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Alarming deaths
Sep 24, 2011

This may not be the right forum for my concern, but it does seem to be the best of the choices available. Over the past few years, we HIV+ folks have been given increasingly optimistic news about our condition and our life- and lifestyle-expectations. My own ID specialist is so convinced that the current pharmaceuticals and also those in the pipeline are so effective that if one remains adherent there is little possibility that I (and we HIV+ people) will die of AIDS, but rather from the various ravages of old age that most everybody dies from. Yet, there has lately been a spate of relatively young HIV+ people who have died recently,namely Dr Robert Frascino who participated in this site, and Marcel van Soest, Executive Director of World AIDS Campaign, who died last week at age 46. What gives? Is HIV/AIDS as chronic disease (Sanjay Gupta called it that just the other day) just an optimistic myth or are the recent deaths of these two HIV/AIDS champions merely coincidental and not indicative of an HIV/AIDS future?

Response from Dr. Young

Hello and thanks for posting.

While we all are painfully aware of the losses of those who we closely know and it's tempting to draw broad conclusions from the deaths of prominent members of the community, I'd try to keep the conclusions about life expectancy based on the best large cohort studies.

For example, our published and ongoing analysis of several thousand HIV+ people in multiple US clinics (called HOPS) has shown that among positives in care, that HIV-related deaths are vanishingly rare. Life expectancy estimates are a moving target, but these and other cohorts in North America and Europe, suggest very long, AIDS-free life.

That said, it would be unfair not to note your concern- it's reflective of growing awareness of the changing spectrum of possible complications, pre-mature aging and possible decreased life-expectancy compared to the general population.

What I can say is that in our clinic of about 1000 individuals in one small city (Denver), AIDS-related deaths are vanishingly rare (I can hardly remember the last case) and that people seem to be living into (at least) early old age. We are challenged not by AIDS complications, but as you call them, the ravages of old age- such as heart and kidney disease, bone disease and cancer. As I too age (and can no longer deny the title of middle aged), I also reflect on the loss of an increasing number of my peers from (HIV-negative) college and high school. No less painful, but indicative of the bell-shaped curve of life (and death).

Be well and as Dr. Bob would say, stay well, BY



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