A 20-year-old man with HIV who begins antiretroviral therapy today had better start saving for his golden years.
Although HIV infection was once considered a certain death sentence, research published today shows that the average person infected with HIV in North America can expect to live to the age of 63. Gay men with HIV can expect to live even longer, to an average age of 77, according to the findings published in PLOS One.
In 2009, the average life expectancy for a 20-year-old American man in the general population was exactly the same—77, the study reported.
“[It is] nothing short of miraculous, given where we were 20 years ago,” said Dr. Mark Smith, who treats people with HIV and also serves as president of the California HealthCare Foundation. “It's a stunning success story for biomedical science and has contributed greatly to our understanding of other viruses and disease processes as well."
The study looked at 23,000 HIV patients in the United States and Canada from 2002 to 2007. Subjects came from a wide range of racial and socioeconomic backgrounds. Intravenous drug users and non-white patients fared the worst, with life expectancies of 49 and 58, respectively.
Minority Health Gap 'Devastating'
Kyle Murphy, assistant director of communications for the National Minority AIDS Council, called the disparity in life expectancy between whites and non-whites with HIV “very real and devastating.”
“Across the board, communities of color fare worse than their white counterparts,” he told Healthline. “They are diagnosed much later and are less likely to be retained in care or to be virally suppressed.”
Dr. Joel Gallant, chair of the HIV Medicine Association, told Healthline he does not believe that race is an independent factor affecting life expectancy. “It's a proxy for more infections from drug use and later presentation to care,” he said.
The gay demographic, he said, tends to get tested for HIV regularly and to begin antiretroviral drugs immediately. Gallant, who said he sees HIV patients even in their eighties, noted that more people are being diagnosed at a later age, in part because older people tend not to get tested as often.
Early detection and treatment can now mean a normal lifespan for otherwise healthy Americans. The study results show that people who begin taking antiretroviral drugs earlier live longer. By lowering the number of viral cells in the blood, antiretroviral therapy, or ART, also helps to prevent HIV transmission.
Prevention, Treatment Go Hand-in-Hand
“It turns out that with HIV, treatment is prevention,” Smith told Healthline. “That is, effectively treating HIV with modern antivirals not only prevents the opportunistic infections which used to kill people with the disease, but also substantially reduces further HIV infection."
Last month, the HIV Medicine Association released new guidelines for treating people with HIV. Now that so many patients are living into their sixties and seventies, it's necessary to focus on routine preventive care, such as cholesterol and blood pressure screenings and treatment.
Smith said he has one HIV patient who is 70 and just had a hip replacement. “He walks his grandkids to school," Smith said. "The irony is that now I have to worry about the same things I worry about with any 70-year-old—lipids, blood pressure, etc. Five years ago, frankly, I didn't spend a lot of time on mildly elevated blood pressure in people with HIV.”
The best way to live a long life is to start treatment early, take ART drugs consistently, and keep other health problems at bay, said Gallant.