Affordable HIV Medication May Enable ‘Near-to-Normal’ Life Expectancy

A new study published in the “Lancet” medical journal suggests that today’s HIV medications can provide a near-normal life expectancy for some groups living with HIV.

A team at the University of Bristol examined data from 18 European and North American studies investigating HIV-1 — the most widespread strain of the virus. The researchers particularly focused on people who had started antiretroviral therapy, or ART, using a combination of three or more drugs between 1996 and 2010. To be eligible for this review, patients had to have at least three years of follow-up on their treatment.

In total, this study analyzed 88, 504 patients. Of that sample, 2,106 died during their first year of therapy, while an additional 2,302 died during either the second or third year.

The researchers then examined life expectancy based on the period at which each individual began ART, and investigated characteristics like age, sex, risk group and underlying factors — like a person’s CD4 cell count or the particular RNA of the HIV-1 infection they carried.

The researchers found that patients who started therapy between 2008 and 2010 experienced lower fatality rates in their first year of treatment, compared to those who began between 2000 and 2003. This pattern held true when comparing second and third year treatments, with HIV-positive individuals having a better chance of survival in 2008-2010 than those in 2000-2003.

In essence, this demonstrates that antiretroviral treatment is helping people with HIV live longer lives. In particular, researchers noted that younger white people receiving ART could — based on their projections — expect to have a near-to-normal average life expectancy, living to around 78 years of age. These estimates were based on individuals who promptly started ART after contracting HIV at age 20.

Given that, less than three decades ago, contracting HIV seemed almost certain to end a person’s life prematurely, this represents a significant achievement. These findings reflect the broader success of ART which, though not without problems, has been one of the greatest medical interventions in modern times.

But there is still work to do to ensure that people living with HIV have the best shot of a lifespan just as long as their non-positive counterparts.

Lead author Adam Trickey explained:

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.

But non-white people continue to face disparities

It’s important not to miss the bigger picture here, though. While the data is encouraging — particularly for younger white HIV-positive people, there remains a ”persistent gap in the lifespan between HIV-positive and HIV-negative individuals, particularly within key affected populations.”

In this case, the researchers note, “individuals who are not white, have a history of injection drug use, or began ART with low CD4 cell counts have no reduction in mortality or improvements in life expectancy.”

And that news is troubling, especially when antiretroviral therapy continues to improve lives across the globe.

In regions like sub-Saharan Africa, for example, access to ART has provided near-to-normal life expectancy for HIV-positive individuals. But there remain several barriers to treatment in underprivileged nations, including poor infrastructure — which makes routine testing and treatment difficult.

At the same time, within so-called developed nations, social structures that privilege white people above other races creates almost a symbiotic relationship between poverty and a host of other factors including drug use and HIV prevalence. Unless we challenge these systemic disparities, HIV prevalence and mortality are unlikely to decline.

Factor in added penalties through anti-LGBT laws, punitive anti-drug policies and the criminalization of sex work, and we have a significant hill to climb.

Indeed, all these areas must be challenged, dismantled and addressed. Some of them require targeted policy changes. Others require deconstruction of the global and local policies that systematically deprive non-white people at every stage of their lives — particularly in terms of affordable, accessible health care.

Action to that end can come in many forms, but one key step will involve resisting any attempt by Congress or the Trump administration to cut funding for HIV programs. We must also fight efforts to repeal or negatively modify provisions in the Affordable Care Act that make ART and associated medications both accessible and affordable.

It’s only through safeguarding health care access for all — not just affluent white people — that we will one day eradicate HIV and ensure that no one dies prematurely due to this virus.

Photo Credit: VOCAL-NY/Flickr


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Past Member yesterday

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