HIV therapy, clean living means long life

Several new studies confirm the benefits and safety of optimized HIV therapy. One study shows that those with HIV who don’t take their HIV medications or who abuse drugs and alcohol are likely to live significantly shorter lives. The research also shows that those with HIV without these risk factors can live as long as those without HIV. Another study shows that over the long-term, HIV antivirals are relatively safe to take.

The first study was published in the journal PLoS ONE.

Study participants consisted of HIV positive patients from Denmark and Greenland. Over 2200 study participants, aged 25-65, started antiviral therapy after 1998. They were divided into no risk-factor or risk-factor groups. Risk-factor groups included those who, for whatever reason, where not able to achieve an undetectable viral load or increase their CD 4 counts above 200, those with serious infections or death related to HIV, and those who abused drugs and alcohol.

Initially the study showed the rate of survival to be substantially lower in all with HIV compared with those who were not infected with the virus. However, for those with HIV infection and without one of the risk factors the probability of survival was roughly the same as those without HIV infection. In contrast, survival was considerably lower with a four-fold to 20-fold increased risk of death for those with any of the three risk-factors.

“Mortality was associated mainly with well-known HIV and non-HIV-associated risk factors,” according to the study. While “Mortality in HIV-infected patients with no identifiable risk-factors was almost identical to that of the general population with no risk-factors”

“It is my impression that patients often ask themselves a range of questions: ‘What are my long-term prospects? Will I be dead in five years’ time? Will the disease cause brain damage? Will I have heart trouble’?” noted study researcher Professor Niels Obel of the University of Copenhagen. He continued: “We record an exceptional amount of data which we can use to shed light on the long-term effects of disease. This also goes for Danish HIV patients, and it is marvelous to be able to tell them that actually their prospects are quite bright.”

Another study shed some light on the long-term safety of HIV treatment.

Published in AIDS 25, the EuroSIDA study provided strong evidence that taking HIV antiviral medications year after year does not increase the risk death. The study looked at the survival of over 12,000 patients on HIV antiviral therapy after 1996. The study demonstrated a prolonged benefit that included a five percent reduction in the overall risk of death for each year on treatment.

The study did find that for those on treatment longer there was an increased mortality attributed to non-AIDS-related cancers. These could reflect severely immune compromised patients starting therapy later, the aging of the HIV infected population in general, and improvements in cancer screening.

The EuroSIDA study also recognized that newer HIV drugs have may be less toxic than their predecessors as the study noted that death due to accumulating treatment toxicities is a very uncommon event.