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Near Normal LIfe Expectancy?
Feb 7, 2004

Hello Doctors, again thank you for being there. Near Normal Life Expectancy? If you have contracted HIV at 20 years old, does a near normal life expectancy mean you can live for another 50 years? Near normal life expectancy for a 40 or 50 year old is obviously possible. I want to believe that my son will have another 50 years of good health. Please let me know what you reasons are for believing he can have a near normal life span. I so desperatly want to believe he will live far beyond me. Thank so much!

Response from Dr. Pierone

Yes, a 20 year old with HIV can certainly have a near normal life expectancy. HIV is not curable, but is a treatable and controllable disease like diabetes. That is why we talk about the diabetes paradigm for HIV infection. For both diseases lifestyle modification and long-term therapy are necessary and achievable. For both, those that adhere to therapy have much better health outcomes.

Some people with diabetes miss medication doses, eat whatever they want, receive sporadic medical care, and as a result have terrible glucose control. They are much more likely to suffer complications like blindness, kidney failure, infections, and heart attacks than someone with diabetes that is sensible and pays attention to their health.

These same general rules apply to HIV, those that are on a program and can stick with it do really, really well. Not everyone with HIV needs to be on medications from the get go. It depends on viral load and CD4 count and HIV-related symptoms. For those that do require treatment the response to medications is remarkable. However, the regimens are unforgiving with regard to missing doses. If someone on treatment is not able to take their medications with a high level of fidelity, viral resistance may occur. Development of resistance leads to loss of effectiveness of therapy and compromises future treatment options as well.

This said, someone newly infected with HIV at age 20 should have a near normal life expectancy (50 plus years), especially as newer and better medications emerge. Good luck to your son and maintain a positive outlook on his situation.

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