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Hiv lifespan question
Jun 19, 2003

I have read many posts that say that if you take your medicines for hiv exactly as prescribed you will live a normal lifespan. Is this true? If it is then why are so many people in the world dying from it if it was this easy to treat?

Response from Dr. Pierone

Right now we don't know the answer to this critical question, "what is the long-term prognosis of treated HIV infection?" The bad news is that we will not have this answer until you and I have lived out our normal life span and unfortunately we won't be here to hear the answer. But this doesn't stop us from making future predictions based on what we know now.

What we do know now is that the medications currently available for treatment of HIV infection are able to control HIV replication, produce significant improvements in CD4 cell numbers, prevent immune damage, and strengthen the immune system for those with a depleted immune system. Treatment has clearly translated into improved survival for HIV infection and death rates have plummeted for those on treatment.

What will happen to people with HIV infection 10 to 20 years from now (or longer) is simply not known. The optimistic viewpoint is that as a result of medical progress the treatments will be better able to control HIV, have fewer side effects, and people living with HIV infection a decade from now may not have any limitation to their normal life span. (normal life span should also be improving a decade or two from now). The very optimistic viewpoint is that some really bright team of scientists will come up with a practicable gene therapy approach that will control of HIV infection without need for ongoing medications.

The pessimistic viewpoint is that 10 or 20 years from now persons with HIV infection will have multi-drug resistant virus, as yet unknown medication related side effects, and a decreased quality of life and length of life.

My personal view goes with the optimistic scenario for those living with HIV in developed worlds. From the global vantage point, people are still dying with HIV because most lack of access to medications.

100% adherence = 100 % success?

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