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Young People With HIV Can Now Live Longer

Advances in antiretroviral drugs now give young people with the disease a chance to live well into old age.

Young People With HIV Can Now Live Longer

A study in The Lancet HIV medical journal found that advances in antiretroviral drugs now give young people with the disease a chance to live well into old age. Those aged 20 who started antiretroviral therapy in 2010 are projected to live 10 years longer than those first using it in 1996, it found. However, when all age groups are considered, life expectancy for people with HIV is still lower than the general population.

HIV, which can lead to Aids if left untreated, was once considered a certain death sentence. Professor Helen Stokes-Lampard, chairwoman of the Royal College of GPs, said: "It's a tremendous medical achievement that an infection that once had such a terrible prognosis is now so manageable, and that patients with HIV are living significantly longer.

The researchers are hoping the results of this study go a long way to finally removing any remaining stigma associated with HIV, and ensuring that patients with HIV can live long and healthy lives without experiencing difficulties in gaining employment and - in countries where it is necessary - obtaining medical insurance.

Dr Michael Brady, medical director at the Terrence Higgins Trust, said: "Today's report reminds us just how far we've come since the start of the HIV epidemic in the 1980s. Medical advances now mean that people with HIV live long and healthy lives." However, he said that people aged over 50 now represent one in three of all those living with HIV.

"As it stands, the healthcare, social care and welfare systems simply aren't ready to support the increasing numbers of people growing older with HIV," he said.

"We need a new model of care to better integrate primary care with HIV specialist services, and we need a major shift in awareness and training around HIV and ageing, so that we're ready to help older people live well in later life."

The new study used data for 88,504 people with HIV who started antiretroviral treatment between 1996 and 2010 from 18 European and North American studies. Lead author Adam Trickey, from the University of Bristol, said: "Our research illustrates a success story of how improved HIV treatments coupled with screening, prevention and treatment of health problems associated with HIV infection can extend the lifespan of people diagnosed with HIV. "However, further efforts are needed if life expectancy is to match that of the general population. "Combination antiretroviral therapy has been used to treat HIV for 20 years, but newer drugs have fewer side effects, involve taking fewer pills, better prevent replication of the virus and are more difficult for the virus to become resistant to."

What is antiretroviral therapy?

Standard antiretroviral therapy (ART) consists of the combination of antiretroviral (ARV) drugs to maximally suppress the HIV virus and stop the progression of HIV disease. ART also prevents onward transmission of HIV. Huge reductions have been seen in rates of death and infections when use is made of a potent ARV regimen, particularly in early stages of the disease. WHO recommends ART for all people with HIV as soon as possible after diagnosis without any restrictions of CD4 counts. It also recommends offer of pre-exposure prophylaxis to people at substantial risk of HIV infection as an additional prevention choice as part of comprehensive prevention.

"Combination antiretroviral therapy has been used to treat HIV for 20 years, but newer drugs have fewer side effects, involve, taking fewer pills, better prevent replication of the virus, and are more difficult for the virus to become resistant to," Trickey said. Modern HIV treatment is very effective and has low toxicity, he noted. Because of this, deaths in people living with HIV are unlikely to drop with further development of drugs.

Based on the study, the focus needs to be on people to take their drugs consistently. It's also important for people to be diagnosed earlier, and to diagnose and treat other conditions that can occur with HIV, such as hepatitis C.

(Inputs from PTI)
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