AIDS Falls Off List of Top 10 Killers in U.S.

For the first time since it joined the list in 1990, AIDS is no longer among the nation’s top 10 killers, as deaths last year dropped by a remarkable 47%.

The disease moved from eighth to 14th after the unprecedented decline in 1997, according to a report released Wednesday by the Centers for Disease Control and Prevention’s National Center for Health Statistics.

The data came from the CDC’s annual vital statistics report on births and deaths in the United States. The study also reported a new low for infant mortality and continued declines in homicides and teen births.

Health and Human Services Secretary Donna Shalala called the “tremendous decline” in AIDS deaths “particularly striking.” She and others attributed the dramatic reduction to the huge effect of powerful new AIDS drugs that have come onto the market in recent years.

“What this says is that the benefits of the research effort that has been ongoing for the last 15 years is clearly paying off for patients,” said Dr. Robert T. Schooley, who chairs the executive committee of the federal government’s AIDS Clinical Trials Group.

“This is why we do the research, and it’s really gratifying to see these improvements show up so dramatically,” he added. “I would challenge anybody to come up with any single disease that has had such a dramatic change in mortality in such a short period of time.”

Similarly, Daniel Zingale, executive director of AIDS Action, a Washington-based lobbying and education group, called the news “one of the most extraordinary accomplishments in the 15-year fight against AIDS,” adding: “Just a few years ago, those diagnosed with AIDS received a sentence to near-certain death. Today, despair has been transformed into hope.”

AIDS deaths dropped for the first time in 1996, reflecting both the introduction of potent protease inhibitor drugs and increases in resources devoted to treatment and prevention, and the trend has continued, with dramatic declines. Still, last year also saw about 40,000 new infections, a number that isn’t dropping.

In 1995, there were 43,115 AIDS deaths, according to the health statistics center. By 1997, the number had plummeted to 16,685, down from 31,130 in 1996.

In the typically hardest-hit 25- to 44-year-old age group, the declines in deaths were across the board in 1997. In this group, AIDS dropped from being the leading cause of death in 1995 to the third-leading cause in 1996, and the fifth-leading last year.

In the same age group, the death rate of 5.9 deaths per 100,000 population was the lowest since 1987, the first year mortality statistics were available for the disease. The 1997 rate was less than half of the 1992 rate of 12.6, and almost one-third of the 1995 rate of 15.6.

But disparities still exist between whites and minorities ages 25 to 44, with white men showing the greatest gains. And acquired immune deficiency syndrome is still the No. 1 killer in the black population.

For white men and women in this age group, death rates dropped 53.2%, while the decrease for blacks was 42.6%.

And for black males 25 to 44 years old, death rates dropped 44.6% in 1997 compared with the previous year; for white men, it was 54.4%. Mortality dropped 37.3% for black women, compared with 45.5% for white women.

In other statistics, the government reported that the overall infant mortality rate reached a new low of 7.1 deaths per 1,000 live births, and the birthrate to teenage mothers fell about 3% last year, continuing a six-year trend. Also, the homicide rate fell 12% in 1997.

In addition, life expectancy for those born in 1997 reached a record of 76.5 years, CDC said.

Schooley, noting that advocates for increased funding for other diseases have attacked AIDS funding hikes in recent years as unfair, said that current AIDS therapies have proved vastly more cost-effective than other, more routinely used interventions for other diseases.

AIDS drugs cost about $10,000 a year but are offset by savings resulting from fewer hospitalizations and AIDS-related illnesses, Schooley said.

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

AIDS Death Rates

Per 100,000 total population

1995: 15.6

1997: 5.9

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

HIV Deaths Decreasing

HIV-related deaths decreased by nearly 47% in 1997 from 1996. It was the first time since 1990 that HIV wasn’t one of the top 10 causes of death. (Death rate per 100,000 population)

Rank: 1

Causes: Diseases of heart

Death rate: 271.2

% change from ‘96: -3.4%

*

Rank: 2

Causes: Malignant neoplasms

Death rate: 200.8

% change from ‘96: -2.3%

*

Rank: 3

Causes: Cerebrovascular diseases

Death rate: 59.7

% change from ‘96: -1.9%

*

Rank: 4

Causes: Chronic obstructive pulmonary diseases

Death rate: 41.3

% change from ‘96: 1.8%

*

Rank: 5

Causes: Accidents and adverse effects

Death rate: 34.4

% change from ‘96: -4.9%

*

Rank: 6

Causes: Pneumonia and influenza

Death rate: 33.0

% change from ‘96: 3.1%

*

Rank: 7

Causes: Diabetes

Death rate: 23.3

% change from ‘96: -1.5%

*

Rank: 8

Causes: Suicide

Death rate: 11.1

% change from ‘96: -4.6%

*

Rank: 9

Causes: Nephritis, nephrotic syndrome

Death rate: 9.6

% change from ‘96: 4.7%

*

Rank: 10

Causes: Chronic liver disease, cirrhosis

Death rate: 8.3

% change from ‘96: -4.0%

*

Rank: 11

Causes: Septicemia

Death rate: 8.4

% change from ‘96: 2.4%

*

Rank: 12

Causes: Alzheimer’s disease

Death rate: 8.4

% change from ‘96: 0.0%

*

Rank: 13

Causes: Homicide and legal intervention

Death rate: 7.0

% change from ‘96: -11.8%

*

Rank: 14

Causes: Human immunodeficiency virus

Death rate: 6.2

% change from ‘96: -48.6%

*

Rank: 15

Causes: Atherosclerosis

Death rate: 5.9

% change from ‘96: -9.1%

Source: National Center for Health Science