HIV weakens the immune system, making it difficult for the body to fight other infections. But with antiretroviral treatment, many people can live long and healthy lives.

The outlook for people living with HIV has significantly improved over the past three decades.

Kaiser Permanente researchers found that the life expectancy for people living with HIV and receiving treatment has increased significantly since 1996.

Since then, new antiretroviral drugs have been developed and added to existing antiretroviral therapy. This has resulted in a highly effective HIV treatment regimen.

In 1996, the total life expectancy for a 20-year-old person with HIV was 39 years. In 2011, the total life expectancy bumped up to about 70 years.

The survival rate for HIV-positive people has also dramatically improved since the first days of the HIV epidemic.

For example, researchers who examined the mortality of participants in a 2012 study of Swiss people with HIV found that 78% of deaths between 1988 and 1995 were due to AIDS-related causes. Between 2005 and 2009, that figure dropped to 15%.

An estimated 1.1 million people in the U.S. are living with HIV, but fewer are contracting the virus each year.

This may be because of increased testing and advances in treatment. Regular antiretroviral treatment can reduce HIV in the blood to undetectable levels.

According to the Centers for Disease Control and Prevention, a person with undetectable levels of HIV in their blood isn’t able to transmit the virus to a partner during sexual activity.

Between 2017 and 2021, the annual number of new HIV infections in the United States fell by 7%.

Antiretroviral medications can help to slow the damage caused by HIV infection and prevent it from developing into stage 3 HIV (AIDS).

A healthcare professional will recommend taking antiretroviral therapy. This treatment requires taking three or more antiretroviral medications daily. The combination helps suppress the amount of HIV in the body (the viral load). Pills that combine multiple medications are available.

The different classes of antiretroviral drugs include:

Viral-load suppression allows people with HIV to live healthy lives and decreases their chances of developing stage 3 HIV. The other benefit of an undetectable viral load is that it helps reduce transmission of HIV.

The 2014 European PARTNER study found that the risk of HIV transmission is very small when a person has an undetectable load. This means the viral load is below 50 copies per milliliter (mL).

This discovery has led to an HIV prevention strategy known as “treatment as prevention.” It promotes constant and consistent treatment as a way to reduce the spread of the virus.

HIV treatment has evolved tremendously since the onset of the epidemic, and advancements continued to be made. Initial reports from a clinical trial in the United Kingdom and a 2016 study from the United States showed promising results in experimental HIV treatments that could put the virus into remission and boost immunity.

The U.S. study was conducted on monkeys carrying the simian form of HIV, so it’s not clear if people would see the same benefits. As for the U.K. trial, participants showed no signs of HIV in their blood. However, researchers cautioned that there’s potential for the virus to return, and the study isn’t yet completed.

A monthly injection hit markets in early 2020 after showing promising results in clinical trials. This injectable combines the drugs cabotegravir and rilpivirine (Edurant). When it comes to suppressing HIV, the injectable’s proven to be as effective as the standard regimen of daily oral medications.

Though the outlook has gotten much better for those with HIV, there are still some long-term effects that they might experience.

As time passes, people living with HIV may begin to develop certain side effects of treatment or HIV itself. These may include:

  • cognitive impairment
  • coronary artery disease
  • kidney disease
  • inflammation-related complications
  • effects on lipid levels
  • cancer

The body may also shift how it processes sugars and fats. This can lead to more fat in certain areas, changing the body’s shape.

However, these physical symptoms are more common with older HIV medications. Newer treatments have far fewer, if any, of these symptoms affecting physical appearance.

If treated poorly or left untreated, HIV infection can develop into stage 3 HIV or AIDS.

A person develops stage 3 HIV when their immune system is too weak to defend their body against infections. A healthcare professional will likely diagnose stage 3 HIV if the number of certain white blood cells (CD4 cells) in an HIV-positive person’s immune system drops below 200 cells per mL of blood.

Life expectancy is different for every person living with stage 3 HIV. Some people may die within months of this diagnosis, but the majority can live fairly healthy lives with regular antiretroviral therapy.

Over time, HIV can kill cells in the immune system. This can make it difficult for the body to fight serious infections. These opportunistic infections may become life threatening because they can damage the immune system when it’s already weak.

If a person living with HIV develops an opportunistic infection, they will be diagnosed with stage 3 HIV or AIDS.

Some opportunistic infections include:

Opportunistic infections, especially tuberculosis, remain a major cause of death for people living with stage 3 HIV. The best way to prevent an opportunistic infection is by following treatment and getting routine checkups. It’s also important to use condoms during sexual activity, get vaccinated, and eat properly prepared foods.

HIV can quickly cause damage to the immune system and lead to stage 3 HIV, so getting timely treatment can help improve life expectancy.

People living with HIV should visit a healthcare professional regularly and treat other health conditions as they arise.

Starting and staying on antiretroviral treatment right after diagnosis is key to staying healthy and preventing complications and progression to stage 3 HIV.

New tests, treatments, and technological advancements for HIV have greatly improved what was once a grim outlook.

That’s why routine HIV screening is vital.

Early detection and timely treatment are key to managing the virus, extending life expectancy, and reducing the risk of transmission. Those who remain untreated are more likely to experience complications from HIV that could lead to illness and death.

Read this article in Spanish.