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NIH Awards UNC-CH, Duke $21 Million to Boost Care for AIDS Patients, Research

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Duke Health News 919-660-1306

DURHAM -- AIDS specialists at the University of North
Carolina at Chapel Hill and Duke medical schools will receive
$21 million from the National Institute of Allergy and
Infectious Diseases
over the next five years to continue
their battle against the deadly illness.

The money is part of renewed national Adult AIDS Clinical
Trials Group (AACTG) funding. It will support care for people
living with AIDS across North Carolina and clinical trials that
already have resulted in far more effective treatments than
were first available and promise further medical progress, the
physicians say.

"Since the beginning of the AIDS epidemic, the AACTG has
made enormous contributions in helping people with HIV live
dramatically longer and healthier lives," said Dr. Anthony S.
Fauci, director of the institute. "AACTG studies have been and
will continue to be an invaluable source of scientific data,
significantly advancing our ability to treat HIV."

Duke's effort, directed by Dr. John Bartlett, associate
professor of medicine, will receive $8.5 million. UNC-CH's, led
by Drs. Charles van der Horst and Joseph Eron, professor and
associate professor of medicine, respectively, will get $12.5
million.

The new federal funding reflects both the quality of AIDS
research and treatment in North Carolina and the growing number
of people infected with HIV -- the virus that causes AIDS -- in
the region, Bartlett said.

"The fact that two of the 32 units are in North Carolina
calls attention to the ongoing HIV epidemic in the Southeast,"
he said. "The Southeast reports more new cases of HIV infection
than any other region in the country, a fact that has escaped
the attention of many people in the region and nationally."

"AIDS remains a huge problems in North Carolina,
particularly among teen-agers, heterosexuals and
African-Americans," van der Horst said.

In North Carolina, 8,769 people had been diagnosed with AIDS
through 1998, and 8,479 adults and adolescents tested positive
for HIV but had not developed "full-blown" AIDS yet, he said.
In 1998 alone, 788 people were newly diagnosed with AIDS, while
tests showed 978 others contracted HIV.

"This is only the tip of the iceberg since most persons
infected with HIV have not been tested and do not know they are
infected," van der Horst said.

One hundred and nineteen of the new AIDS cases in 1998 were
in young people ages 13 to 29, the physician said. All probably
were infected as teens. Of new AIDS patients, 590 were male,
and of those, 224 contracted the virus through heterosexual
activity or did not know how they became infected. The rest
were homosexuals or drug users.

"In 1998, 333 of the males diagnosed as HIV positive were
between the ages of 13 and 29 and were likely infected as
teen-agers, a huge number," van der Horst said. "Of new AIDS
cases that year, 558, or about three-quarters, were among
African-Americans."

Too few North Carolinians at risk of contracting the virus
are being tested, he said. Deaths from AIDS are down
dramatically, however, and patients' quality of life has
improved.

"We also have a much better understanding of how this virus
works, and we've been able to suppress the virus down to
undetectable levels even though we know it's still there," van
der Horst said. "I had one patient who was getting $30,000
worth of intravenous medication a year to prevent him from
going blind and becoming paralyzed. Now he's been off that
medication for three years, takes only medicines to treat his
HIV, is working full time and paying taxes again."

The federal support to Duke and UNC-CH saves North Carolina
about $3 million each year in medication costs the state would
be required to spend, he said. The continuing research also has
taught physicians a tremendous amount about secondary
infections that can be applied to other health problems
suppressing the immune system such as cancer and kidney, lung
and heart transplants.

Future collaborations between the two schools will include
helping set up a system with community groups to better
coordinate care so that fewer infected N.C. residents go
undiagnosed or untreated.

"AIDS clinical trials sites provide access to
state-of-the-art treatment and experimental therapies for North
Carolinians living with HIV disease," Bartlett said. "In
addition, they extend care to people with little or no
financial resources. Grants like these both advance our
scientific knowledge regarding the best HIV treatments and
provide care for patient who might otherwise be lost."

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