Hand and life expectancy

Question

I have noticed that life expectancy is now in the mid 70s for people with HIV. I have also heard that HAND is causing major issues for half of HIV+ people as they age. Has there been any breakthroughs in medicine to stop Hand and improve the quality of life for those 20+ survivors? Will most of us have severe memory issues after 20+ years even though we are undetectable?

Answer

Thanks for writing. More powerful antiretroviral therapies have significantly reduced HIV associated neurocognitive disorders from the severe dementia common in the early days of the epidemic to more subtle concerns such as HAND, HIV-Associated Neurocognitive Disorders.

You are correct that up to 50% of those of us living with HIV for many years will develop HAND, although in many cases there will be no evident symptoms. When there are, they will include some impairment of motor activity (sloppier hand writing and clumsiness) and issues with memory, usually involving things like word recall. Keep in mind we cannot differentiate memory issues caused byHAND from other concerns caused by aging or other physical health problems.

While there is no specific treatment for HAND there are some things you can do. Start by keeping your viral load undetectable and limiting the amount of substances like alcohol or other drugs that you ingest. Treat any co-occurring mood disorders like anxiety or depression because these can compound memory issues. Finally, physical exercise has been shown to improve cognition in persons living with HIV.

If you are interested in something a bit more technical here is a link to an article I wrote for TheBodyPRO concerning cognitive decline and protease inhibitors.

There is no evidence that HAND impacts longevity in persons living with HIV. The major concern is quality of life. Follow the recommendations about and keep yourself as healthy as possible. For today, that is our best defense for dealing with HAND.

All the best,

David