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Thousands More AIDS Cases on Jan. 1

December 29, 1992

ATLANTA (AP) _ The number of people diagnosed with AIDS will climb dramatically when a new definition of the disease goes into effect Friday, raising demand for treatment and dollars.

Under the new definition, an estimated 90,000 Americans will be diagnosed with full-blown AIDS in 1993, according to the Centers for Disease Control and Prevention. That’s almost double the current average of 50,000 a year.

Since 1981, about 242,000 Americans have been diagnosed with AIDS and 160,000 have died.

The new definition could make it easier for people infected with the virus to collect disability benefits available to those diagnosed with AIDS. It would also enable them to take part in drug trials and qualify for low-cost medicines.

At the same time, some AIDS activists warned that it would sharpen competition for scarce dollars.

″All of the services are already strained and on the edge,″ said John Kappers of the National Association of People With AIDS.

Under the CDC’s current, 5-year-old definition, people infected with the AIDS virus are diagnosed as having AIDS when they develop certain blood infections, the skin cancer Kaposi’s sarcoma or any of 21 other indicator diseases

Activists charged that women and drug users weren’t receiving the help they needed because many of the diseases they got weren’t included on the list.

The new definition, approved earlier this year, adds pulmonary tuberculosis, recurrent pneumonia and invasive cervical cancer.

In addition - and more important, according to the CDC - the agency approved a new indicator: 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.

Up to 190,000 of the 1 million Americans infected with the virus have CD4 counts below 200 and most don’t know they are infected or have never had a CD4 count, said Dr. James Buehler, acting deputy director of the CDC’s AIDS division.

″We hope the definition will draw attention to the importance of testing,″ he said.

The Ryan White CARE Act distributes federal AIDS funds to cities according to the number of AIDS cases, so more cities may be eligible under the new definition. However, the act has never been fully funded, leaving AIDS clinics understaffed and many Americans who can’t afford the $200 CD4 tests.

″People are seeking these tests and being told they have to wait six months for the next clinic opening,″ Kappers said. ″That’s six months they could be taking medicine to prolong their life.″

The AIDS clinic at Grady Memorial Hospital, Atlanta’s only clinic for indigent patients, is already so crowded it can care for only the sickest patients, said director Curtis Morriss.

″This is contrary to everything we know about HIV disease because treatment is most effective in the early stages,″ Morriss said.

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