HIV, the New Chronic Illness

By Rebecca Kreston | November 24, 2015 4:57 pm

Just thirty-odd years ago, a HIV diagnosis was a death sentence. Advances in pharmaceuticals and in our understanding of the mechanisms of HIV infection mean that today it is a manageable, chronic disease on par with diabetes, hypertension, and cardiovascular disease. People with HIV are living longer, and a graph recently published by the Centers for Disease Control and Prevention (CDC) shows that in the United States the average age at death from HIV infection has dramatically increased since 1987. (1)

Average age at death from HIV disease by gender in the  United States from 1987 to 2013. Image: J Xu, CDC. Click for source.

Average age at death from HIV disease by gender in the United States from 1987 to 2013. Image: J Xu, CDC. Click for source.

For men, the average age at death has increased 34% from 37.9 years of age in 1987 to 50.8 years in 2013. For women, the improvement is even more dramatic – the average age at death increased by 41.2% from 35.2 years in 1987 to 49.7 years in 2013.

A good life expectancy for HIV-positive patients requires timely initiation of medical treatment, as well as access and committed adherence to long-term therapy and medical care. As demonstrated in an article published last year in the journal AIDS, HIV-positive individuals that started anti-retroviral therapy even with a low CD4 T-cell count – an indicator of a depressed immune system –  significantly improved their life expectancies by both reducing their viral load and also increasing their CD4 cell count, evidence of an immune system recovering and controlling the viral infection. (2)

Two years ago, in an article on HIV infection as a chronic illness in The Lancet a group of physicians wrote, “AIDS-related illnesses are no longer the primary threat, but a new set of HIV-associated complications have emerged, resulting in a novel chronic disease that for many will span several decades of life.” (3) 
For people with HIV, their concern now becomes the health conditions that must be managed as a result of having an immunodeficiency or as a side effect of taking anti-retrovirals. This can include an increased risk of cardiovascular disease and heart attacks, as well as certain types of cancers and neurological diseases. 

For an infection that once had a life expectancy measured in months, a HIV-infected individual can expect to live for decades when treated appropriately. This extraordinary improvement in longevity is a testament to our advancements in the treatment and management of HIV, from discoveries and developments in anti-retroviral drugs, treatments for opportunistic infections, and insights into the pathophysiology of this fascinating virus.

Previously on Body Horrors

On the Road: The Evolution of HIV Along Highway Networks

A Formula for Hate: Captain Planet & the Planeteer’s HIV Episode

June 5, 1981. Pneumocystis Pneumonia. Los Angeles.

References

(1) [No authors listed] (2015) QuickStats: Average Age at Death from HIV Disease, by Sex – United States, 1987-2013. MMWR Morb Mortal Wkly Rep. 64(43): 1228.

(2) MT May et al. (2014) Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy. AIDS. 28(8): 1193–1202

(3) SG Deeks et al. (2013) The end of AIDS: HIV infection as a chronic disease. Lancet382(9903): 1525-33

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  • John C

    Drunk driving, smoking, obesity, alcoholism, HIV.

    Avoid the behavior, avoid the disease.

    • Miss Cellany

      I certainly agree in principle but I think very few people are completely chaste until marriage these days… And unfortunately it only takes 1 instance of the “behaviour” to contract HIV.

      • cdv102

        Not to mention that there are plenty of people who contract the disease through their spouses. The only “behavior” they were engaged in was sleeping with their husband or wife. And what of the children born to AIDS patients before treatments progressed enough to prevent the transmission of the virus to babies? What of those who were raped by someone HIV positive? We’re way too far along this road to pass judgment on anyone suffering from this disease. It’s much more constructive to put your thoughts and energy toward helping to find a cure or vaccine for all, while working to educate anyone who’s at risk (which is all of us) on how to protect themselves and their partners.

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Body Horrors

Body Horrors looks at the history, anthropology and geography of infectious diseases and parasites.

About Rebecca Kreston

Rebecca Kreston is an infectious disease scholar trained in microbiology and epidemiology. She obtained her Biology degree from Reed College and her Masters of Science in Tropical Medicine from Tulane University. She's lived in tropical jungles, beaches and deserts around the world and has been exposed to several of the diseases that she studies. She currently lives in New Orleans, is a fourth year medical student and regularly battles insects of the Diptera, Siphonaptera and Hymenoptera orders.

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