Hi, I have 3 questions:

1) Will the virus eventually finds ways of resisting the drugs no matter how adherent you are?

2) If so, are new drugs likely to be developed fast enough to provide new combinations?

3) How far off do you think an effective therapeutic vaccine is?

The reason I'm asking (apart from obvious general interest) is that I'm not sure whether to start saving for my pension, a pension which will not be paid out until I'm 65 (I'm 30 now and in perfect health except for the infection itself). So I guess I'm trying to figure out what the chances of getting to 65 are.... if slim, I might as well blow all the money now! 3)

There are some reasons for optimism in the answer to question #1. HIV+ persons with excellent long term adherence have remained with viral loads below detection for over 5 years in several cohorts. There is no way to predict how long these good outcomes will last, but it is certainly possible that 10+ years of success will follow. There is no way to predict out 35 years from now.

The answer to question #2 is mixed. There are good choices now for 3 or 4 regimens in sequence, and the new drugs in development may or may not provide another option, depending on their performance in clinical trials. It's too soon to tell.

Unfortunately, the first two HIV vaccine trials were unsuccessful, so we're still searching for an effective vaccine. Several other trials are in process. Thus we are at least 3-5 years, and possibly longer, from a vaccine.