I understand that a distinction is made between HIV and AIDS. I think the average life expectancy after diagnosis of HIV ranges from 5 years to 25 years. Is that correct? Once the AIDS-defining illness occurs, what is the prognosis, and the average life expectancy? Thank you for your time and expertise.

Having had AIDS is just a way of saying that HIV has dammage the immune system. It doesn't say much about future survival with good care. The current standard of care regimens, like those listed in the DHHS guidelines, should effectively suppress your virus and have a good record for long term (more than years and extrapolated data suggests possibly "indefinite") effectiveness with good safety. The longer term health issues for many people with HIV may therefore relate to other diseases like liver disease (if you have hepatitis or drink lots of alcohol), smoking-related disease, heart and kidney disease. So looking after your general health with no smoking, a good diet and exercise is critical. Its hard to predict life expectancy for any individual, doctors aren't good at play in God! Several large cohort studies have published data on HIV and life expectancy. In the Danish and ART collaboration cohorts survival with HIV has been getting closer and closer to normal even for people who became infected quite young. So I think you should continue to plan for a long and healthy life. CD4 low point (nadir) and robustness of CD4 recovery on therapy are both of interest to researchers at present in further narrowing the gap between HIV+ survival and HIV- survival. The general view being that starting treatment with a stronger immune system and recovering to normal CD4 values is probably the best plan. Hope this helps Dr Moyle