CHAPEL HILL - 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 pay, 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."
Physicians at Duke's infectious disease clinic and its outreach clinics in Henderson and Fayetteville follow more than 1,200 HIV-infected patients. UNC-CH doctors, who maintain outreach clinics in Greensboro and Charlotte, follow about the same number.
Note: van der Horst and Eron can be reached at 919-966-2536, Bartlett at 684-6416
Duke contact: Richard Merritt
684-4148
UNC-CH contact: David Williamson
962-8596