Is HIV a Manageable Chronic Disease?

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When I first began taking care of HIV infected individuals right here at the NIH, I started, literally, within weeks to a month or two after the first cases were reported, I became fascinated and was convinced that this was truly a new disease that was going to get out of control. I didn't know what it was, I knew it was infectious, I knew that it was sexually transmitted, but I had no idea what the ideology was.

So I turned around the direction in my career and started studying these patients, and at the time that I began admitting them to our hospital here, the median survival was six to eight months which means that 50% of your patients would be dead in six to eight months, and then that was because almost all of them didn't come in and were noticed to have AIDS until they were already far advanced whereas now we know from years of experience that you can get infected and go for several years doing reasonably well. So all we were seeing was advanced patients.

Now, if you look at the combinations of drugs that have been developed, and when used in combination of three or more reasonably early enough in the course of a person's infection so that they haven't already devastated their immune system, you can do a mathematical modeling of predicting that if a 25 year old person gets infected and within a reasonable period of time from the initiation of the infection, they go on a typical combination antiretroviral therapy that they would live an additional five, zero, 50 years so that you can live till you're in your 70s, which is almost a normal life span.

So it is entirely correct to say that with the current therapies and the current care we have available, that we've actually converted HIV into a manageable chronic disease.