Her team was also not able to account for the impact of chronic conditions such as heart disease and diabetes, because that information was not available. That’s a shortcoming in the research, Schwarcz said, because as people with HIV live longer, they develop typical diseases of aging such as cancer and heart disease.
Still, opportunistic infections can arise if HIV medication is not taken as directed. These include a brain infection called progressive multifocal leukoencephalopathy (PML), brain lymphomas and other infection-related cancers — all of which remain highly fatal for people with AIDS even today, Schwarcz said.
Grant agreed that early diagnosis of HIV infection and strict adherence to treatment are key in raising survival rates. He added that, earlier this year, a major study confirmed “that starting therapy for HIV earlier brings clinical benefits.”
But he also said that a population of aging, HIV-positive patients is increasingly encountering diseases that can affect everyone.
“The causes of mortality in HIV-positive persons has changed,” Grant said. “While opportunistic infections and lymphomas were the main causes of mortality in the past, mortality is now often due to lung cancer, heart disease, suicide and overdose.”
These too, can be prevented, however. “Attention to substance health — including tobacco use — and mental health are keys to decreasing mortality in this era,” Grant said.
The study was published recently in the Journal of Infectious Diseases.
SOURCES: Sandra Schwarcz, M.D., M.P.H., senior HIV epidemiologist, San Francisco Department of Public Health; Robert Grant, M.D., M.P.H., University of California, San Francisco; June 4, 2015, Journal of Infectious Diseases
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