I read the recent Lancet article on the prognosis for lifespans with those with HIV. It seemed a bit vague. I started therapy when I was 45 and my T-cells were under 90. For the past 12 years I've been totally well (just a bit overweight), but my T-cells never go above 500. Anyway, it seems according to this article that I should live till I'm 65 or so. I'm 57 now. Is there a way to really forecast this kind of thing? Thanks Ajax

Dear Ajax The ART Collaboration article in the Lancet August 3 2008 evaluated 18 587, 13 914, and 10 854 ersons with HIV who initiated combination antiretroviral therapy in 199699, 200002, and 200305, respectively. 2056 (47%) deaths were observed during the study period, with crude mortality rates decreasing from 163 deaths per 1000 person-years in 199699 to 100 deaths per 1000 person-years in 200305. Potential years of life lost per 1000 person-years also decreased over the same time, from 366 to 189 years. Life expectancy at age 20 years increased from 361 (SE 06) years to 494 (05) years (i.e a 20 years old would on average expect to live to 69.4years of age). As in the general population, women had higher life expectancies than did men. Life expectancy was lower in patients with lower baseline CD4 cell counts than in those with higher baseline counts (324 [11] years for CD4 cell counts below 100 cells per ěL vs 504 [04] years for counts of 200 cells per ěL or more). The authors concluded that life expectancy in HIV-infected patients treated with combination antiretroviral therapy increased between 1996 and 2005, although there is considerable variability between subgroups of patients. Tis is great news that years on year tha gap is closing. Since 2005 we have had multiple new and better agants approved so we believe that this gap has noarroed further. Avoiding hepatitis C and injection drug use are two factors known to widen the gap. The data are not intended to predict life expectancy in individuals but to provide a guide to assist future planning. At age 57 with an undetctable viral load and a reasonable CD4 count you can expect to for better than the average because youv'e already made it almost to the average. I would suggest looking at your family history as the best guide to your life expectancy Kind regards Dr Moyle