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National Institute Article
Sep 21, 2006

Hi: I read the following and would like to know if the 3 year stat is correct. Isn't that kinkda low for these days.....

Excerpt from Disease Progression

Potent combinations of three or more anti-HIV drugs known as highly active antiretroviral therapy, or HAART, can reduce a persons viral burden (amount of virus in the circulating blood) to very low levels and in many cases delay the progression of HIV disease for prolonged periods. Before the introduction of HAART therapy, 85 percent of patients survived an average of 3 years following AIDS diagnosis. Today, 95 percent of patients who start therapy before they get AIDS survive on average 3 years following their first AIDS diagnosis. For those who start HAART after their first AIDS event, survival is still very high at 85 percent, averaging 3 years after AIDS diagnosis.

Response from Dr. Daar

Thank you for your post.

When looking at these kinds of statistics it is important to understand the intervals they are referring to. We often talk of the time from HIV infection (not diagnosis, but infection) to symptoms. Then there is the time from symptoms or the diagnosis of AIDS to death. In this case they are talking about the latter, so these are people who on average have been infected for 8 to 10 years and have now been diagnosed with advanced stages of HIV infection, or AIDS. Prior to antiretroviral therapy it was estimated that half of those with AIDS would die within one year of diagnosis. In this study they are saying that in the era of potent combination therapy that 85% (85 out of 100) individuals who are diagnosed with AIDS and then start antiretroviral therapy will still be alive after 3 years. It is not stated, but for a large percentage of these individuals it may turn out that they will still be alive after 5 or even 10 years.

The other side of this is that only 15 out of 100 in this situation will die within 3 years of diagnosis of AIDS. An important question is what is different about these people than those that survive this interval. This data is not available, but I would suggest from my experience that these individuals most fall into two different categories. One group would be those who present so late in the course of their disease that they can not overcome the initial infections or malignancies they presented to medical care with. This would include those whose diagnosis with AIDS includes a process for which we do not have good treatment such as select types of cancer. The other group are those who have difficulty while in care prior to their diagnosis with AIDS and have failed multiple drug regimens in the past and are unable to be effectively treated. Alternatively, these people may have social and/or psychological problems that contributed to their delay in being diagnosed with HIV and thier ability to follow-up with a provider and take prescribed medications. Regardless, the the overwhelming majority are alive at 3 years after the diagnosis of AIDS. In addition, these results do not imply that many more remain alive and well even beyond this 3 year period.

Best, Eric

When does HIV become Aids
HIV+ / Herpes -

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