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effectiveness of meds
Dec 17, 2006

Hi, Just wanted to say thank you for everything you contribute to this wonderful website. Ok so I am confused about data I read as far as people stating an expected 24 year life expectancy, etc. If one can remain undetectable for a decade or so on even the first round of drugs, with so many other options after that how could such a short life expectancy be given? I know the future cannot be predicted but for people completely undetectable 10 years on HAART it seems unlikely to imagine them only being expected another 10 or 15 years of life? What are your opinions on this, any news on pipeline meds? I've heard a new Merck protease inhibitor is coming out soon or is out already? Thank you very much

Response from Dr. Wohl

Do not read too much into the 24 year survival figure. This number is from one study that used a computer model to estimate benefit and costs of HAART. The point really is that the life expectancy of people living with HIV has tripled over the past dozen years. People with HIV are dying but increasingly of non-HIV related diseases.

Certainly, those who maintain undetectable viral loads for 23 years do not have to start worrying that they have 12 months to live. But, there are a number of people who do not maintain control of their HIV and many who present for care with advanced AIDS. These folk have more of a challenge than those who are detected early and are able to maintain long term HIV supression.

As you indicate, an additional cause for optimism is the promise of new drugs. The Merck integrase is already available via expanded access as is TMC-125 - a new non-nuke active against some virus that is resistant to efavirenz and nevirapine - and a CCR5 inhibitor. These can only further help pave the way for added years of HIV control.

DW



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