Twenty-five years after the discovery of the AIDS virus, the deadly disease has been halted in its tracks – so much so that sufferers are now dying at a ripe old age.
Nearly 85 per cent of patients being treated for HIV-AIDS with drug cocktails have undetectable levels of virus in their bloodstream, according to new data from the B.C. Centre for Excellence in HIV-AIDS in Vancouver.
“People with HIV are not exempt from destiny,” Dr. Julio Montaner, the centre's director, said in an interview, “but they are no longer dying from AIDS.” That fact, he said, “really tells the story of how far we've come with treatment.”
When Margaret Heckler, then secretary-general of the U.S. Health and Human Services Department, announced at a Washington news conference on April 23, 1984, that the “probable cause” of AIDS had been found, she boldly predicted a vaccine within two years and eradication of the disease by 1990.
If only it were so.
There is still no vaccine, no cure, and HIV-AIDS continues to spread relentlessly, with 2.7 million new infections worldwide last year and 33 million people living with the virus.
The good news is that scientists have learned to subdue the wily human immunodeficiency virus: Powerful drug combos are used to shut down HIV replication and limit the damage it inflicts on the immune system.
The impact of this treatment regime, known formally as highly active antiretroviral treatment (HAART), is undeniable – adding, on average, 13 years to the life expectancy of HIV-positive people, according to a study by Robert Hogg of the B.C. Centre for Excellence in HIV-AIDS.
Virtually anyone with money – or access to a public-health system like Canada's – can neutralize the virus's effects on the immune system and have a normal life expectancy.
“There's no reason people can't live 50 years with HIV,” said Anita Rachlis, an infectious-diseases consultant at Sunnybrook Health Sciences Centre in Toronto. “But people with HIV often have a lot of co-morbidities.”
Indeed, while survivors are living longer, they are also dealing with a combination of related health challenges: the ravages inflicted on the immune system by the virus over many years; the damage done by long-term use of powerful drugs; and the effect of other infections that came along for the ride with HIV (such as hepatitis, herpes and HPV), not to mention the normal process of aging.
“I wonder what's going to get me, but I don't think it's going to be AIDS,” said Ron Rosenes, a Toronto activist who has been living with HIV since the early days of the epidemic. Rather, he worries about anal cancer, lymphoma and heart disease – which are common in long-time survivors because of immune-system damage.
Like most Canadians with HIV-AIDS, Mr. Rosenes takes a cocktail of three drugs to keep the virus in check. He also takes medication to deal with some of the side effects, including drugs for osteoporosis and acid reflux, and a powerful vitamin and mineral supplement called K-PAX to bolster his immune system. “I never thought I would live to 50, let alone 61,” Mr. Rosenes said.
There is, in fact, a growing legion of people reaching their golden years with what was once a disease of the young.
“Treatment advances have transformed HIV from a death sentence to a life sentence,” said Bill Cameron, president-elect of the Canadian Association for HIV Research.
Dr. Cameron said medications have evolved over time. At first they were used to control infections, then drugs were combined to suppress the virus, and now those drugs are being refined to be less toxic and better tolerated.
