Anti-retroviral therapy for HIV is so successful that some young patients can expect the same life expectancy as healthy people, according to an analysis published today.
In the last two decades, patients with HIV have enjoyed an increase in life expectancy of about ten years following the introduction of the therapy, according to the report in The Lancet HIV.
Researchers say that newer drugs are less toxic than the original antiretroviral therapies. Along with a greater range of options and improved adherence to treatment, this has contributed to improved survival.
The researchers say a patient diagnosed at the age of 20 and achieving a low viral load after one year of treatment now has a life expectancy of 78.
The researchers studied more than 88,000 patients beginning treatment over a 15-year period and taking part in 18 research projects.
Researcher Adam Trickey, from Bristol University, UK, said: “Our research illustrates a success story of how improved HIV treatments coupled with screening, prevention and treatment of health problems associated with HIV infection can extend the lifespan of people diagnosed with HIV.
"However, further efforts are needed if life expectancy is to match that of the general population.
“Combination antiretroviral therapy has been used to treat HIV for 20 years, but newer drugs have fewer side effects, involve taking fewer pills, better prevent replication of the virus and are more difficult for the virus to become resistant to.”
He added: “Since modern treatment is highly effective with low toxicity, deaths in people living with HIV are unlikely to be reduced by further development of drugs. Now we need to focus on the issues surrounding drug adherence, late diagnosis of HIV, and diagnosis and treatment of co-occurring conditions."
The findings were welcomed by the UK Royal College of GPs.
Chair Professor Helen Stokes-Lampard said: “It’s a tremendous medical achievement that an infection that once had such a terrible prognosis is now so manageable, and that patients with HIV are living significantly longer.
“We hope the results of this study go a long way to finally removing any remaining stigma associated with HIV, and ensuring that patients with HIV can live long and healthy lives without experiencing difficulties in gaining employment and – in countries where it is necessary – obtaining medical insurance."
Adam Trickey et al. Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies Lancet HIV 10 May 2017; doi:10.1016/S2352-3018(17)30066-8 [abstract]
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