Number of Diagnosed AIDS Cases in U.S. Rises For First Time Since 1993, CDC Researchers Announce at Retrovirus ConferenceCDC officials yesterday at the 10th Conference on Retroviruses and Opportunistic Infections in Boston, announced that the number of diagnosed AIDS cases in the United States rose by 1% from 2000 to 2001 to 41,311, the first increase since 1993, USA Today reports. In addition, the number of HIV diagnoses increased by 8% from 1999 to 2001 in the 25 states that report such figures to the federal government. However, Ronald Valdiserri, deputy director of the CDC's National Center for HIV, STD and TB Prevention, said that the "statistical snapshot" of data might not be accurate, as it does not include New York, California and other states that account for 75% of AIDS cases nationwide. "We may be seeing a resurgence of HIV infection in the United States," he said, adding, "We don't want to be alarmist, but now is the time to address this. We don't want to wait two or three years" (Sternberg, USA Today, 2/12). Approximately 850,000 to 950,000 people in the United States are HIV-positive, "more than at any point in the epidemic," Valdiserri said, adding that 280,000 of HIV-positive people in the United States do not know they are infected. The CDC report also showed that 5% of men and 6% of women who were newly diagnosed with HIV were tested because a health care provider recommended doing so, while 5% of men and 11% of women were tested because the clinic offered the service. However, most people who were newly diagnosed were tested after they started to notice symptoms, the Los Angeles Times reports (Maugh, Los Angeles Times, 2/12). Valdiserri also reported that the incidence of new HIV cases diagnosed among gay men rose 14% between 1999 and 2001, "significantly higher" than the 8% rise seen in the general population, according to the San Francisco Chronicle. He added, "It's only a single point in time, and we can't say it's a trend, but it is very worrying" (San Francisco Chronicle, 2/12). Valdiserri said that the CDC hopes to have more accurate data in 2004, when all 50 states will be required to report new HIV cases (USA Today, 2/12).
Internet Linked to Risky Behavior
Another study presented at the conference found that "new venues" for meeting sex partners, especially the Internet, could be contributing to the spread of HIV, the Wall Street Journal reports (Zimmerman, Wall Street Journal, 2/12). Researchers from the Medical and Health Research Associates of New York City, along with colleagues from the New York Blood Center, the New York State Psychiatric Institute and Columbia University, surveyed nearly 3,000 men who have sex with men who visit chat rooms on a "general interest" Web site called gay.com (Altman, New York Times, 2/12). The respondents included men from all 50 states, 85% of whom were white and almost 90% of whom had attended at least some college. About 8% of the respondents were HIV-positive. Eighty-four percent of the men said that they had met a sexual partner online, and those men were more likely to have had unprotected anal intercourse in the past six months (64%), compared with men who did not meet sexual partners online (58%). HIV-positive men who found sex partners online were more likely to have had unprotected intercourse than other men who used the Internet to find sex partners, the Washington Post reports. Sabina Hirshfield, lead author of the study, said, "The Internet is a new venue associated with high-risk sex." She added that "it may be possible to reach high-risk (men) through Internet interventions" (Brown, Washington Post, 2/12).
Increased Use of HIV Quick Test
CDC officials at the conference also called for more widespread use of a rapid HIV test, which was approved by the FDA in November 2002, to help curb the spread of the disease by identifying newly infected people "as soon as possible," the New York Times reports (New York Times, 2/12). Earlier this month, President Bush announced that HHS had approved expanded availability for OraSure Technologies' OraQuick HIV test, which offers results that are 99.6% accurate within 20 minutes, to more than 100,000 doctors' offices and public health clinics across the country. The FDA in November 2002 approved the test for use in only about 40,000 hospitals and clinics with laboratories. AIDS groups had advocated for making the test available at smaller outreach clinics and mobile testing sites in order to make the test more accessible to the general population (Kaiser Daily HIV/AIDS Report, 2/3). Validserri said the test should be "part of routine health care for those at risk of infection," according to the Times. The quick test is "an important tool in the government's stepped-up program to reduce by half the annual number of new infections by 2005," the Times reports (New York Times, 2/12).
Researchers at the conference also discussed a "bumper crop" of at least 10 "promising" new HIV/AIDS drugs that could "substantially expand the arsenal of medicines available" to treat the disease, the Boston Globe reports (Smith, Boston Globe, 2/12). Currently, the FDA has approved 16 antiretroviral drugs, most of which are aimed at "just two targets in the virus' life cycle," the AP/Wall Street Journal reports. But new drugs in development are aimed at eight different points in the HIV life cycle. The next drug expected to win FDA approval is Fuzeon, a fusion inhibitor that blocks HIV from attaching to blood cells. The drug was formerly known as T-20 and is being developed by Roche and Trimeris, (AP/Wall Street Journal, 2/12). Fuzeon is designed to be used for HIV-positive patients who have developed a resistance to other antiretroviral drugs. Fuzeon must be injected twice a day, and the drug will cost between $10,000 and $15,000 per patient per year. The FDA granted the drug priority review status in October and will likely review the application by March (Kaiser Daily HIV/AIDS Report, 12/20/02). At the conference, researchers also discussed the "next generation" of this type of drug, T-1249, intended to be used when the virus becomes resistant to Fuzeon. Other drugs in the pipeline include Tanox's TNX-355, an antibody that works by blocking "the spot on blood cells where HIV normally attaches itself." Initial testing of the drug by Boston's Brigham and Women's Hospital found that one injection every one to three weeks significantly reduced virus levels, the AP/Journal reports (AP/Wall Street Journal, 2/12).
Possible Long Wait for Approval
Dr. John Mellors, chief of infectious disease at the University of Pittsburgh, said, "The pipeline of new drugs has an impressive number of candidates in it. This is something we haven't seen in many years." He estimated that there were six drugs in clinical trials that aim to help patients who have developed resistance to existing antiretroviral drugs, compared with only one or two such drugs that were in trials a few years ago. However, Dr. Calvin Cohen, research director of Community Research Initiative of New England, warned that the drugs in the pipeline "will take several years" to gain approval. "It's wonderful to see the drug industry looking and to see some of these results ... [b]ut it's also important not to rely on new drugs to get us out of this mess," Cohen said (Boston Globe, 2/12). Selected highlights from the conference, which ends on Friday, are available online at HIVandHepatitis.com (HIVandHepatitis.com, 2/12).