In the journal AIDS, Jensen-Fangel of Aarhus University Hospital and colleagues note that they followed 647 HIV-infected patients starting HAART and 64,700 members of the general population (the "control" group) for an average of 3.5 years.

During follow-up, there were 53 deaths in the HIV group and 815 in the control group. This yielded an overall mortality rate of 26.9 per 1000 people per year in the HIV group and 3.8 per 1000 people per year in the control group.

However, mortality rates in HIV-infected patients ranged from 70 per 1000 people per year in those with the lowest CD4 cell counts (less than 50 cells per microliter) to 3.2 per 1000 people per year in those with the highest counts (200 cells per microliter or greater). The mortality in the latter group, say the investigators, is akin to that reported in patients with insulin-treated diabetes.

Thus, the researchers conclude that HIV-infected patients starting HAART with a CD4 count above 200 cells per microliter had "low mortality rates that were comparable with the rates found in other chronic medical diseases."

SOURCE: AIDS, January 2, 2004.

During the study period, 101,877 new HIV infections were recorded. By state, the prevalence of infections acquired through heterosexual contact ranged from 13 percent to 47 percent. Although a rise in heterosexually transmitted cases occurred during the 4-year period, the increase was not statistically significant.

Sixty-four percent of the heterosexually transmitted cases occurred in females, the report indicates. In terms of age groups, people 30 to 39 years of age accounted for more than one third of such cases.

As noted, the majority of cases acquired through heterosexual contact involved minority ethnic groups. In contrast, the racial distribution of cases non-heterosexually acquired, such as by intravenous drug use or homosexual contact, was more equal.

"Prevention and education programs targeting heterosexually active teens, especially females and persons in certain racial/ethnic populations should be developed," the CDC advises.

In addition, "barriers to care and prevention services" for non-Hispanic black and Hispanic populations "should be removed."

SOURCE: Morbidity and Mortality Weekly Report CDC Surveillance Summary, February 20, 2004.

"Over the past five to six years, we've diagnosed about 250 new HIV cases annually. But in 2002, that number rose to 280, and last year, we registered 380 new cases," Milton told AFP.

About half of the new cases can be attributed to immigrants who moved to Sweden already infected with the virus, while about 80 to 90 new infections were contracted by Swedes traveling abroad, Milton said.

"A number of those cases can be attributed to sex tourism," he said, pointing out that about 40 percent of the cases where Swedes were infected abroad concerned heterosexual men, while another 40 percent were homosexuals.

Only between 20 to 30 people were infected through heterosexual intercourse or needle-sharing in Sweden in 2003, Milton said.

On a global scale, that number may appear low, but Milton insisted that there is reason for concern.

"We have seen a sharp increase in other sexually transmitted diseases. There's been a tripling of gonorrhea cases, and of clamydia cases since the mid-90s, and we're registering five times more syphilis," Milton said.

"Young people and men who have sex with men are demonstrating riskier sexual behavior. More people are having sex without a condom," he added, explaining that the fear of AIDS appears to have subsided in Sweden.

"A lot of young people don't seem to realize how serious this illness is," he said.

About 3,200 people living in Sweden, which has a population of almost nine million, have been diagnosed with HIV.

HIV growth rates in Estonia, Russia and Ukraine are among world's highest, U.N. declares

MOSCOW — Russia, Ukraine and the Baltic nation of Estonia have some of the world's fastest HIV growth rates, the United Nations Development Program declared in a report released Tuesday. The world body said one in every 100 adults of the three countries is infected.

According to the report on HIV and AIDS in the Commonwealth of Independent States, or CIS, and Eastern Europe, the HIV crisis poses a threat to the region's economic growth, placing new pressure on already threadbare social welfare programs.

"It is already too late to speak of avoiding a crisis," said Kalman Mizsei, the U.N. Development Program's assistant administrator for Europe and the CIS, in a statement.

The crisis has increased health spending from 1 to 3 percent of the nations' gross domestic product and cut annual GDP growth by 1 percent due to premature death among the productive population.

"Nevertheless, there is still much that governments and civil societies can do to reduce the social, demographic, and economic consequences of HIV/AIDS and even reverse the epidemic," Mizsei said in the statement.

The U.N. AIDS agency, UNAIDS, estimates that up to 280,000 people in the CIS and Eastern Europe had contracted HIV last year. In all, some 1.8 million people in the region have HIV, according to UNAIDS data.

According to Tuesday's report, 80,000 people required treatment for AIDS but only 7,000 were receiving it.

AIDS in Russia and other former Soviet republics appeared later than in other countries, but then spread rapidly due to weak anti-drug and prevention programs.

"A better balance needs to be struck between bringing hard-core narcotics traffickers to justice and responding to a public health menace," the U.N. Development Program said in its report.

HIV and AIDS cases in Russia used to involve mainly drug addicts and homosexuals, but heterosexual transmission has been on the rise lately. According to the Russian Justice Ministry, the infection rate in prisons is rising by 15 percent to 20 percent a year.

"But it can spill over and ... become a generalized epidemic," Marcia Kran, an adviser with the U.N. Development Program in Bratislava, Slovakia, told reporters in Vienna, Austria.

Officials have recorded more than 257,000 HIV cases in Russia, more than 7,500 of which involve children. But Vadim Pokrovsky, head of the Health Ministry's AIDS Prevention and Treatment Center, has estimated that the actual infection rate was much higher — from 700,000 to 1.5 million.

In Ukraine, some 68,000 people are officially registered as HIV-positive, but experts estimate 500,000 people — more than 1 percent of the population — are infected with the virus that causes AIDS.

In Estonia, 3,621 people are officially registered as HIV-positive, according to the Social Welfare Ministry. Ministry spokeswoman Katrin Pargmae said unofficial estimates were twice as high.

BERLIN - Scientists in Germany on Monday launched the country's first test of an HIV vaccine, a yearlong program that will involve up to 50 volunteers and is backed by the New York-based International AIDS Vaccine Initiative.

The trial will be conducted at university clinics in Bonn and Hamburg, and also at Belgian hospitals in Brussels and Antwerp, the international initiative said.

Known as tgAAC09, the vaccine targets HIV subtype C, prevalent in South Africa, India and China, and responsible for a large part of the world's HIV infections. The vaccine was developed by Seattle-based Targeted Genetics Corp. and the Columbus Children's Research Institute.

The first-phase testing in Germany and Belgium is aimed at determining the vaccine's safety and whether it produces immune responses. If it is successful, the second and third phases of testing would be carried out in developing countries, project leader Jan van Lunzen told reporters.

IAVI estimates that some 30 HIV vaccine tests already are under way worldwide. The German trial should start in the next two weeks, IAVI spokesman Michael Nord said.

Experts believe a vaccine is the only way to stop the worldwide AIDS epidemic, which has killed 20 million people and infected 40 million more. The search has been frustrating, because the virus has developed elaborate and effective strategies to elude the body's usual defenses against microbes.