Positive thinking: Living with the Aids virus - Health News - Health & Families - The Independent

Positive thinking: Living with the Aids virus

view gallery VIEW GALLERY

More Britons than ever have HIV – but their life expectancy after diagnosis has never been higher

Julian Hows is one of the lucky ones. When he was diagnosed with HIV in 1990, the disease was a death sentence. Now infection with the virus that causes Aids has become a way of life for almost 100,000 people in Britain. Improvements in drug treatment over the past decade have dramatically extended life expectancy for patients with HIV by an average of 16 years, according to research published today.

Julian survived those early years without treatment – the drugs available such as AZT were toxic with unpleasant side-effects and he didn't trust them. "I left my job, went round the world, did some serious damage to my credit card and came home. Then I realised: 'I am not dead yet'."

By 2000, when he was seriously ill with pneumonia and shingles, new combination therapy involving a cocktail of drugs was starting to show dramatic improvements. "There was great suspicion of antiretroviral drugs at first – we didn't know their toxicity or the dosing regime. I was fortunate because just as my health began to deteriorate and I needed treatment they started to get it right."

More than a decade later, Julian, 56, a programme officer with the Global Network of People Living with HIV in the Netherlands, is living proof of the power of the new drugs. But the advance has brought a crisis in its wake. The numbers in treatment have trebled since 2000 at a cost of almost £1bn a year. Efforts to prevent the disease, condemned as "woefully inadequate" by a Lords committee last month, are failing to curb the increase and there are warnings that complacency among young people about the risks has grown, fuelled by the success of treatment.

New diagnoses of HIV acquired in the UK have almost doubled from 1,950 in 2001 to 3,780 in 2010, according to the Health Protection Agency (HPA). More than a quarter of those infected have not been tested and are unaware of their condition, increasing the danger to themselves and the risk that they will pass on the infection. Research published in the British Medical Journal today shows that the average 20-year-old diagnosed with HIV can now expect to live to their mid-60s. The same person diagnosed in the mid-1990s had a life expectancy to age 50. That improvement is down to modern combination drugs that keep the virus in check.

From a killer infection that cut down millions of young men and women in their prime, HIV/Aids has been transformed into a chronic disease that people live with, rather than die from.

Last month's report by the House of Lords HIV and Aids Select Committee noted that just £2.9m was spent on HIV prevention in the UK in the last year compared with £762m on treatment. Avoiding one infection saves treatment costs estimated at £280,000-£360,000. The HPA said the NHS could have saved £1.2 bn if all 3,780 cases infected in the UK in 2010 had been prevented.

The committee was chaired by Lord Norman Fowler who, as Health Secretary in 1986, launched the "Don't die of ignorance" campaign, the first to warn of the Aids pandemic. Lord Fowler said: "In the last 25 years the development of new drugs has dramatically reduced the death toll but that should not encourage a false sense of security. Prevention must be the key policy."

His words were echoed by the authors of today's BMJ study, based on more than 17,000 patients with HIV, of whom 1,248 died between 1996 and 2008. It showed that the earlier patients were diagnosed and the sooner they started treatment the better their outlook.

Doctors assess how far HIV infection has advanced by counting the number of CD4 cells in the blood, a measure of the strength of their immune systems.

The researchers from the University of Bristol, found that patients who were tested and treated early in the course of the infection – when their immune systems, as measured by their CD4 cell counts, were still relatively robust – had the longest life expectancy into their 70s (for those diagnosed at age 20). Those who delayed testing and did not start treatment until the disease was advanced had a life expectancy on average only until their 50s.

Mark Gompels, co-author of the study and director of HIV and Aids Services, North Bristol NHS Trust, said: "These results are very reassuring news for current patients. People are frightened of getting tested because they think they are going to die. But the message of these results is that they should get tested."

"Of those who delay and present to us with late-stage HIV infection, 20 per cent die within six months. Had they been tested and treated early they would have looked forward to a life expectancy of the kind we report."

But Dr Gompels admitted "one worry" about the success of treatment was that it could make people complacent. "We must not let that happen," he said.

Men who have sex with men are at highest risk of contracting the disease in the UK, with new diagnoses up 70 per cent in the past 10 years. An expansion of HIV-testing in the 38 primary care trusts with the highest HIV prevalence was recommended in guidance from the National Institute for Clinical Excellence last March.

For Julian, the future remains bright, though he now faces a new challenge – how to support himself in a retirement he never thought he would see.

"I don't have a pension and I will probably have to work to my late 60s. But I would rather be facing the poverty trap than a six-foot box underground."

Sir Nick Partridge, chief executive of Terrence Higgins Trust, yesterday hailed the advance revealed in the latest research. "It demonstrates why it's so much better to know if you have HIV. Late diagnosis and late treatment mean an earlier grave, so if you've been at risk for HIV, get tested now."

The UK's relationship with HIV has come a long way in 30 years

1981

Reports of pneumonia clusters among gay men in California and New York bring the condition – initially known as Gay Related Immune Deficiency (Grid) – to public attention.

1982

First use of the term Acquired Immune Deficiency Syndrome (Aids).

1983

Terrence Higgins Trust formally established, in memory of the late Terry Higgins, an early Aids victim. UK Aids cases: 17.

1984

Human Immunodeficiency Virus (HIV) isolated in France and US (initially as LAV and HTLV-III).

1985

Body Positive, a self-help group for virus-carriers, established. Royal College of Nursing warns of one million infections by 1991 if trends continue.

1987

"Don't die of ignorance" campaign launched in the UK, along with nationwide HIV testing and pilot needle exchange schemes. AZT, the first anti-retroviral drug, is approved in the US.

Diana, Princess of Wales, defies convention by publicly shaking hands with an Aids patient.

1988

World Aids Day established. London Lighthouse (a residential centre for people with Aids) opens.

1989

Red Ribbon introduced as HIV symbol. AZT found to slow progress of Aids.

1990

John Major announces £42m compensation for haemophiliacs infected with HIV through blood transfusions.

1991

Freddie Mercury dies of Aids.

1993

Aids education becomes mandatory in schools. Kenny Everett and Holly Johnson announce they are HIV-positive. UK Aids cases: 7,045.

1995

Highly Active Antiretroviral Therapy (HAART), the first combination therapy, is approved in the US. In the UK, 25,689 are HIV-positive, 11,872 have Aids, and 1,715 die of Aids.

1996

Protease inhibitors found to be effective in the treatment of HIV.

1997

UK Aids deaths: 737.

1998

First trials of a putative HIV vaccine.

2000

More than 3,000 new diagnoses of HIV infection in the UK – a record.

2001

Major pharmaceutical companies stop opposing the production of generic antiretrovirals.

2002

5,854 new HIV infections diagnosed in the UK (more than twice the figure for 1996).

2003

Many drug companies lower their prices for antiretrovirals in poorer countries. In the UK, 49,500 people are HIV-positive.

2004

Globally, nearly 8,000 people a day are dying from Aids.

2005

G8 leaders pledge universal access to antiretroviral treatment by 2010.

2006

Annual cost of managing the condition in the UK is £500m.

2007

7,734 new HIV diagnoses in the UK – the most ever.

2009

85,600 people in the UK have HIV, of whom about a quarter are unaware of it.

2010

Annual cost of managing HIV in the UK reaches £760m

2011

Number of HIV-positive people in the UK passes 100,000 – but a 20-year-old just diagnosed with the virus has a life expectancy of another 46 years.

News
Paper trail: the wedding photograph found in the rubble after 9/11 – it took Elizabeth Keefe 13 years to find the people in it
newsWho are the people in this photo? It took Elizabeth Stringer Keefe 13 years to find out
Arts and Entertainment
Evil eye: Douglas Adams in 'mad genius' pose
booksNew biography sheds light on comic genius of Douglas Adams
Sport
FootballFull debuts don't come much more stylish than those on show here
News
i100
PROMOTED VIDEO
Life and Style
ebooksA superb mix of recipes serving up the freshest of local produce in a delicious range of styles
Life and Style
ebooksFrom the lifespan of a slug to the distance to the Sun: answers to 500 questions from readers
Life and Style
Kim Kardashian drawn backlash over her sexy swimsuit selfie, called 'disgusting' and 'nasty'
fashionCritics say magazine only pays attention to fashion trends among rich, white women
Arts and Entertainment
TVShows like Agents of S.H.I.E.L.D are little more than marketing tools
Arts and Entertainment
Hit the roof: hot-tub cinema east London
architectureFrom pools to football pitches, rooftop living is looking up
Travel
travel
News
The ecological reconstruction of Ikrandraco avatar is shown in this illustration courtesy of Chuang Zhao. Scientists on September 11, 2014 announced the discovery of fossils in China of a type of flying reptile called a pterosaur that lived 120 millions years ago and so closely resembled those creatures from the 2009 film, Avatar that they named it after them.
SCIENCE
Life and Style
tech
Arts and Entertainment
Matisse: The Cut-Outs exhibition attracted 562,000 visitors to the Tate Modern from April to September
art
Life and Style
Models walk the runway at the Tom Ford show during London Fashion Week Spring Summer 2015
fashionLondon Fashion Week 2014
News
Kenny G
news
News
peopleThe black actress has claimed police mistook her for a prostitute when she kissed her white husband
Life and Style
techIndian model comes with cricket scores baked in
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    KS1 and KS2 Primary NQT Job in Lancaster Area

    £85 - £140 per day: Randstad Education Preston: Randstad Education is urgently...

    Supply teachers needed- Worthing!

    £100 - £120 per day: Randstad Education Crawley: Supply teachers needed for va...

    KS1 and KS2 Primary NQT Job in Lancaster Area

    £85 - £140 per day: Randstad Education Preston: Randstad Education is urgently...

    Secondary Supply Teacher Lowestoft

    £110 - £140 per day: Randstad Education Cambridge: Randstad are currently look...

    Day In a Page

    Mystery of the Ground Zero wedding photo

    A shot in the dark

    Mystery of the wedding photo from Ground Zero
    His life, the universe and everything

    His life, the universe and everything

    New biography sheds light on comic genius of Douglas Adams
    Save us from small screen superheroes

    Save us from small screen superheroes

    Shows like Agents of S.H.I.E.L.D are little more than marketing tools
    Reach for the skies

    Reach for the skies

    From pools to football pitches, rooftop living is looking up
    These are the 12 best hotel spas in the UK

    12 best hotel spas in the UK

    Some hotels go all out on facilities; others stand out for the sheer quality of treatments
    These Iranian-controlled Shia militias used to specialise in killing American soldiers. Now they are fighting Isis, backed up by US airstrikes

    Widespread fear of Isis is producing strange bedfellows

    Iranian-controlled Shia militias that used to kill American soldiers are now fighting Isis, helped by US airstrikes
    Topshop goes part Athena poster, part last spring Prada

    Topshop goes part Athena poster, part last spring Prada

    Shoppers don't come to Topshop for the unique
    How to make a Lego masterpiece

    How to make a Lego masterpiece

    Toy breaks out of the nursery and heads for the gallery
    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Meet the ‘Endies’ – city dwellers who are too poor to have fun

    Urbanites are cursed with an acronym pointing to Employed but No Disposable Income or Savings
    Paisley’s decision to make peace with IRA enemies might remind the Arabs of Sadat

    Ian Paisley’s decision to make peace with his IRA enemies

    His Save Ulster from Sodomy campaign would surely have been supported by many a Sunni imam
    'She was a singer, a superstar, an addict, but to me, her mother, she is simply Amy'

    'She was a singer, a superstar, an addict, but to me, her mother, she is simply Amy'

    Exclusive extract from Janis Winehouse's poignant new memoir
    Is this the role to win Cumberbatch an Oscar?

    Is this the role to win Cumberbatch an Oscar?

    The Imitation Game, film review
    England and Roy Hodgson take a joint step towards redemption in Basel

    England and Hodgson take a joint step towards redemption

    Welbeck double puts England on the road to Euro 2016
    Relatives fight over Vivian Maier’s rare photos

    Relatives fight over Vivian Maier’s rare photos

    Pictures removed from public view as courts decide ownership
    ‘Fashion has to be fun. It’s a big business, not a cure for cancer’

    ‘Fashion has to be fun. It’s a big business, not a cure for cancer’

    Donatella Versace at New York Fashion Week