Controlling HIV

HIV treatments keep risk of death at normal rates

(RxWiki News) A diagnosis of HIV is no longer a death sentence. A recent study hinted that HIV treatments have progressed to a point at which many patients may have a normal life expectancy.

The study found that patients who used modern antiretroviral therapy (ART) to manage their HIV and keep immune cell counts high had no greater risk of dying than the average person without the disease.

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Researchers, led by Alison Rodger, PhD, of University College London in the United Kingdom, utilized data from the Strategies for Management of Antiretroviral Therapy (SMART) and Evaluation of Subcutaneous Proleukin in a Randomized International Trial (ESPRIT) studies.

This new study focused on 3,280 patients who received continuous ART. For 76.7 percent of these patients, treatment resulted in “suppressed viral load” – meaning that their HIV was no longer detectable and that counts of their immune cells were high. 

Patients (79.7 percent of whom were men) were between the ages of 20 and 70 years old with an average age of 43. Researchers compared death rates of these patients to those of the general population using the Human Mortality Database. 

During about three years of follow-up with patients, 62 deaths occurred. Only two of these deaths (3 percent) were related to AIDS. 

By comparison, 19 of the deaths (31 percent) were related to cardiovascular disease or a sudden death, and 12 of the deaths (19 percent) were due to non-HIV cancers.

When these death rates were compared to the general population, the authors concluded that for these patients with well-controlled HIV, "we identified no evidence for a raised risk of death compared with the general population."

In patients whose immune cell counts dropped below normal, the risk of death did increase relative to the risk of death of the general population. However, the risk of death returned to normal in those whose cell counts dropped then later recovered due to continued treatment.

The findings led the researchers to write, "Our data support the importance of early diagnosis and treatment to improve clinical outcomes, and it is likely that much of the excess mortality associated with HIV would be preventable with timely diagnosis of HIV and initiation of ART."

It is important to note that though the sample size was large, the overall number of deaths to examine was relatively small. More research is needed to confirm these findings. 

The study was published in March in the journal AIDS. No conflicts of interest were reported.

Review Date: 
March 18, 2013