Alarming rate of AIDS cases concerns CDC

ATLANTA — The number of Americans with AIDS increased at a surprising rate during the first three months of the year, when more than 35,000 new cases were reported, federal health officials said Thursday.

Most of the new cases stemmed from a new definition of the deadly disease, but even cases not attributed to the broader definition increased by 21 percent, double the rate for the period last year.

“That is higher than we expected,” said Dr. John Ward, chief of AIDS surveillance for the Centers for Disease Control and Prevention. “Some of that 21 percent is a sign that the AIDS epidemic is continuing to grow.”

It also means that people with HIV who have fought off AIDS with medication for several years are starting to get sick, said Lynora Williams, spokeswoman for the AIDS Action Council, a patient advocacy group based in Washington.

“The figures should definitely be read as a cause for concern,” she said.

Since 1987, HIV patients were defined as having AIDS once they contracted certain blood infections, the skin cancer Kaposi’s sarcoma or any of 21 other indicator diseases.

On Jan. 1, three more diseases — pulmonary tuberculosis, recurring pneumonia and invasive cervical cancer — were added. So was a dip in the level of the body’s master immune cells, called CD4s, to 200 per cubic millimeter, or one-fifth the level of a healthy person.

Between Jan. 1 and March 31, 35,779 new AIDS cases were diagnosed nationwide, a 204 percent increase from the 11,770 new cases during the same period in 1992 under the old definition, the CDC reported. Last year, under the narrower definition, cases increased about 10 percent every three months.

Sixty percent of this year’s increase, or 21,582 cases, was based solely on the new definition — a surge the CDC expected. These are people long infected with HIV who were never considered AIDS cases because of the definition’s technicalities.

In Maine, 51 new cases of AIDS were reported between January and March, and more than 65 percent of them were attributed to the new definition, said Geoff Beckett, assistant state epidemiologist in the state Bureau of Health.

Ward attributed some of this year’s extra increase to the publicity surrounding the new AIDS definition, which may have made doctors more aware of the indicator diseases and prompted them to test more patients.

But also it’s probably due to patients succumbing to AIDS because AZT and other anti-viral medications work only for a few years, Ms. Williams said.

The AIDS Action Council also said some of the surge may have resulted from an attempt by cities to get more funding for AIDS prevention. The first of the year is when cities report their eligibility for federal AIDS funds under the Ryan White CARE Act, which disburses money according to how many cases each city has.

The CDC had predicted 90,000 new AIDS cases will be diagnosed in 1993, 40,000 of them from the new definition. The agency’s latest report did not revise that projection.

Since 1981, 289,320 AIDS cases have been reported in the United States. The CDC estimates 1 million people are infected with HIV.