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life cycle
Apr 23, 2004

doctor

if one takes his medicines without fail and have no other habits like smoking drinking alchol drugs abuse and works out weekly 5days and takes good food and rest can he expectto live next 20 years without problem .

iam 40 years male old on meds for hiv for last 6 months

my present cd4 is 500 and vl is undetectable.

any kind reply will be helpful .

ilook forward for your help

Response from Dr. Sherer

As physicians are not fortune tellers, this is an important question to which we have no solid answer.

Our experience with 3 drug therapy is only 8 years old, and our experience with the best of 3 drug regimens is shorter than that. We are all living in the natural history experience of the impact of 3 drug ART on people with HIV.

In the best cases, 5 or more years of positive outcomes, i.e. good viral control, rising CD4 cells, and freedom from HIV symptoms have been achieved.

In some mathematical modeling efforts, it has been estimated that a 40 year old with recent HIV infection and an optimal response to ART could have a normal life expectancy. I believe this prediction, as I have seen many people with HIV who have had such a course, and who after 5 years seem to have entered into a healthy relationship with their HIV infection (If such a thing is possible) AND with their ART regimen, i.e. they are optimally adherent, they have good viral control and rising CD4 cells, and not suffering from side effects that might compromise their health, or their response to the virus.

But a mathematical model is not data, and my opinion above is only that - one doctor's opinion. On the other hand, I do hold the hope of a normal life, and normal life expectancy, out to my patients, and it is based on more than just speculation. It is based on 21 years of experience in the care of people with HIV, and the best outcomes I have seen over the past 8 years with 3 drug ART.

To my mind, the available data suggests that there are ample reasons for your to share that hope. And again, hopes and opinions are not the same as hard data. I advise you to talk to your doctor about this question.


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