The average 20-year-old who starts HIV treatment today can likely expect to live a decade longer than someone who began taking antiretrovirals (ARVs) at the same age in the early days of effective treatment. This phenomenal leap since the advent of combination ARVs in 1996 appears to be a result of improvements both in treatments and the overall medical care of people living with the virus.
Researchers analyzed data on 88,504 participants in 18 long-term studies of Europeans and North Americans who started HIV treatment with three or more ARVs between 1996 and 2010.
Based on death rates among the participants during their first three years on ARVs, the investigators projected that the life expectancy for 20-year-olds starting treatment between 2008 and 2010 in the United States was 66 years for men and 63 years for women. This represented a life expectancy leap of about 10 years for men and nine years for women between 1996 and 2010. Furthermore, the average age of death for a 20-year-old starting ARVs during 2008 to 2010 with a CD4 count greater than 350 one year into treatment was expected to be 78 years. By comparison, average life expectancy overall in the United States is 78 years for men and 82 years for women.
The study’s lead author, Adam Trickey, a PhD candidate in medical statistics at the University of Bristol in the United Kingdom, estimates that continued improvements in ARVs during the 2010s have likely further raised life expectancy.
“If people with HIV start ARV therapy, continue taking it as prescribed by their doctor and in general take steps to look after their health, as any person should, then it is expected that they will live for almost as long as someone without HIV,” Trickey says.