It’s hard to find recent scientific and clinical studies about life expectancy of people living with HIV/AIDS in the western world. Keep in mind that life expectancy varies so much depending on when a person is diagnosed, how diligent the patient is with medication compliance, as well as their social situation (nutrition, street life, drug use, accessing medical care, mental illness, prostitution, co-infections, etc). This recent report in Medical News Today is indicating an average life expectancy of 65.8 years in the United Kingdom.
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Life Expectancy for People Living with HIV/AIDS
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New Guidelines for Treatment of HIV-positive Children

The United States Department of Health and Human Services (HHS) has released an updated version of its “Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection.”
The guidelines contain updated recommendations in several areas, including when to start antiretroviral therapy and factors to consider in selecting an antiretroviral regimen. The guidelines also contain new sections on rates and management of various side effects related to the use of antiretrovirals.
The guidelines are intended for use by doctors and other health care professionals when treating HIV-positive children and teens. They were last updated in August 2010.
Key updates to various sections of the guidelines are summarized below.
Start Of Antiretroviral Therapy
Suggestions for when to initiate antiretroviral therapy vary according to age group.
Antiretroviral therapy is now recommended for children five years or older who have CD4 (white blood cell) counts of less than 500 cells per microliter, even if their symptoms are mild or nonexistent. Previous guidelines recommended treatment at a CD4 count threshold of 350 cells per microliter.
The guidelines continue to recommend treatment for children aged one year or older who have normal CD4 counts but HIV viral loads (amount of HIV in the blood) of 100,000 copies per milliliter of blood or higher, regardless of whether or not they have symptoms.
For children under the age of 12 months, the guidelines also continue to recommend starting antiretroviral therapy regardless of CD4 count, viral load, or the presence or absence of symptoms. Several studies have shown that starting therapy early in children of this age significantly reduces the chances a child will progress to AIDS or die.
In children with normal CD4 counts whose HIV viral loads are less than 100,000 copies per milliliter and who have mild or no symptoms initiation of treatment can be either considered or deferred.
Selection Of Antiretroviral Regimens
As with adults, all HIV-positive children should be treated using combination therapy that includes at least three different antiretroviral drugs from two different classes.
For children aged 14 days to three years, the preferred initial treatment regimen is now Kaletra(lopinavir/ritonavir) plus two nucleoside reverse transcriptase inhibitors (NRTIs). Viramune (nevirapine)-based regimens are now considered an alternative regimen in this age group.
However, due to recent information on toxicity of Kaletra in newborn infants, particularly premature infants, Kaletra should not be given to newborns until at least 42 weeks from the date of the mother’s last menstrual period and 14 days after birth (see related AIDS Beacon news).
For children older than six years, Reyataz (atazanavir) boosted with low-dose Norvir (ritonavir) has been added as a second preferred protease inhibitor for initial treatment regimens; Kaletra is already considered a preferred protease inhibitor for this age group.
The preferred dual-NRTI regimen backbones for initial therapy in children are zidovudine (Retrovir) plusEpivir (lamivudine) or Emtriva (emtricitabine) (any age), Ziagen (abacavir) plus Epivir or Emtriva (children three months or older), and Viread (tenofovir) plus Epivir or Emtriva (children 12 years or older who have finished puberty).
Two new alternate dual-NRTI backbones have been added to the guidelines: didanosine (Videx) plus Epivir or Emtriva (any age), and Viread plus Epivir or Emtriva (children 12 years or older in intermediate stages of puberty). Viread plus Epivir or Emtriva is now listed as a possibility under special circumstances for children 12 years or older in the initial stages of puberty.
The guidelines do not recommend use of the new antiretroviral Edurant (rilpivirine) in children for initial antiretroviral regimens due to lack of information on dosages for children and the absence of a child-friendly formulation of the drug.
The guide continues to recommend that patients who have never received antiretroviral therapy complete antiretroviral drug resistance testing before choosing which drugs to use for treatment.
Monitoring Of HIV-Positive Children
The updated guidelines now note that transient viral load increases of up to 1,000 copies per milliliter (“blips”) are normal and should not be considered a sign of treatment failure.
The guide also recommends that urinalysis be conducted in children at their first visit and repeated every six to 12 months. Urinalysis usually measures aspects of a person’s urine such as pH, presence or absence of blood or protein, and signs of a possible bacterial infection.
To read the article in it’s entirety, click here.
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Anti-retroviral Drugs ‘Help Reduce’ Transmission
This blog has featured previous studies and reports about ARVs reducing transmission, and here is one more:
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UNAIDS Plan to Eliminate New HIV Infections In Children by 2015

UNAIDS has released a plan to eliminate new HIV infections in children by 2015. This means I will have no more HIV+ babies to advocate for in 4 years! Of course I will keep advocating for the older children, but what a wonderful day that will be when people get in touch about adopting a baby with HIV and I can reply “Nope – babies aren’t born with HIV any more”
I can hardly wait. See the Global Plan to Eliminate New HIV Infections Among Children by 2015.
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30 Years of HIV/AIDS
It all started on June 5, 1981 when the first cases of AIDS were published in a medical journal. The syndrome did not have a name yet. The term Acquired Immune Deficiency Syndrome was introduced by the Center for Disease Control in 1982. The virus that causes the syndrome was discovered in 1983 and was named Human Immunodeficiency Virus. The POZ Timeline–Milestone in the HIV/AIDS Pandemic documents these and other milestones over the past 30 years including the end of the HIV travel ban and the first person cured of the disease (both in 2010).
The Center for Disease Control (CDC) is featuring a lecture series titled – “HIV/AIDS: 30 Years of Leadership and Lessons”.
The Smithsonian’s National Museum of American History will mark the 30th anniversary of the emergence of what became known as the HIV and AIDS epidemic with a three-part display and website beginning June 3.
“HIV and AIDS Thirty Years Ago” will look at the public health, scientific and political responses in the early phase (1981-87) of the global pandemic. This showcase will be located in the museum’s “Science in American Life” exhibition, which focuses on the connections among science, culture and society in American history. The display will feature photographs, magazine covers and other graphics plus equipment that Dr. Jay Levy used to isolate the virus in his lab at the University of California, San Francisco, a copy of the Surgeon General’s 1986 report presenting the government’s position, samples of the drugs AZT and Retrovir and public health information pamphlets from AIDS service organizations. The website will be available at americanhistory.si.edu/hivaids.
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World AIDS Orphans Day
May 7th is World AIDS Orphans Day. I am commemorating the day by highlighting how we can end pediatric HIV. There are several campaigns going on concurrently to end vertical transmission of HIV from mother to child by 2015 by enabling pregnant women with HIV and newborn babies born to positive mothers universal access to ARV meds. Pediatric HIV is an entirely preventable disease.
I have reported on this topic before, but it bears repeating. All the major players are now saying it is an achievable goal to halt mother to child transmission of HIV/AIDS within the next few years. UNICEF has revealed it’s Children and AIDS: Fifth Stocktaking Report, 2010. Here are some statements from The Global Fund, Elizabeth Glaser Pediatric AIDS Foundation, UNICEF, and World Health Organization. I can’t wait until there are no more HIV-positive orphans for me to advocate for! Here are some video reports.
UNICEF has released a statement which states an “HIV-free generation is achievable”.
According to latest United Nations data, 370,000 children were born with HIV in 2009.
“This is something we know how to prevent.”
Just over half of all pregnant women infected HIV got the drugs they needed to prevent mother-to-child transmission in 2009, compared with 45 percent in 2008.
Margaret Chan, director-general of the World Health Organization, said there was now “strong evidence that elimination of mother-to-child transmission is achievable.”
In a separate statement before world AIDS day on December 1, the UNAIDS director Michel Sidibe said: “Nothing gives me more hope than knowing that an AIDS-free generation is possible in our lifetime.”
’20 20′ – ABC News
Born HIV Free Achievements of the Campaign to Move us Toward an HIV free Generation
UNICEF – Children and HIV and AIDS – ‘Children and AIDS Fifth Stocktaking Report’ launched
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Patient Assistance Programs for HIV Medication
The following information is provided by the American Academy of HIV Medicine
Many states have reported either waiting lists or changes in their ADAP, insurance, and other programs. Co-pays and deductibles associated with private insurance, state subsidized insurance, or Medicare can make accessing lifesaving medications very difficult.
Most drug companies have programs to provide free drugs to people with no insurance, inadequate insurance, or financial
difficulties. Each program has different requirements, and often, a healthcare provider needs to make the phone call, and fill out a form.
Patient Assistance Programs
The Fair Pricing Coalition also publishes this printable guide to accessing patient assistance programs for HIV and Viral Hepatitis drugs.
•Patient Assistance and Co-Pay Programs for HIV and Viral Hepatitis Drugs
ADAP Crisis
Many states have experiences state budgetary shortfalls that have lead to waiting lists for state AIDS Drug Assistance (ADAP) programs. A private partnership now offers a resource specifically for patients on ADAP waiting lists.
• On an ADAP waiting list? Welvista Pharmacy can help!
Other Resources
• RX Assist: Patient assistance program directory listed by manufacturer
• The Access Project: Patient assistance and co-payment programs from Housing Works
• Needy Meds: Patient assistance or drug co-pay programs for medications required to treat conditions in addition to HIV disease, e.g., medications for high cholesterol
• Together RX: Prescription savings program for uninsured individuals sponsored by many of the nation’s leading pharmaceutical companies
• Partnership for Prescription Assistance: Public and private patient assistance programs directory
• Positively Aware, AIDSMeds and Project Inform Hotline (1-800-822-7422): HIV co-pay programs resource
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Conflicting Reports on How People Do Long Term When Born with HIV
Two new studies have been reported over the past 2 weeks about how patients born with HIV are doing as young adults.
The first is from St. Mary’s Hospital in London; Young Adults Who Were Infected at Birth: the Complexities of Lifelong HIV are Increasingly Apparent. It presents health data on 58 perinatally infected young people. Two thirds of the people in the study were taking ARV medication. The report indicates many medical and psychological complications, and implies the complications were in the one third of people who were not adhering to treatment.
Adherence to medication is challenging for this group and a problem which drives many of the health complications described above.
Individuals who had good self-reported adherence in childhood generally maintained the same behaviour as young adults and continued to have good treatment response. Similarly, those with poor adherence in childhood most commonly continued to have difficulties, with sub-optimal clinical outcomes.
The researchers suggest that as adherence patterns appear to be established in childhood, it is essential to support adherence when children begin therapy in order to promote long-term adherence and survival.
The second study is by Dr. Russell Van Dyke at Tulane in New Orleans; Kids Born with HIV Growing Up Well. This report also indicates that 2/3 of participants had undetectable viral loads. The other 1/3 have complications although the doctor indicates
“their disease can be treated as chronic, more akin to diabetes than cancer. Van Dyke expects many of the patients in his study to have a normal or near normal life span.”
“These kids are doing very well,” Van Dyke says. “They’re going to school and doing all of the things that kids should do. Hopefully, they will be living 50 or 60 years or more, so what’s going to happen 40 years from now is the real concern.”
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Life Expectancy for Children Born with HIV
One of the big questions I hear when people are considering parenting a child with HIV is “what will their life expectancy be?” Dr. McComsey says “relatively normal life expectancy” and Dr. Gallant says “close to normal”. Medical professionals don’t know the exact answer because children born with HIV/AIDS are nearing 30 years of age at the most (HIV/AIDS was first discovered in this country in the early 1980s). Sadly, many of the children born with HIV in the early days died of AIDS because there were no adequate treatment options. However, children born today with HIV have an excellent prognosis due to the antiretroviral medications. Studies regarding life expectancy are done on adults and it is extremely important to remember that the participants in these studies are often in vastly different situations than children growing up in adoptive families. For example, they have other risk factors that affect their life expectancy in addition to HIV such as poor nutrition, co-infections, IV drug use, homelessness, low socioeconomic status, unhealthy lifestyles and poor adherence to treatment.
Only the most recent studies are worth reading since HIV/AIDS research changes all the time as the treatment options get better. Studies from 2005 indicate anywhere from 6 years less than normal to 21 years less than normal. The average between these 2 extremes is 13.5 years less than the normal US lifespan (78) which is an average life expectancy of 64.5 years (2005). These studies are already 6 years old and the numbers get higher all the time as the medications get better. This means that children born with HIV can live long enough to meet their grandchildren. The best thing we can do to increase life expectancy is encourage our children to lead a healthy lifestyle and diligently adhere to their medications.
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Lafayette Sanders, 24, West Philadelphia,
Perinatally Infected
Paige Rawl, 17, Indianapolis, Perinatally Infected
CNN –
