HIV life expectancy near normal, research confirms

A study carried out by the University of Bristol has shown that the life expectancy of 20-year-olds starting treatment for HIV has increased by around a decade in the EU and North America since the introduction of antiretroviral therapy, closer to a normal life expectancy.

It is hoped the findings, published in The Lancet, could help to reduce stigmatisation and help people with HIV gain employment and obtain medical insurance, as well as encouraging those diagnosed to start treatment as soon as possible and continue it fully.

The study used data for 88,504 people with HIV who started antiretroviral treatment between 1996 and 2010 from 18 European and North American studies. In order to estimate life expectancy, researchers tracked how many people died during the first three years of their treatment, their cause of death, HIV viral load, immune cell (CD4 cell) count and whether they were infected through injecting drugs.

Their projections suggested that life expectancy of a 20-year-old who began treatment from 2008 onwards and had a low viral load after a year of treatment may approach that of the general population (around 78 years old).

Adam Trickey, from the School of Social and Community Medicine at the University of Bristol and lead author of the study explained: ”Our research illustrates a success story of how improved HIV treatments coupled with screening, prevention and treatment of health problems associated with HIV infection can extend the lifespan of people diagnosed with HIV. However, further efforts are needed if life expectancy is to match that of the general population.
Combination antiretroviral therapy has been used to treat HIV for 20 years, but newer drugs have fewer side effects, involve taking fewer pills, better prevent replication of the virus and are more difficult for the virus to become resistant to."

Tricky added: “Since modern treatment is highly effective with low toxicity, deaths in people living with HIV are unlikely to be reduced by further development of drugs. Now we need to focus on the issues surrounding drug adherence, late diagnosis of HIV, and diagnosis and treatment of co-occurring conditions. In drug users we must promote therapy and improve access to therapy to treat addictions as well as increasing access to hepatitis C treatment for people with both infections. Although most people are likely to start treatment soon after diagnosis of HIV, this will only result in improved survival overall if the problems of late diagnosis and treatment access are addressed."