in 1990. This "Adult/Adolescent Spectrum of Disease Project" has studied over 49,000 people with HIV. By January, 1998, 9,280 had died. Patients on any anti-HIV treatment were less likely to die than those with similar illness who weren't taking anti-HIV medicine. People not taking anti-HIV drugs were 6 times as likely to die as comparable patients on 3-drug HAART combinations.
Another cohort, the HIV Outpatient Study, has followed over 3,500 HIV patients in eight U.S. cities since 1992. In this group, people not taking any anti-HIV treatment were four and a half times as likely to die as comparable patients taking combinations that included a protease inhibitor. Several large studies in Europe have shown the same kind of result.
In San Francisco, the Department of Public Health has kept track of about 95 percent of the city's AIDS patients. Patients taking combinations that included a protease inhibitor were 57 percent less likely to die than people who didn't take any anti-HIV treatment.
See our Web site (http://www.aidsnews.org) for a PDF version of AIDS Treatment News #354.
ISSN # 1052-4207
Copyright 2000 by John S. James. Permission granted for noncommercial reproduction, provided that our address and phone number are included if more than short quotations are used.
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