How Long Can You Live If You Get HIV?

It is natural to wonder how long you could live if you have HIV. While people will assure you that it's a treatable disease, what does that actually mean in terms of not only lifespan but a person's quality of life?

The answer is both simple and not-so-simple. By and large, the outlook is extremely positive. With advances in antiretroviral therapy, people with HIV can today expect to live longer and healthier than ever If treatment is started early and taken daily as directed.

A 2014 study from the UK Collaborative HIV Cohort (UK CHIC) further supported these findings, showing that male HIV-positive patients in the UK who have CD4 cell counts over 350 and suppressed viral loads from treatment have a life expectancy equal to or slightly higher than the general population. Researchers believe the latter occurrence could be due to earlier diagnoses and better monitoring of HIV patients.

But that doesn't mean that there aren't challenges that can take back many of those gains. From an individual perspective, longevity is subject to numerous factors that can either increase or decrease life expectancy in a person with HIV. These factors range from things we can control (such as drug adherence) to things we can't (such as race or income status).

Moreover, HIV is really only part of the long-term concern. Even for those able to maintain an undetectable viral load, the risk of non-HIV-associated diseases, like cancer and heart disease, is far greater than in the general population and can occur anywhere from 10 to 15 years earlier.

So profound are these concerns that a person with HIV is far more likely to die prematurely of a non-HIV-related illness than an HIV-related one.

Factors that influence life expectancy are either static (fixed) or dynamic (able to change over time).

Static factors, like race or sexual orientation, influence life expectancy because they are ones people are often unable to escape. For example, high levels of poverty in African American communities combined with a lack of access to health care and high levels of HIV stigma take back many of the gains seen in white communities.

Dynamic factors, by comparison, have a strong cause-and-effect relation to survival times. For instance, treatment adherence is directly related to disease progression. The less adherence is maintained, the greater the risk of drug resistance and treatment failure. With each failure, a person loses more and more treatment options.

When looking at both static and dynamic risk factors, we can begin to identify where an individual can gain or lose life-years without even knowing it. Among them:

• A person's CD4 count at the start of treatment remains one of the strongest indicators of life expectancy. The life expectancy between those whose CD4 count is less than 200 at the start of treatment is 8 years less than those whose count is over 200 at the same time.
• Smokers with HIV lose more life-years to smoking than to HIV. In fact, the risk of death from smoking is twice as high among smokers with HIV, and can trim as much as 10 years a person's lifespan irrespective of HIV.
• Race and longevity are integrally linked to HIV. According to a 2012 study, the mortality rate among HIV-positive African Americans was 13 percent higher than the rate for whites, and 47 percent higher than the rate for Hispanic populations.
• Injecting drug users suffer losses, both in terms of HIV-and non-HIV-related illnesses. The strongest contributing factors were poor adherence and hepatitis C co-infection. All told, mortality rates are nearly twice as high for HIV-positive injecting drug users than HIV-positive non-injecting drug users.

It is important to remember that statistics are not a prognosis. They cannot predict what will happen during the course of an infection. They can only suggest what you steps you can take to minimize the risk of illness based on the factors you, as an individual, can readily change.