As HIV Rx improves, it may be possible for an HIV-positive person to survive for decades on Rx (treatment). However, we don’t yet have data to say whether or not someone diagnosed with HIV in their 20s will be able to live past 80. Currently, life expectancy for HIV-positive depends on whether or not they take combination Antiretroviral therapy or cART () every day for life. This in turn depends on availability, affordability and access to these drugs.
Clearly, in places like the USA, with better access to long-term combination ART, it’s possible for HIV patients to live longer. For example, data from the US CDC showed steadily increasing death rate changes for HIV-positive in different age groups shifting towards older age groups, meaning they’re living longer (, ). A 2013 analysis of US HIV-positive mortality trends suggested that life expectancy for those diagnosed with HIV at 20 years of age increased from ~36 years in 2000 – 2002 to ~51 years by 2006 – 2007 ( ).
A 2017(4) found
- No gender differences in life expectancy among those on cART.
- Unsurprisingly, life expectancy of 20 year olds diagnosed with HIV was better in high income countries.
- However, life expectancy of those on cART still hasn’t reached that of the general population, even in high income countries.
Another 2017 analysis on 88504 patients from 18 European countries plus North America (see below from) found estimated life expectancy for 20 year old HIV-positives starting ART in 2008-2010 had increased to ~63 years in women and ~66 years in men in North America. However, this is still lower than estimated life expectancy increases to ~68 years in European HIV-positive women and men as well as general US life expectancies of 82 and 78 years, respectively, for women and men.
Even when HIV is well-controlled through daily ART, problem is long-term consequences of the infection in the form of cancer or liver disease or accelerated aging remain tangible risk factors (6). While there are a handful of examples of patients ‘cured’ of HIV (), mainly following either stem cell transplantation or getting started on very powerful ART very shortly after getting infected with HIV, main obstacle to its complete elimination from the body is , i.e., virus is still present in a dormant state in the body.
2. Libman, H. “Will You Still Treat Me When I’m 64? Care of the Older Adult With HIV Infection.” Topics in antiviral medicine 23.2 (2014): 97-103.)
3. Samji, Hasina, et al. “Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada.” PloS one 8.12 (2013): e81355.
4. Teeraananchai, S., et al. “Life expectancy of HIV‐positive people after starting combination antiretroviral therapy: a meta‐analysis.” HIV medicine 18.4 (2017): 256-266.
5. Antiretroviral Therapy Cohort Collaboration. “Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies.” The Lancet HIV (2017).
6. Taddei, Tamar H., Vincent Lo Re, and Amy C. Justice. “HIV, Aging, and Viral Coinfections: Taking the Long View.” Current HIV/AIDS Reports 13.5 (2016): 269-278.