Deaths from AIDS-related illnesses among Chicagoans plummeted by more than half in 1997, sending the total back to 1988 levels, Chicago Health Department officials said Monday.
The drop builds on a nationwide trend that began in 1996. AIDS deaths fell 19 percent in Chicago that year, to 783. The numbers released Monday put the toll at 377 in 1997, a drop of 52 percent.
And, for the first time, the decrease is nearly as dramatic among African-Americans and Hispanics as it is among white men. Deaths for women had their first annual decline, with 36 percent fewer deaths than in 1996.
“Overwhelmingly, it’s the largest decrease we’ve seen,” said Dr. Steven Whitman, director of epidemiology for the Chicago Department of Public Health.
From 1980 to 1996, he pointed out, the numbers of AIDS-related deaths never declined.
Whitman credited the results to so-called drug cocktails, combination drug therapies that have restored health to many by arresting the ability of HIV, which causes AIDS, to replicate and survive in the body. The far-reaching results showed that the drugs, also known as protease inhibitors, are being made available to people in all communities, he said.
Experts cautioned, however, that the virus has developed resistance to drug cocktails in some patients on the regimen. Combined with a steady rate of new HIV infections–just under 60,000 per year nationwide–the uncertain future of the new therapies means physicians, patients and researchers must struggle to keep the gains won so far.
“The fight is far from over when hundreds of people continue to die,” said Mark Ishaug, associate director of the AIDS Foundation of Chicago.
During the plateau years of 1993 to 1995, nearly 1,000 deaths were attributed to HIV-related complications each year in Chicago. The nationwide decline that started in 1996 came as the first combination drug therapies became widely available.
In 1995, 536 blacks in Chicago died of complications from AIDS. In 1996, 474 died and in 1997 the number dropped to 258 deaths.
In 1995, 115 Hispanics died of AIDS complications. In 1996, the number dropped to 104 and in 1997 it fell to 45.
Among whites, the numbers fell from 315 deaths in 1995 to 196 deaths in 1996 and 73 deaths in 1997.
Despite such promising trends, AIDS experts said more can be done to make new treatments available to minorities and women.
“You’re seeing a more equal but not completely equal distribution of the good news,” said Dr. Mardge Cohen, director of the Women and Children’s HIV program at Cook County Hospital. “Any difference between groups makes us wonder if there are obstacles in the health care system.”
One major hindrance is cost–combination therapy still can run as much as $25,000 per year, though Cohen’s poorest patients get their treatment for free from the government. Another challenge, Cohen said, is getting physicians to help all their patients build enough motivation to stick to the treatment, which often involves taking a dozen pills a day.
Although national AIDS death statistics for 1997 are not yet available, deaths around the country declined by 44 percent in the first half of the year. The Centers for Disease Control and Prevention is scheduled to release figures for the whole year at the 12th International Conference on AIDS, set to begin June 28 in Geneva, Switzerland.
Whitman, who believes the rate of new HIV infections may actually be increasing, said the best way to reduce deaths from AIDS is still to keep infections from ever occurring.
“It is absolutely crucial that people not let down their guard and believe there is no need to practice safer techniques,” Whitman said. “The best course of action is prevention. It’s the safest, most sensible and cheapest option.”
