The outlook for people living with HIV has significantly improved over the past two decades. Many people who are HIV-positive can now live much longer, healthier lives when regularly taking antiretroviral treatment.
Kaiser Permanente researchers found that the life expectancy for people living with HIV and receiving treatment increased significantly from 1996 on. Since that year, new antiretroviral drugs have been developed and added to the existing antiretroviral therapy. This has resulted in a highly effective HIV treatment regimen.
In 1996, the total life expectancy for a 20-year-old person with HIV was 39 years. In 2011, the total life expectancy bumped up to about 70 years.
The survival rate for HIV-positive people has also dramatically improved since the first days of the HIV epidemic. For example, researchers who examined the mortality of participants in a study of Swiss people with HIV found that 78 percent of deaths between 1988 and 1995 were due to AIDS-related causes. Between 2005 and 2009, that figure dropped to 15 percent.
Between 2010 and 2014, the annual number of new HIV infections in the United States fell by
Antiretroviral medications can help to slow damage caused by HIV infection and prevent it from developing into stage 3 HIV, or AIDS.
A healthcare provider will recommend undergoing antiretroviral therapy. This treatment requires taking three or more antiretroviral medications daily. The combination helps suppress the amount of HIV in the body (the viral load). Pills that combine multiple medications are available.
The different classes of antiretroviral drugs include:
- non-nucleoside reverse transcriptase inhibitors
- nucleoside reverse transcriptase inhibitors
- protease inhibitors
- entry inhibitors
- integrase inhibitors
Viral-load suppression allows people with HIV to live healthy lives and decreases their chances of developing stage 3 HIV. The other benefit of an undetectable viral load is that it helps reduce transmission of HIV.
The 2014 European PARTNER study found that the risk of HIV transmission is very small when a person has an undetectable load. This means that the viral load is below 50 copies per milliliter (mL).
This discovery has led to an HIV prevention strategy known as “treatment as prevention.” It promotes constant and consistent treatment as a way to reduce the spread of the virus.
HIV treatment has evolved tremendously since the onset of the epidemic, and advancements continued to be made. Initial reports from a clinical trial in the United Kingdom and a published study from the United States showed promising results in experimental HIV treatments that could put the virus into remission and boost immunity.
The U.S. study was conducted on monkeys infected with the simian form of HIV, so it’s not clear if people would see the same benefits. As for the U.K. trial, participants showed no signs of HIV in their blood. However, researchers cautioned that there’s potential for the virus to return, and the study isn’t yet completed.
A monthly injection is expected to hit markets in early 2020 after showing promising results in clinical trials. This injectable combines the drugs cabotegravir and rilpivirine (Edurant). When it comes to suppressing HIV, the injectable's proven to be as effective as the standard regimen of daily oral medications.
Though the outlook has gotten much better for those with HIV, there are still some long-term effects that they might experience.
As time passes, people living with HIV may begin to develop certain side effects of treatment or HIV itself.
These may include:
- accelerated aging
- cognitive impairment
- inflammation-related complications
- effects on lipid levels
The body may also undergo a shift in how it processes sugars and fats. This can lead to having more fat in certain areas of the body, which can change the body’s shape. However, these physical symptoms are more common with older HIV medications. Newer treatments have far fewer, if any, of these symptoms affecting physical appearance.
If treated poorly or left untreated, HIV infection can develop into stage 3 HIV, or AIDS.
A person develops stage 3 HIV when their immune system is too weak to defend their body against infections. A healthcare provider will likely diagnose stage 3 HIV if the number of certain white blood cells (CD4 cells) in an HIV-positive person’s immune system drops below 200 cells per mL of blood.
Life expectancy is different for every person living with stage 3 HIV. Some people may die within months of this diagnosis, but the majority can live fairly healthy lives with regular antiretroviral therapy.
Over time, HIV can kill cells in the immune system. This can make it difficult for the body to fight serious infections. These opportunistic infections may become life-threatening because they can damage the immune system when it’s already weak.
If a person living with HIV develops an opportunistic infection, they will be diagnosed with stage 3 HIV, or AIDS.
Some opportunistic infections include:
- recurring pneumonia
- brain and spinal cord disease
- different types of lung infections
- chronic intestinal infection
- herpes simplex virus
- fungal infections
- cytomegalovirus infection
Opportunistic infections, especially
HIV can quickly cause damage to the immune system and lead to stage 3 HIV, so getting timely treatment can help improve life expectancy. People living with HIV should visit their healthcare provider regularly and treat other health conditions as they arise.
Starting and staying on antiretroviral treatment right after diagnosis is key to staying healthy and preventing complications and progression to stage 3 HIV.
New tests, treatments, and technological advancements for HIV have greatly improved what was once a grim outlook. Thirty years ago, being diagnosed with HIV was considered a death sentence. Today, people with HIV can live long and healthy lives.
That’s why routine HIV screening is vital. Early detection and timely treatment are key to managing the virus, extending life expectancy, and reducing the risk of transmission. Those who remain untreated are more likely to experience complications from HIV that could lead to illness and death.