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Reduction in U.S. HIV-Related Deaths, 1996 to 1997: Statement of Anthony S. Fauci, Director National Institute of Allergy and Infectious Diseases National Institutes of Health

Date: October 7, 1998
Source: National Institutes of Health (NIH)
Author: National Institute of Allergy and Infectious Diseases (NIAID)

The age-adjusted death rate from HIV infection in the United States dropped an estimated 47 percent from 1996 to 1997, according to a new report from the National Center for Health Statistics of the Centers for Disease Control and Prevention.

The report, Births and Deaths: Preliminary Data for 1997, indicates that HIV infection was the 14th leading cause of death in the United States in 1997, down from 8th in 1996. Among people ages 25 to 44, HIV was the fifth leading cause of mortality in 1997; in this age group, HIV had been the leading cause of death in 1995, and the third leading cause of death in 1996.

This new report is encouraging news for individuals living with HIV, as well for the community devoted to understanding, treating and preventing HIV infection. Many HIV-infected people in this country are leading longer and healthier lives.

However, it is important not to become complacent with regard to the HIV/AIDS epidemic because the fight against the disease is far from over. The new mortality data should not obscure the fact that the rate of new HIV infections in this country -- approximately 40,000 per year -- continues at an unacceptably high level. Globally, one in every 100 adults 15 to 49 years of age is now HIV-infected, and the epidemic continues to accelerate. Each day, 16,000 people are newly infected with HIV, mostly in regions where access to anti-HIV therapy is limited or non-existent.

Clearly, we must continue to stress HIV prevention efforts, which have been shown to reduce the number of new infections when properly executed. In addition, the development of new therapies and a safe and effective HIV vaccine are critical public health needs and important priorities of the NIH.

The recent decline in HIV-related mortality in the United States is probably due to several factors, particularly the increased use of potent, albeit expensive, combinations of anti-HIV drugs. In addition, our armamentarium of medications to prevent and treat the opportunistic infections associated with HIV disease continues to grow. Consensus guidelines have been developed for treating both HIV and related infections; these guidelines, when appropriately applied, have improved the prognosis for HIV-infected individuals.

It also is likely that increased access to care, our growing expertise and experience in caring for HIV-infected people, and the decrease in new HIV infections in the late 1980s due to prevention efforts are partly responsible for the reduction in HIV-related deaths we are seeing today.

Unfortunately, many HIV-infected individuals have not responded adequately to currently available anti-HIV drugs, cannot tolerate their toxicities, or have difficulty complying with complex dosing schedules. In addition, the ability of HIV to mutate and become resistant to the current drugs is a persistent threat, both to individuals receiving therapy and to uninfected individuals who engage in unsafe sexual or drug-taking behavior with HIV-infected individuals carrying drug-resistant strains of the virus.

These realities underscore the importance of sustaining our commitment to learning more about the HIV disease process and developing the next generation of antiretroviral therapies; these agents would ideally be potent, inexpensive, relatively non-toxic even after prolonged periods, active against viral strains resistant to currently available agents, and easy to administer. In addition, the development of safe and effective therapies that boost the immune system is an important research priority.

NIAID, a component of the National Institutes of Health (NIH), supports research on AIDS, malaria and other infectious diseases, as well as allergies and asthma. NIH is an agency of the U.S. Department of Health and Human Services.