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Life Expectancy
Aug 14, 2003

What kind of life expectancy am I looking at if I have been diagnosed HIV positive but don't do any of the following?

1. take recreactional drugs, including poppers. 2. take antiretroviral drugs to treat "aids". 3. take rectally deposited sperm. 4. repeatedly acquire other stds. 5. use antiboitics often. 6. live in fear of dying from hiv. 7. have a lot of stress. 8. suffer from lack of sleep/malnutrion.

Are there any mortality studies which have been conducted on hiv positive people outside of the risk groups, living healthy lives? I haven't been able to find any.

Response from Dr. Pierone

The natural history of a disease is what typically occurs in the untreated condition over time. I believe you want some evidence or studies of the natural history of HIV infection for someone that is living a well-balanced, low stress, healthful life, with avoidance of recreational drugs and unsafe sex.

The natural history of untreated HIV infection is about 10 years from acquisition of infection to development of AIDS, then about 1-2 years from point of AIDS diagnosis. This is the average, some people are more susceptible to the deleterious effects of HIV, some less so. In fact, there are persons with long-term non-progression of HIV infection. There are people documented to have had HIV for over 20 years and still have normal CD4 counts. This underscores the tremendous variability in human response to HIV infection. Measurement of viral load provides a general sense of how active the untreated infection is and how rapidly it will advance. Those with lower viral load levels have a better prognosis (when untreated, those with high viral load can do very well with treatment).

One of the determinants of viral load is concurrent infection. If someone has ongoing infections and STDs this will often lead to spikes in HIV replication as the immune system responds to the infection and latently infected CD4 cells activate and start producing HIV. These repeated spikes might lead to more rapid development of AIDS, so leading a life with fewer opportunities for infection probably confers some long-term benefits.

With regard to HIV positive patients outside of risk groups leading healthy lives, I am not aware of studies that select only these individuals.

Actually, all of the strategies that you list are really good ideas. The only point that I disagree with is number 2, when antiretroviral treatment becomes necessary, it is lifesaving. The death rate has plummeted in recent years in developed countries because of HIV medications. Hope this explanation helps, good luck.



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