According to a U.K. study, people with HIV may enjoy a close to normal life expectancy—if they remain on antiretroviral (ARV) therapy, maintain a suppressed viral load and a CD4 count above 350, are uninfected with hepatitis B or C, and do not use injection drugs.
“Working with the current rates,” says the study’s lead author Margaret May, PhD, a reader in medical statistics at the University of Bristol’s School of Social and Community Medicine, “it seems to us that people with HIV are likely to live long lives, similar with having other diseases which are well-controlled.”
Basing its projections on a theoretical 35-year-old man who has been on HIV treatment for five years, the study found that those with CD4 counts above 350 could expect to live to 77 on average. On the flip side, those without an undetectable viral load would lose 11 years of life expectancy, and those with less than 200 CD4s could expect to live only to 55.
May pushes earlier treatment for people with HIV, saying, “It really matters that you start treatment before you get immunosuppressed. And it also matters that you’re virally suppressed once you are on treatment. Because both of those are contributing independently to life expectancy.”
A major caveat of May’s research, however, is that she and her colleagues did not factor in potential downsides to long-term ARV therapy, including potential liver and kidney toxicities, that may affect mortality rates among people with HIV.