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AIDS epidemic slowing nationwide, but not in Md. Rate of new cases in state last year was 4th-highest in U.S.

Although the number of new AIDS cases in the United States dipped last year, the epidemic has shown no signs of abating in Baltimore and Maryland.

With 2,951 people diagnosed in the state last fiscal year, Maryland had the fourth-highest rate of new cases in the nation, trailing New York, Florida and New Jersey, according to figures released by the U.S. Centers for Disease Control and Prevention. Two years ago, the state ranked eighth.

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In the fiscal year that ended June 30, about 59 new cases were diagnosed for every 100,000 people living in the state, compared with 45 per 100,000 a year earlier. Baltimore's rate was about 84 per 100,000 last year, more than twice the national average for a city with more than 500,000 residents.

"These are new AIDS cases, which means behaviors that took place a while ago," said Dr. John Bartlett, chief of infectious diseases at the Johns Hopkins Medical Institutions. The largest share of new cases stemmed from transmission between needle-sharing drug addicts as many as 10 years ago.

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It can take that long for the infection to progress to full-blown acquired immune deficiency syndrome, in which the patient falls prey to an assault of devastating infections.

Nearly 12,000 cases of AIDS have been reported in Maryland since the epidemic began.

"The epidemic is not going away," said Dr. Thomas Quinn, a professor of medicine and international health. "It's not under control at all."

Worldwide, the epidemic has taken its greatest toll in Africa, where 11 million people are infected, but Dr. Quinn said India looms as the next disaster area.

In the United States, the epidemic struck gay men hardest when it surfaced in the early 1980s. More recently, intravenous drug addicts have been most affected.

In Baltimore, slightly more than half of the new AIDS cases last year occurred among addicts; gay men accounted for 17 percent of the new cases.

Dr. Bartlett, speaking at a World AIDS Day observance at the downtown Stouffer Hotel Friday, estimated that 1,000 people in Baltimore will become infected this year with the virus that causes AIDS, about three new infections each day.

He said about 14,000 city residents are infected, about 2 percent of the population.

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The region will face a staggering financial burden as cases mount in years to come, experts said at the forum.

Dr. Alfred Sommer, dean of the Johns Hopkins School of Hygiene and Public Health, said it will cost about $7.5 billion to treat 50,000 infected people in the Baltimore-Washington corridor as their illnesses progress and they require drugs, hospitalization and counseling.

The federal government recorded 76,802 newly reported cases of AIDS in the fiscal year that ended June 30, down from 84,577 a year earlier.

Dr. Liza Solomon, director of the Maryland AIDS Commission, hailed the advent of the drug 3TC as the first new therapy against the human immunodeficiency virus in many years. But she said many of the patients who volunteered for clinical trials might not be able to afford the drug now that it is available commercially.

The drug is to be used in combination with AZT. The wholesale price for the combined drug therapy will be $12.67 to $13.96 per daily dose, as much as $5,100 a year, the Associated Press reported. The cost to patients would be higher.

The manufacturer, Glaxo Wellcome Inc. of Research Triangle, N.C., promised the volunteers a one-month free supply when the drug received federal approval last month. But Dr. Solomon said the company should consider providing for patients who lack health insurance.



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