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HIV or DRUGS that kill ?
May 27, 2014

Dear Ben,

Thanks for your reply. I have gone thru the website that you have recommended. Nevertheless, I couldnt find any research specifically targeted on HIV+ people who are free of drugs (harmful substances like Ice, Crystal, Methamp, etc) and how this affect their life expectancy ??

Firstly my point is does being diagnosed early or late with HIV matters for one who has no history of drug addiction ? Cause HAART could revive someone back to normal health with the recovery of CD4 etc. Also with substance abuse, one's health will deteriorate faster even with a higher CD4 ??

Specifically I dont see any research done on this segment. My concern is could it ever be possible that a HIV+ who is drug-free and maintains healthy lifestyle, non-smoker could achieve normal life expectancy regardless of whether he is diagnosed early or late ??

This will definitely change how we look at HIV sufferers now?? Cause we often categorised people as HIV+ and as someone with full blown AIDS. Why dont we categise them as high risk HIV+ (one with a strong history of drug addiction) and low risk HIV+ (one with no history of drug addiction)

Based on my communication with other fella HIV+ friends, many of whom are addicted to substances, it would make things right and would offer them some reasons to abstain from drugs altogether. Many of them even think that such substances have health benefits cause they are used in the medical professions.

Response from Dr. Young

Hello and thanks for the follow up post- sorry for the late reply.

Yes, being diagnosed late with HIV is not a good thing, even in the absence of drug addiction. There are many studies that show that the later the diagnosis (ie., low CD4 or with an active AIDS complication), the greater the risk of death, risk of side effects and risk of poorer recovery on medications.

That said, recovery to at least low-normal CD4 counts is entirely possible after late diagnosis if one remains engaged in their care and adherent to medications. Drug dependency's major issue is the difficulty that some may have with adherence to appointments and medications.

BTW, normal life expectancy is indeed possible- and reported by multiple national level groups in North America and Europe (for starters). A history of injection drug use is, however, associated with lower estimated life expectancy. Still decades, but less than those who don't have this history. Similarly, those who start treatment with CD4s less than 350 are statistically likely to have lower life expectancy on average. Note that the average means that 50% will exceed this number and 50% will have less- do for any particular individual, this does not predict with any accuracy how long they will live, only what is possible, on average.

Getting off of addictive drugs is generally a good thing, but in the moment, not necessary to take or be adherent to HIV medications. It's important to note here that not all drugs of dependency have the same risks or toxicities. (There are no health benefits to addictive drugs, excepting the medical use of marijuana, so just because one is a medical professional doesn't mean that their addiction is a good thing.)

Hope that's helpful, BY



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