People in North America and Europe who are infected with HIV and who begin treatment with a triple-drug cocktail can expect to live nearly as long as people who aren’t infected by the virus, a new study suggested.
A combination of factors — including less toxic drugs and better medical management — have resulted in longevity gains for people who are HIV-positive, concluded the study, published in the journal Lancet HIV.
“Between 1996-99 and 2008-10, life expectancy in people living with HIV starting [antiretroviral therapy] increased by around 10 years for both sexes, in Europe and North America,” wrote the authors, who work at a variety of academic institutions through North American and Europe.
The findings reflect a trend that has been apparent for some time among people with HIV and their health care providers. A disease that was once a death sentence has become a chronic condition for people who have access to and the ability to stick with an HIV drug regimen.
“We’re just getting better at what we do,” said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. Fauci, who was not involved in this study, is a leader in HIV research; he continues to see HIV-positive patients who get treatment at the National Institutes of Health.
“We have better drugs. … People are adhering better because they know these drugs really work,” he told STAT. “I think the combination of all of those [factors] easily explains in a logical way the results of that study.”
The authors also suggested patients may be more motivated to take care of their health — quitting smoking, say — and their doctors more motivated to aggressively treat other health conditions because both understand that HIV treatment is effective.
The researchers pooled data from 18 studies that followed or are following HIV-positive people in 10 countries in Europe and North America, giving them information on roughly 88,500 people. They compared survival and longevity data for people who began taking triple-drug therapies during three periods of time — 1996 to 1999, 2000 to 2003, and 2008 to 2010.
The researchers looked at both death figures in the first year of treatment — when patients were typically at their sickest — and then life expectancy of people who survived the first year of treatment.
They concluded that an HIV-positive 20-year-old who started antiretroviral therapy between 2008 and 2010 and whose infection was well controlled by the drugs could expect to live to the age of 78.
Still, a commentary published with the study noted that these gains, while impressive, aren’t being made by all infected with HIV, particularly by individuals who are not white, have a history of injection drug use, or began treatment with low white blood cell counts.
Ingrid Katz of Harvard Medical School and Brendan Maughan-Brown of the University of Cape Town in South Africa wrote that in order to make additional gains in life expectancy, early detection of HIV and commencement of treatment will be needed.
Fauci said he thinks that further life expectancy gains can be made for people with HIV. But he believes the damage the virus does can’t be completely erased by early treatment. “I think we’re going to get really close to a normal life expectancy,” he said. “I would be surprised if it would be exactly the same. But I think it will be close enough to be dramatic.”
The study was funded by Britain’s Medical Research Council and the UK Department of International Development as well as the European Union.