Life expectancy
There’s more good news about the life expectancy of people doing well on HIV treatment.
The latest UK research shows that prognosis is now near normal for those with a CD4 cell count above 350 – the current threshold for starting HIV treatment.
Doctors looked at mortality rates in approximately 40,000 people who received HIV care between 2000 and 2008.
They calculated that a 35 year-old-man taking HIV treatment, with an undetectable viral load and a CD4 cell count above 350, could expect to live to the age of 77. Life expectancy increased to 81 years for those with a CD4 cell count above 500. The corresponding life expectancy for women doing well on HIV therapy was 81 and 88 years.
This compares to a life expectancy in the general population in the UK of 80.1 years for men and 88.6 years for women.
Injecting drug use reduced life expectancy by more than ten years.
Separate Australian research showed that developing drug resistance and running out of treatment options was associated with a shorter life expectancy: 65 years compared to 82 years for those doing well on HIV treatment.
Taking HIV treatment carefully, as prescribed, is an important part of staying well. Find out more in our Adherence & resistance booklet.
Smoking and heart disease
Hearing about improvements in life expectancy often prompts people to think about their health in the long term, and it’s more important than ever that people with HIV consider what they can do to look after their health.
The health risks of smoking are well known. Spanish researchers have found that smoking is the single biggest risk factor for the development of heart disease in people with HIV.
Their study involved 57 people who were diagnosed with acute heart disease after having a heart attack, or developing conditions such as angina.
They compared the characteristics of these patients with other people living with HIV who did not develop heart disease.
The results showed that people with coronary disease were more likely to smoke (72 vs 42%), often had a family history of cardiovascular illness (12 vs 3% and also had elevated cholesterol (39 vs 25%).
Further analysis showed that smoking increased the risk of acute heart disease by a factor of four and that 54% of cases could be attributed to smoking.
There are lots of things you can do to look after your health, including not smoking, eating a healthy diet, taking regular exercise and getting enough sleep. Talk to someone at your HIV clinic or your GP for more advice on these and any other aspects of your health and wellbeing.
Safety of treatment to prevent mother-to-child HIV transmission
There has been some debate about the other possible effects of taking HIV treatment during pregnancy, especially regarding the risk of having a premature, or pre-term, delivery.
The evidence is contradictory, but the risk seems to be especially associated with starting treatment during pregnancy, and the use of HIV treatment combinations based on a protease inhibitor.
Doctors in Manchester looked at the records of 157 women living with HIV who took antiretroviral therapy during pregnancy. They looked at 208 pregnancies in total, as some of the women had more than one pregnancy during the study period.
The rate of pre-term delivery was just under 11% – this compares to a rate of 7.5% in the general UK population.
Babies born early, but after 34 weeks of pregnancy, don't appear to experience health problems as a result. Approximately 6% of babies were born very early (before week 34 of pregnancy), higher than the 3.6% seen in the general population.
There was some evidence that women who started treatment during pregnancy were more likely to have a pre-term delivery than those who were already taking HIV treatment when they became pregnant.
Regardless of these findings, the benefits of taking HIV treatment to prevent mother-to-child transmission by far outweigh the possible risks.
Italian researchers found that a fifth of women over-estimated the risk of passing on HIV to their baby.
In a separate study, presented at the same conference, UK researchers found that a high proportion of women with HIV had a detectable viral load when they had their first viral load test after giving birth.
Breastfeeding is not recommended for mothers with HIV in the UK because of the risk of mother-to-child transmission and the availability of safe formula milk. UK researchers found that a high proportion of mothers with HIV had a detectable viral load after giving birth, which would increase the risk of transmission if they breastfed.
The researchers said that before guidelines on infant feeding could be relaxed, monitoring of viral load in mothers would need to be intensified.
Information on HIV, pregnancy and infant feeding is included in our booklet HIV & women, which is available on our website in English, Dutch, French, German, Norwegian, Russian, Spanish and Turkish.
HIV treatment and prevention
There’s now very good evidence that HIV treatment that suppresses viral load to undetectable levels significantly reduces the risk of HIV transmission.
The research also looked at rates of unprotected sex with partners who were HIV negative.
Overall, 15% of men reported having unprotected sex with a partner who was HIV negative or whose HIV status they didn’t know.
Drug and alcohol use were associated with sex involving a possible risk of HIV transmission. Rates were especially high in men co-infected with hepatitis C, and those reporting large numbers of partners.
For more information, you may find our factsheet on HIV treatment as prevention helpful.
Hepatitis C
Almost all the research involved people with hepatitis C mono-infection, and the results are very encouraging, showing that the infection can be cured with drugs that work directly against the virus.
Good outcomes were also seen in people with more advanced liver disease – the group who need treatment most urgently.
You can read reports from the conference on our website.
Editors' picks from other sources
UNAIDS reports a more than 50% drop in new HIV infections across 25 countries
from UNAIDS
In some of the countries which have the highest HIV prevalence in the world, rates of new HIV infections have been cut dramatically since 2001; by 73% in Malawi, 71% in Botswana, 68% in Namibia, 58% in Zambia, 50% in Zimbabwe and 41% in South Africa and Swaziland.
US panel advises HIV tests for everyone ages 15 to 64
from Los Angeles Times
Nearly everyone ages 15 to 64 should be screened for HIV even if they're not at great risk for contracting the virus, according to new guidelines proposed by an influential panel of medical experts.
US military reverses course on HIV-positive people serving overseas
from OutServe
On August 13 the Pentagon quietly released a revision to the Department of the Navy policy, which now allows HIV-positive sailors to be stationed at US military installations outside of the country and on select large ship platforms.
66.6% of life assurance companies now offer HIV life assurance
from Your Money
A detailed study of HIV life assurance policies found that nearly 67% of independent brokers offer it. Although 40% of bank assurers say they offer HIV life assurance, the report suggests that in reality very few of the banks' actual offers of insurance are being taken up.