Will a long life be a good one?

[nychope1]

http://aidsmap.com/news/Will-a-long-life-be-a-good-one-The-50-Plus-Project/page/1532717/

But with good quality treatment, someone diagnosed now in their mid-30s (as is most common) can hope to live into their 70s. Studies still report that HIV cuts, on average, eight to ten years off life expectancy, about as much as smoking 20-a-day. But that’s as good as or better than many other chronic, long-term, life-threatening conditions, and it continues to improve all the time, with some groups of people with HIV now on a par with the general public.

[Assurbanipal]

Studies still report that HIV cuts, on average, eight to ten years off life expectancy, about as much as smoking 20-a-day. But that's as good as or better than many other chronic, long-term, life-threatening conditions, and it continues to improve all the time, with some groups of people with HIV now on a par with the general public.

Everybody thinks they understand life expectancy.

But most don't.  

The author of the article you quoted appears to be a member of the majority.



Life expectancy is the arithmetic average of the expected number of years of life until death for a group.  Averages can be tricky to work with.  If you have a sizable subset of people expected to die much younger than normal they can bring down the average a lot.  But that doesn't mean that most people living with HIV will die a lot younger than expected.  

There are still a lot of people who are diagnosed late (me included).  Not all of us can successfully make it onto a regimen that works and we can stick with.  But those who do, on average, die only a little faster than one would otherwise expect.  Recent studies show that a lot of groups living with HIV have pretty much normal life expectancies.  Now that's not great -- given the amount of medical care and the attention we give our health, you might expect a little above the average.  But if you are someone who has made it on to a drug regimen that works and you can tolerate, you shouldn't be assuming you will still be dying a decade sooner than you otherwise would.

Of course the main point of the article you linked is that people might face a long period of illness during those newly added years of life.  We don't really know if that will happen.

But the same question was raised for the general (non-HIV) population in the 90's as we saw life expectancies rise then.  Many people asked if life spans were going up only to generate more years of disability.  Well, the results of the research studies on that are now in and the answer for the US population is a resounding no. http://www.nltcs.aas.duke.edu/research_topics.htm Not only have life expectancies gone up for the general population, but the expected healthy lifespan has increased even more than life expectancy!  


The story is a little different in the UK (which is where that article is from).  There, while the number of healthy life years has increased, life expectancy has been increasing faster.
http://www.tf-he.eu/archives/TF%20on%20HE/Meeting/2_TF_Meeting_Jun2006/4_PPT/2_UK.ppt
But still, the number of healthy years has been increasing for the general population there as well, so at least some portion of the increase in life expectancy is going to healthy years.  (Two items of note: first, recent studies have suggested that once Medicare kicks in, it may be a better program for maintaining health than the NHS and second, life expectancy improvement in the UK shows a decided cohort effect absent in the US -- thought to be the result of food shortages and rationing in the UK past)

So, continue to be hopeful.  (And in 30 years, report back to us...  )