Just a year ago it was said that the timely and informed use of combination antiretroviral therapy (cART) could increase HIV life expectancy rates in many developed countries to near-normal levels. That's not necessarily true any longer.
According to a new study published in the medical journal PLOS|ONE, if cART is initiated at a CD4 count above 350 cells/mL, many people with HIV can now enjoy a life expectancy equal to or even greater than that of the general population.
In the comprehensive eight-year review, which looked 22,937 HIV-positive people in the U.S. and Canada from 2000 to 2007, life expectancy for a 20-year-old male just starting cART was estimated to be around 77 years, while a 20-year-old female could live to the age of 82.
By contrast, the average life expectancy for all men and women in the U.S. is 75 and 81 years, respectively.
The most remarkable gains were seen among men who have sex with men (MSM), with those newly infected at the age of 20 having 50/50 chance of reaching the age of 89.
However, the picture is not so rosy on the whole. Among all people living with HIV, both those on therapy and not , the average life expectancy was still well below that of the general population -- roughly 15 years less for men and 19 years less for women.
Similarly, among injecting drug users (IDUs), life expectancy for a 20-year-old infected with HIV is estimated to be a mere 49 years. Moreover, the disparity between whites and non-whites remain ever dismaying, with an average 13 years shorter life expectancy among people of color in both the U.S. and Canada.
What is particularly worrying is the fact that only 28% of the cohort started cART at a CD4 count above 350 cells/mL (a statistic which may likely improve with current U.S. guidelines allowing for the initiation of therapy upon diagnosis, regardless of CD4 count).
In fact, the most recent update of the HIV Treatment Cascade has revealed that of the 980,000 Americans currently diagnosed with HIV, only 33% are on cART while only 25% are able to maintain undetectable viral loads.
Photograph by Julian Lim is used under a Creative Commons License and is available at http://www.flickr.com/photos/julianlim/4598412264/