LIVING WITH HIV

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If you’re living with HIV, or you’ve been recently diagnosed, you can still look forward to a long, happy and healthy life.[1] Several decades ago, the life expectancy for someone living with HIV was often less than ten years after diagnosis.[2] Thanks to a better understanding of the condition and improvements in HIV treatment, today, the life expectancy for someone living with HIV can be similar to those living without it.[1]

HOW LONG CAN I LIVE WITH HIV?

How long an individual person will live with HIV is dependent on many factors. Life expectancy is just an average number based on current death rates, and it’s difficult to predict accurately. However, with effective treatment and early diagnosis, more people with HIV are living into an older age than ever before.[1,3]

In the US, over half of the 1.1 million people diagnosed with HIV in 2022 were aged 50 or older. Similarly, in England, nearly half of those receiving specialised HIV care in 2021 were over 50, compared to just one in five in 2007.[4,5]

As healthcare for people living with HIV continues to improve, treatments are becoming more effective, and come with a better understanding and management of side effects.[1]

Additionally, medical knowledge is advancing around the prevention and management of conditions like heart disease, diabetes, and cancer in people living with HIV.[1]

Factors affecting HIV life expectancy

When calculating life expectancy, important data is not always accounted for, such as social and economic conditions, genetics, mental health, and lifestyle choices. In reality, people living with HIV may live longer or shorter than the given average life expectancy. Factors that can affect your life expectancy include:

  • Access to HIV treatment and care: Effective antiretroviral therapy (ART) and quality medical care are crucial for improving life expectancy.[1,6]
  • Adherence to medication: Taking your HIV medication as prescribed is important for life expectancy, as it ensures you get the optimal benefits from your medication and reduce risks associated with non-adherence.[6]
  • CD4 count and viral load: A high CD4 count and undetectable viral load significantly increases life expectancy. Maintaining these levels is more important than past counts or viral loads.[1,3]
  • HIV-related illnesses: Illnesses or infections that develop before or after your HIV diagnosis or treatment can negatively affect life expectancy.[1]
  • Other health conditions: Diseases like heart disease, liver disease, and cancer are often more likely to affect life expectancy than HIV itself.[1]
  • People who inject drugs (PWID): PWID with HIV tend to have shorter life expectancies due to higher risks of overdoses, infections, and conditions like chronic liver disease from viral hepatitis.[1,7,8]
  • Alcohol and recreational drug consumption: Can weaken your immune system, worsen HIV progression, and reduce the effectiveness of HIV medication.[9]
  • General factors: Life expectancy varies based on income, education, social class, and upbringing. Gender, genetics, stress levels, and lifestyle choices also can influence life expectancy.[10]

It’s always best to be honest with your healthcare team about your lifestyle choices. Remember, they are there to help you, not judge you. Visit our Let’s talk about HIV care together page to see people living with HIV chatting with healthcare professionals.

HIV LIFE EXPECTANCY FOR SOMEONE ON TREATMENT

The life expectancy of someone living with HIV who is taking ART has increased substantially over the past 25 years, now predicted to be similar to the average life expectancy of someone living without HIV.[3]

As of 2024, the average life expectancy in most European countries is around 79 years old for men and 84 for women. In the US, it’s 74 for men and 80 for women. [11] Studies have shown that for people living with HIV, the average life expectancy is very similar.[3]

One study of people found that people with a high CD4 count (above 500) who started taking ART after 2015, had a life expectancy similar to the general population—77 years of age for men and 79 for women.[3] This included data from people living in Europe and the US.[3]

In 1996, the average life expectancy of someone 20 years old who’d been diagnosed with HIV was just 39. Due to the introduction of ART, in 2008 this had increased to 67, and by 2011 to 73.[12]

CD4 count, viral load, and HIV life expectancy

Studies show that a higher CD4 count and undetectable viral load can lead to a higher life expectancy than a low CD4 count and high viral load.[3]

CD4 count:

CD4 cells are a type of white blood cell crucial for immune function. In the context of HIV, the CD4 count measures the number of these cells in your blood. A higher CD4 count indicates a stronger immune system.[13]

Viral load:

This measures the amount of HIV in the blood. An undetectable viral load means that the amount of HIV is so low that it can't be detected by standard tests.[14]

Managing lifelong HIV treatment 

While taking ART is crucial for extending your HIV life expectancy, maintaining overall health and quality of life is even more important. Many people on HIV treatment are concerned about long-term side effects of HIV medications, which can affect 
their well-being.

Regular check-ups and close collaboration with your healthcare provider are essential for managing these effects and ensuring a high quality of life. Here, Xiana talks about the importance of telling her doctor about her healthcare needs as she ages.

LIFE EXPECTANCY WITHOUT HIV TREATMENT

The life expectancy of someone living with HIV who is not receiving any treatment is lower than that of someone on treatment. Without treatment, an HIV infection can progress into more severe stages.

The CDC states that once someone receives an AIDS diagnosis (stage 3), they typically have a life expectancy of three years. However, with advances in HIV treatment, progression to stage 3 is less common today.[16] Most people will be able to take medication that prevents HIV from progressing to AIDS.

The stages of HIV infection:

The HIV infection progresses through three stages:[15]

  • Acute HIV infection: flu-like symptoms (e.g. fever, headache), HIV multiplies rapidly and is very transmittable.
  • Chronic HIV infection: the latent asymptomatic phase, HIV multiplies but at low levels. Without ART, chronic HIV infection usually advances to acquired immunodeficiency syndrome (AIDS) in around 10 years.
  • AIDS: is the final, most severe stage of HIV infection where the body can no longer fight off opportunistic infections due to a weakened immune system.

HIV, AGEING AND OTHER HEALTH CONDITIONS

Ageing brings health challenges for everyone, including those with HIV. Advances in HIV treatment have allowed the first generation of people living with HIV to reach later life and access age-related care.[17]

People living with HIV can face the same age-related conditions as others, but they are also at increased risk for additional health issues like cancer and hepatitis. Common illnesses, such as infections, can also be more severe and progress more quickly.[18,19]

While many illnesses are treatable, some medications may impact the effectiveness of HIV treatment, so it’s crucial to consult your healthcare team promptly if you develop a new condition or if an illness affects your health.[20]

Years in good health with HIV

Even though people living with HIV now often have life expectancies similar to those without the virus, research suggests they may experience fewer years in good health. People living with HIV tend to face higher rates of age-related conditions like heart disease, diabetes, osteoporosis, and kidney disease.[21]

A study found that, on average, people living with HIV may develop serious health issues 16 years earlier than those who are HIV-negative.[21] This is likely influenced by a mix of factors, including the effects of HIV itself, its treatments, socioeconomic conditions, and lifestyle. However, people living with HIV typically see doctors more regularly, leading to earlier diagnosis of other conditions.[22]

Challenges remain for people ageing with HIV

HIV care continues to change, but it’s still good to know the potential challenges of ageing with HIV. Paul discusses the challenges he’s faced following his HIV diagnosis in 1988.

HOW SOCIOECONOMIC FACTORS AFFECT HIV LIFE EXPECTANCY

Life expectancy for people living with HIV varies based on socioeconomic factors like income, education, and location. Those from lower socioeconomic backgrounds often face barriers such as:

Delays in treatment:

socioeconomic challenges often lead to late HIV diagnosis and delayed ART initiation, increasing the risk of complications and reducing life expectancy.[10]

Medication adherence:

financial struggles and unstable living conditions can make it difficult to stick to a daily ART regimen, leading to treatment failure and lower life expectancy.[10]

Nutrition:

access to proper nutrition is vital for effective HIV treatment. Food insecurity can weaken the immune system, exacerbating the effects of HIV.[10]

Geographical disparities:

where you live plays a significant role in HIV outcomes. In high-income countries, life expectancy for those on treatment can be near-normal, while in low- and middle-income countries, limited healthcare resources and higher prevalences of stigma can lead to poorer outcomes.[10]

References:

  1. AIDSMAP. Life expectancy for people living with HIV. 2023. Available from: https://www.aidsmap.com/about-hiv/life-expectancy-people-living-hiv [Accessed September 2024]
  2. Time from HIV-1 seroconversion to AIDS and death before widespread use of highly-active antiretroviral therapy: a collaborative re-analysis. Collaborative Group on AIDS Incubation and HIV Survival including the CASCADE EU Concerted Action. Concerted Action on SeroConversion to AIDS and Death in Europe. Lancet. 2000;355(9210):1131-1137.
  3. Trickey A, Sabin CA, Burkholder G, Crane H, d’Arminio Monforte A, Egger M, et al. Life expectancy after 2015 of adults with HIV on long-term antiretroviral therapy in Europe and North America: a collaborative analysis of cohort studies. Lancet HIV. 2023 May 1;10(5):e295–307.
  4. HIV.gov. Aging with HIV.2024. Available from: https://www.hiv.gov/hiv-basics/living-well-with-hiv/taking-care-of-yourself/aging-with-hiv [Accessed September 2024]
  5. THT. HIV statistics. Available from: https://www.tht.org.uk/hiv/about-hiv/hiv-statistics# [Accessed September 2024]
  6. May M, Gompels M, Delpech V, Porter K, Post F, Johnson M, Dunn D, Palfreeman A, Gilson R, Gazzard B, Hill T. Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study. Bmj. 2011 Oct 11;343.
  7. Marcus JL, Chao CR, Leyden WA, Xu L, Quesenberry CP Jr, Klein DB, et al. Narrowing the gap in life expectancy between HIV-infected and HIV-uninfected individuals with access to care. J Acquir Immune Defic Syndr. 2016 Sep 1;73(1):39–46.
  8. Sun J, Mehta SH, Astemborski J, Piggott DA, Genberg BL, Woodson-Adu T, et al. Mortality among people who inject drugs: a prospective cohort followed over three decades in Baltimore, MD, USA. Addiction. 2022 Mar 1;117(3):646–55.
  9. Althoff KN, Smit M, Reiss P, Justice AC. HIV and ageing: improving quantity and quality of life. Curr Opin HIV AIDS. 2016 Sep;11(5):527–36.
  10. American Psychological Association. HIV/AIDS and Socioeconomic Status. 2010. Available from: https://www.apa.org/pi/ses/resources/publications/hiv-aids [Accessed September 2024]
  11. Worlddata.info. Life Expectancy by Country. 2014. Available at https://www.worlddata.info/life-expectancy.php [Accessed September 2024]
  12. Marcus JL, Chao CR, Leyden WA, Xu L, Quesenberry CP Jr, Klein DB, Towner WJ, Horberg MA, Silverberg MJ. Narrowing the Gap in Life Expectancy Between HIV-Infected and HIV-Uninfected Individuals With Access to Care. J Acquir Immune Defic Syndr. 2016 Sep 1;73(1):39-46.
  13. May MT, Gompels M, Delpech V, Porter K, Orkin C, Kegg S, Hay P, Johnson M, Palfreeman A, Gilson R, Chadwick D. Impact on life expectancy of HIV-1 positive individuals of CD4+ cell count and viral load response to antiretroviral therapy. Aids. 2014 May 15;28(8):1193-202.
  14. NIAID.NIH.gov. 10 Things to Know About HIV Suppression. 2024. Available from: https://www.niaid.nih.gov/diseases-conditions/10-things-know-about-hiv-suppression [Accessed September 2024]
  15. NIH. The Stages of HIV Infection. Available from: https://hivinfo.nih.gov/understanding-hiv/fact-sheets/stages-hiv-infection [Accessed September 2024]
  16. CDC. About HIV. 2024. Available from: https://www.cdc.gov/hiv/about/index.html [Accessed September 2024]
  17. Sayegh P, Moore DJ, Fazeli Wheeler P. HIV/AIDS in Later Life. In: Oxford Research Encyclopedia of Psychology. Oxford University Press; 2018. Available from: [Accessed September 2024] https://oxfordre.com/psychology/display/10.1093/acrefore/9780190236557.001.0001/acrefore-9780190236557-e-430
  18. Highleyman L. End-stage liver disease is a concern for people with HIV and hepatitis B or C co-infection. aidsmap.com. Available from: https://www.aidsmap.com/news/apr-2015/end-stage-liver-disease-concern-people-hiv-and-hepatitis-b-or-c-co-infection [Accessed September 2024]
  19. NHS. Living with HIV and AIDS. 2021. Available from: https://www.nhs.uk/conditions/hiv-and-aids/living-with/ [Accessed September 2024]
  20. Wilberg M. HIV treatment and drug-drug interactions. aidsmap.com. Available from: https://www.aidsmap.com/about-hiv/hiv-treatment-and-drug-drug-interactions [Accessed September 2024]
  21. Marcus JL, Leyden WA, Alexeeff SE, Anderson AN, Hechter RC, Hu H, et al. Comparison of overall and comorbidity-free life expectancy between insured adults with and without HIV infection, 2000-2016. JAMA Netw Open. 2020 Jun 1;3(6):e207954.
  22. AIDSMAP. Yes, the same life expectancy as HIV-negative people, but far fewer years in good health. 2020.Available from: https://www.aidsmap.com/news/mar-2020/yes-same-life-expectancy-hiv-negative-people-far-fewer-years-good-health [Accessed September 2024]
  23. Beyene SD. The impact of food insecurity on health outcomes: empirical evidence from sub-Saharan African countries. BMC Public Health. 2023 Feb 15;23(1):338.

NP-GBL-HVX-COCO-250002 February 2025

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist, or nurse. This includes any possible side effects not listed in the package leaflet. You can also report side effects directly via the GSK Reporting Tool link https://gsk.public.reportum.com/. By reporting side effects, you can help provide more information on the safety of this medicine.

If you are from outside the UK, you can report adverse events to GSK/ ViiV by selecting your region and market, here.