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People With HIV Still Live Shorter, Sicker Lives - WebMD

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THURSDAY, June 18, 2020 (HealthDay News) -- HIV may not be the death sentence it was 20 or 30 years ago, but people who are HIV-positive still face much shorter lives than other adults -- even if they're treated with medications that make the virus undetectable.

A new study reports that people who were HIV-positive at age 21 had an average life expectancy of 56 years -- nine years fewer than their virus-free peers.

The likely reason: a weaker immune system and a greater risk for other chronic health issues, even when HIV is kept in check.

"Our findings suggest that people with HIV who initiate treatment early are approaching the same lifespan as people without HIV, but that we need to be paying closer attention to preventing comorbidities [other chronic diseases] among people with HIV," said lead author Dr. Julia Marcus, an assistant professor at Harvard Medical School in Boston.

When antiretroviral therapy -- or HAART -- was introduced for HIV treatment in 1996, it was a game-changer.

Taken daily, the medications can suppress the virus to undetectable levels, keeping patients healthy and eliminating the risk of sexual transmission. The U.S. Department of Health and Human Services recommends starting HAART immediately after an HIV diagnosis.

Marcus and her team wanted to find out if there was still a gap in life expectancy between people with HIV and those without.

To find out, they reviewed disease and death histories drawn from Kaiser Permanente records for nearly 430,000 people between 2000 and 2016. About 39,000 were HIV-positive, and nearly nine in 10 of these patients were male (average age: 41).

The investigators focused on two points in time: 2000 to 2003, and 2014 to 2016.

During the first period, life expectancy for a 21-year-old with HIV was 38 years, compared to 60 for uninfected peers.

By 2014, that gap narrowed dramatically: A 21-year-old with HIV could expect to live to 56, compared to age 65 for uninfected adults, according to the report.

Still, a nine-year gap remained, and the researchers noted that it narrowed only slightly when they looked at HIV-positive 21-year-olds who were taking HAART between 2011 and 2016. So the team checked their odds for six chronic illnesses -- diabetes, cancer, and liver, kidney, lung or heart disease.

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