Sunday, 29 December 2013


Pusit Public Service ---

hmmm... US - UK - AUS - TH --- andami ko pang pwede puntahan... Mag migrate kaya ako?



ako si BONG

ito ang aking diary


Friday, 27 December 2013


at ito ang simula ng mahigit 3 oras na kwentuhan...

habang pareho namin iniintay ang epekto ng EFAV!

ang masasabi ko lang....


Buntis rin sya!!!

Omg! abangan ang twist and turns sa buhay ko...


ako si BONG

ito ang aking diary


Monday, 9 December 2013


Ang Disyembre ko ay malungkot

'pagkat miss kita

Anumang pilit kong magsaya

miss kita pag Christmas

Kahit nasaan ako

pabaling-baling ng tingin

walang tulad mo

Ang nakapagtataka'y

maraming nakahihigit sa iyo

Hinahanap-hanap pa rin kita

Ewan ko kung bakit ba

ako’y iniwan mong nag-iisa

Miss kita, o giliw

Pasko’y sasapit

'di ko mapigil ang mangulila

Hirap niyang mayroon ka nang iba...



ito ang aking diary

ako si BONG


Sunday, 1 December 2013


december 1, 2013


today is also sunday

and what do i do first thing in the morning on a sunday?

hanggang kelan kaya ito?

ako si BONG
ito ang aking diary



Saturday, 30 November 2013



Well now, I get low and I get high,

And if I can't get either, I really try.

Got the wings of heaven on my shoes.

I'm a dancin' man and I just can't lose.

You know it's all right. It's OK.

I'll live to see another day.

We can try to understand

The New York Times' effect on man.


Whether you're a brother or whether you're a mother,

You're stayin' alive, stayin' alive.

Feel the city breakin' and everybody shakin',

And we're stayin' alive, stayin' alive.

Ah, ha, ha, ha, stayin' alive, stayin' alive.

Ah, ha, ha, ha, stayin' alive.


~ bee gees

this is how much i have to deal with to stay alive.

difficult you say? nah!!!

it takes a little time to get used to

definitely confusing at times

pero its actually easy

these meds keeps me healthy

parang multivitamins lang

today my routine labs went well, spotless

and so i can breathe easy

coudn't ask for more

sabi nga ni Janina San Miguel,

"i dont peel eyni preysyur rayt now"

today we celebrate WORLD AIDS DAY!

25 days til christmas!



ako si BONG

ito ang aking diary

Friday, 29 November 2013

1st SHOT!


Waiting for my 2nd doctor's appointment, i already had my 1st shot of HPV Vaccine a while back. 2 more shots in the next 6months. hepa B and pneumonia vaccines are next!

Mahal magkasakit, mahal din ang mga vaccine para maiwasan magkasakit. thanks to my younger brother for sponsoring some of my upcoming meds and vaccines.

Yes nagdisclose na ako sa younger brother ko who is a nurse. Siya kauna unahang nakakaalam sa family ko. I was desperate, and got no one else to turn to. He was shocked and asked me how i can keep this to myself and not tell them for more than 2 years. I said i dont want anyone to worry about me and since i got my close friends to support me naman, so there wasn't any real threat to my life. He said for me to get the best treatment and not to hesitate to ask for funds. Im touched. Makes my life much easier and i just have to really take care of myself and not worry about looking for funds if needed be.

Today is my 3rd month on ARVs without any issues. After todays routine check-up i will have my 3months supply of ARVs.

Salamat naman, the scary stage is over and am doing really well so far.

Kayo? Kamusta naman kayo?


ako si BONG

ito and aking diary


Tuesday, 22 October 2013



At several points throughout the year most of us will be bombarded with the maddening effects of Mercury in retrograde. Mercury is a planet which governs all transportation and communication issues. Mercury is not an emotional planet, but rather a highly objective, truth-seeking one. It rules intelligence, education and truth. When it is in retrograde, some of its power is held back.

When Mercury starts turning in an apparent backward motion, we will start to feel the effects of this event days or even as far as two weeks earlier. When the planet normalizes we will see the tempo of events pick up in our lives as the planet becomes "stationary" and then speeds forward.

Gemini and Virgo are signs ruled by Mercury, so if you are one of those born during those months, you will be complaining especially loudly. If you work in the industries ruled by this planet such as sales, writing, public relations, advertising, publishing, air freight, the post office or express mail, any transportation industry, from the airlines to Amtrak, you'll also be especially vulnerable to this planet's weird motions in September. (If you are a Gemini, for example, who works in publishing, it's no use calling in for a month of mental health days--you can't escape!)

What happens when Mercury retrogrades? You miss appointments, your computer equipment crashes, checks get lost, you find the car you just purchased during Mercury retrograde is a lemon. (Or, you hate your haircut, the lamp you bought shorts out, your sister hates her birthday gift.) There will be countless delays, cancellations and postponements--but know these will benefit you in the long run. Don't fight them, although your frustration level and feeling of restlessness will be hard to cope with at times.

In matters of the heart, if your boyfriend or girlfriend breaks up with you or says something hurtful, take a wait-and-see attitude. Since Mercury rules speech, they may not mean what you think they are saying now. Let them have some space, and wait to see if they mean in October what they said in September.



------ I love you so much hon! Di magbabago yun! I am letting you go not because i am giving up but because i want you to be happy. Remember to always reflect on what your goals are and what needs to be done. Sana eh wag mong pababayaan ang sarili. Ang mga boys will just come and go! Most impt is you love and protect urself all the time. I will miss you! Thanks for the most memorable 1 1/2 years of my life.


and so today is the start of my new state of #SINGLEBLESSEDNESS #efavirenz4REBOUND

dont ask me if am okay coz am PERFECTLY FINE :)

ito ang aking diary

ako si BONG


Monday, 23 September 2013



Good Day po,

Salamat ng marami sa blogs nyo.I just stumbled in your website seeking for advice. Bago lang po ako dito sa Dubai on a visit visa at naghahanap ng trabaho to stay and make a living. Pero natatakot po ako na ma blood test prior to issuance of residence visa. Mandatory po kasi ang HIV test dito na conducted ng government ng Dubai. Ayoko pong mapahiya, madetained, madeport at mabanned for life kung may nakita silang problema sa dugo o baga ko. I considered myself as high risk dahil ako po ay natreat na ng STI before but never been tested for HIV. Ang favor ko lang po baka merong alam po kayo na pwedeng magdeliver ng rapid HIV testing kit sa bansa na ito. At kung wala, baka po may magtip na available yung kit dito at mabigyan ako ng pangalan ng pharmacy so i can buy this product. Sa gayon, pwede po ako magtesting sa bahay. At kung sakali na ako ay magpositive, I will voluntarily leave the country without a bad record. Kahit malaman ko yung bad news, my next step is to seek treatment in our country.

Help me kung pano po ako maka acquire nung testing kit. That maybe will have a peace of mind. Meron akong naresearched malapit dito na discreet HIV testing. (Zach's) pero bukod sa mahal ang fee, marami ang nagsasabi na irereport din sa pulis ang malalamang positibo sa test as required by UAE law.

Sana matulungan nyo po aq sa queries ko,

Salamat po in advance,


Hello Tony,

sorry for the late reply and i hope this blog through one of its readers will be able to help you find the answers that you seek.

unfortunately i dont have a clue if a home test kit is available anywhere in the UAE or if they will allow delivery in their country, if there is, it must be illegal and hard to find knowing how strict UAE is in monitoring and deporting HIV cases.

from past inquiries, a few of my dubai readers decided to take their HIV test when hey were vacationing/travelling in HK, Europe, US or somewhere else where anonymous testing is available.

goodluck and heres hoping some of the other readers can answer your question helpfully.


ako si BONG

ito ang aking diary



Wednesday, 18 September 2013



Hi this is kat.. i am a nurse. i got pricked with Hepa B reactive patient through a needle prick injury.. I got tested with baseline diagnostics like HBsAg, Anti-HBs, HCV and HIV Screening tests.. Good thing that I have active titers from Hepatitis B when I was vaccinated in college.. I had negative results from all the labs stated above and had immunity against hepa B.. In this regard, I am being tested again for confirmation, does RITM offer all the above mentioned labs? and wat are the other services they offer? VDRL, etc.. thanks! hope to hear from you.. I hope ur doing fine..



hello kat,

maraming salamat sa iyong pagsulat, we only offer the following 3 tests at the malate hub FOR FREE: 1. HBsAg (HepaB) 2. SY (Syphillis) 3. HIV Antibody Screening. they have other laboratory tests for other STIs but it's not free, please call them on the numbers noted below for more details:


LOVEYOURSELF HUB (RITM Satellite Clinic Manila)

1850 Leon Guinto St. Malate, Manila.

Tel. 5479334 or 09178351038

Mondays, Thursdays Fridays & Saturdays 11 AM to 7 PM.

(Cut-off at 5:30 PM)

Sunday 9 AM to 4 PM.

(Cut-off at 2 PM)

Tuesdays & Wednesdays Clinic is CLOSED

indeed these needle prick injuries can happen to health workers and we always encourage the practice of universal precaution at all times, at this time and age, safety is always an utmost priority.

i sincerely wish that your retest results would be non-reactive.


ako si BONG

ito ang aking diary


Saturday, 7 September 2013


through the years, there has been a lot of inquiries about Genital Warts among PLHIVs (even non PLHIVs) to the point na meron na akong top 3 clinics where i refer them everytime me nagtatanung sa akin. mukhang usong uso ang ganito sa mga immunocompromised na mga tao...


Genital warts (or condylomata acuminata, venereal warts, anal warts and anogenital warts) are symptoms of a highly contagious sexually transmitted disease caused by some types of human papillomavirus (HPV). It is spread through direct skin-to-skin contact, usually during oral, genital, or anal sex with an infected partner. Warts are the most easily recognized symptom of genital HPV infection. Although some types of HPV are known to cause cervical cancer and anal cancers, these are not the same types of HPV that cause genital warts.[1] Although 90% of those who contract HPV will not develop genital warts, those infected can still transmit the virus. Although estimates of incidence vary between studies, HPV is so common that nearly all sexually active people will get it at some point in their lives.[2]

HPV types 6 and 11 are most frequently the cause of genital warts. The Gardasil vaccine includes coverage for these types. While types 6 and 11 are considered low risk for progression to cancers, it is also possible to be infected with different varieties of HPV, such as a low-risk HPV that causes warts and a high-risk HPV, either at the same or different times.


di ko na lang ipopost ang mga pictures kasi medyo gross...

dahil na rin sa kung anu anung mga horror stories na narinig ko before on sobrang mahal daw mag pa treat (cautery) meron pa daw minsan sumisingil ng P30k, some naman said 5k and above. what i did na lang is to research further and visit the best recommended clinic base sa mga PLHIV friends na napagtanungan ko.

dipende naman daw pala talaga kung anu ang extent ng kaso, ang sina suggest na lang ng mga duktor eh magpatingin kaagad sa first sign pa lang ng warts para maagapan. kasi kung masyado na daw malala, mas mahal syempre, kasi kung super konti palang minor lang daw at topical anaesthesia lang ang ginagamit.

back to the clinic. i found that the best recommended and affordable clinic that caters for Genital Warts is BARIA CLINIC (or Surgical Specialist) sa Cainta. consulation is about Php300 and Cautery procedure starts at Php 1500 only for early stage. here's how to reach them.




MWF - 9am to 1130am

TThS - 2pm to 5pm

CALL MARYANN: 02.655.4701


ayan thats all that i found out. reminder that the earlier you seek medical attention, maaring mas mura ang cautery procedure. and since HPV ang cause ng genital warts, get vaccinated, whether positive ka na or negative ka pa sa HPV advisable pa rin na mag HPV vaccine para daw di pabalik balik ang warts or mas bumagal bumalik kasi ganun daw talaga yun. pinakamurang HPV vaccine na narinig ko for groups would be Php 2225 or as high as 5k per shot and we're supposed to get 3 shots in a span of 6 months.

yan muna.

stay safe always


ako si BONG

ito ang aking diary





Friday, 6 September 2013


OA naman, parang big big deal. parang nagkasakit... hindi naman. i just survived Day 1 of m ARV medications. am now on day 2. So far so good, its not as bad as i expected.

(SHIP - my new clinic in shaw blvd)


i am now with SAGIP Unit (STI/AIDS Guidance Intervention & Prevention Unit) under UP-PGH. lumipat ako from RITM-ARG at mabilis lang naman ang proseso, napaka accommodating pa rin ng mga taga RITM Alabang and i soooo love them still. pero there are some important considerations why i have to transfer. kaya ayun, wednesday morning i was at RITM Alabang then kinahapunan, dala ko na ang endorsement at medical abstract ko sa clinic sa shaw.

bakit kamo? kasi nga am about to start ARV na. eversince naman eh naisip ko na that when the time comes na kelangan ko ng mag gamot and my CD4 count gets to lower than 350, i would like to have a private doctor, someone who can give my case more attention. syempre lahat naman tayo gusto yung naaalagaan tayo. hassle din kasi minsan ung dami nakapila for consulatation then all you get is a few minutes with the attending doctor. minsan lang feeling ko baka may di mapansin sa case ko at baka may mamiss-out.

and so i found a great doctor, (si Dra. Kate) dahil super duper highly recommended sya ng ilang friends ko. at dahil under sya sa UP-PGH kaya i needed to transfer hubs. ang good news pa eh she holds clinic sa shaw blvd lang, lapit lang sa akin, all labs and dispensing of medications can be done there so super convenient para rin sa akin. syempre dahil sa philhealth libre pa rin lahat ng gamot and labs, mabuti na lang at continuous ang contributions ko. having a private doctor means me consultation fee (not free) and for me its totally fine, so long as ensured ako na naaalagaan ang case ko. Php 550 per consultation, i'd say not bad kasi halos ganun din naman nagagastos ko everytime bumibiyahe ako sa Alabang.

i am going to miss alabang.


after waiting for a few weeks para sa results ng sputum at xray ko, i was finally cleared and ready to start ARVs. all my labs wer great except that medyo mataas daw cholesterol ko - DIET DIET DIET sabi ni dra.!!! kaloka i soooo love her, sya yung duktor na super kwela at masaya kausap, walang ni isa mang hint ng judgement sa pagkatao mo kaya nga because of that i feel soooooo safe to tell her everything even my occassional recreational drug use. tapos super sipag pang sumagot sa mga emal at text, feel ko na she really wants to help out and take care of you.

so i brought my BF during my ARV counseling para maging treatment partner ko. naexplain naman ni doc ang mga gamot ko and possible side effects. sabi nya of all yung EFAV lang talaga ang medyo nakakagroggy kaya sa gabi sya tinatake before sleeping.

(efavirenz -adverse effects)


and so yesterday was day 1, TENOFOVIR - LAMIVUDINE - EFAVIRENZ, considered 2nd-line ARV na yata yun because dra thinks its best for my case. i stayed at home the whole day to see what happens.

morning medications did not have any noticeable effect whatsoever. yung efav sa gabi ang medyo nahilo at nagroggy nga ako. parang slight naka ecstasy ka lang pero since nakahiga na rin ako agad 30mins after taking it di ko na siguro naramdaman yung ibang effects. i just noticed mga 3x ako nagising middle of the night at parang medyo restless, pagkagising ko kaninang umaga hilo pa rin ako for about 1hr tapos unti unti rin nawala. itinodo ko na rin yung aircon kagabi kasi sabi nila it can feel hot sometimes. dahil dun di ko naman nafeel kung uminit nga ako.

so ayun success ang day 1 ko ko, i hope tuloy tuloy lang and that after 1 month my labs will show good numbers pa rin. wish me luck.



have to save money pala for more vaccines to protect myself from other possible diseases. magastos din but have to do it. IPON IPON IPON!


so ayan, alam nyo na na buhay pa rin ako, alive and kicking all over. happy lang. tamad lang talaga ako magblog lately. sensya naman.

o kamusta naman kayo?


ako si BONG

ito ang aking diary


Wednesday, 4 September 2013

Thursday, 8 August 2013


kasalukuyang nasa canteen ng RITM alabang, naghihintay ng 1 oras bago lamnan ang pangalawang sputum vial.

dahil sa resulta ng huling CD4 count ko kanina, nag request ang aking duktor ng karagdagang chest xray at sputum test.

mukhang kailangan na talagang magsimula at hindi na pwedeng ipagpaliban, dalawang taon din akong naghintay.

meron pa akong mga 2 linggo para gawin ang mga nararapat na lab tests at mga konsultasyon.

maliban duon eh wala naman ibang dapat ikabahala, wala naman akong nararammdaman.

pero bagong adustment na naman.

but i feel great.

i am ready.

329 = arv


ito ang aking diary,

ako si BONG


(PS: sira ang aking mobile number, you can reach me sa email)




Thursday, 30 May 2013


Stats update, i'm back at 498 from a low of 382 two months ago. so am back to "not wanting to get meds" ulit.

it was actually a steady improvement for 1 1/2 years until i got some bacterial infection last february that led to some neuropathic problems (unrelated to my serostatus). i was under medications which is expected to bring my immune system down. fortunately i recovered fast in just a matter of 3 weeks and my doctor said that it's a sign that despite my HIV status my immune system seems strong.

true enough my cd4 went down 382 last february and the doctor recommended that i start ARVs na. i hesitated and decided to wait another 3 months and see if my cd4 count would improve. nevertheless they started me on 6mo of daily doze isoniazid which is a phropylactic medications for TB.

and now the great news --- as of May my cd4 is up at 498 and i should say back on track.

improving without ARV medications.

something that i am very thankful of.

hindi nagpapatalo ang immune system ko, palaban pa rin.

i dont know how long they can hold this fight and i sincerely hope that they would not need medicinal reinforcements soon.

but then again there are a lot of study pointing to early medications as very beneficial to PLHIVs and that it will promise better protection for my sexual partner (bf). kaya mahirap pa rin magdecide i am torn between keeping a status quo and try to live a healthy life free of medications. or starting a new life on medications which can potentially impact my lifestyle.

for now am choosing the easier route of the status quo. i think my immune system deserves a chance to prove itself and fight this virus without reinforcements.

the elusive 500 cd4 count, i hope in another 3 months time i get to that mark or higher. it will surely make my resolve stronger that despite my serostatus, my body is winning the battle, for now.

ito ang aking diary

ako si BONG


Wednesday, 15 May 2013


Exactly what level of adherence to HIV medications is required to maintain virological control?

Dear Dr. Young:

This is a question that has always intrigued me, ever since I started on an effective antiretroviral treatment combination in 1997. Back then we were warned that even missing a single dose of our medications could spell disaster i.e. HIV resistance and subsequent loss of virological control. So I mustered all the self-discipline I could and took my medications as "correctly" as humanly possible and attained virological control (viral load measurements below the limit of quantification using whatever technology at the time) that I have maintained. Recently I undertook a very rigorous audit of my adherence that disclosed that in fact I take about 99 per cent of my doses and completely miss about one per cent in a one-year timeframe. Despite this error and lack of perfection my viral load remains undectable. I was just curious because even with the utmost of care that I bring to the task I still fall short of one hundred per cent perfection. Thank you for any insight you can provide.

Please accept my best regards,

Wayne Toronto, Canada


Response from Dr. Young

Hi Wayne and thanks for posting from Canada.

Perfection might be a goal, but rarely achieved.

You're adherence is exemplary- 99% is excellent and not associated with any decline in viral suppression. I would not be concerned about a 1% missed dose at all.

While we continue to quote a 95% goal (from a ~1999 study), with current medications, it's quite likely that lower levels of adherence continue to provide very good viral suppression.

In my clinic of less-than-perfect patients, loss of viral control has been exceptionally rare, and often the result of complete discontinuation of medications, rather than the inadvertent missed dose. So, worry not.

Be well, BY



Sunday, 5 May 2013


By Jake Wallis Simons (6:30PM BST 27 Apr 2013)


Researchers are working on "novel strategies" to find a cure for HIV, with the first results expected “within months”.

Danish scientists are hoping for results that will show that “finding a mass-distributable and affordable cure to HIV is possible”.

They are conducting a clinical trial to test a “novel strategy” in which the HIV virus is "reactivated" from its hiding place within human DNA and potentially destroyed permanently by the immune system.

The move would represent a step forward in the attempt to find a cure for the virus, which causes Aids.

The scientists are currently conducting human trials on their treatment, in the hope of proving that it is effective. It has already been found to work in laboratory tests.

The technique involves unmasking the “reservoirs” formed by the HIV virus inside resting immune cells, bringing it to the surface of the cells. Once it comes to the surface, the body’s natural immune system may be able to kill the virus.

In vitro studies — those that use human cells in a laboratory — of the new technique proved so successful that in January, the Danish Research Council awarded the team 12 million Danish kroner (£1.5 million) to pursue their findings in clinical trials with human subjects.

These are now under way, and according to Dr Ole Søgaard, a senior researcher at the Aarhus University Hospital in Denmark and part of the research team, the early signs are “promising”.

“I am almost certain that we will be successful in activating HIV from the reservoirs," he said.

“The challenge will be getting the patients’ immune system to recognise the virus and destroy it. This depends on the strength and sensitivity of individual immune systems, as well as how large a proportion of the hidden HIV is unmasked.”

Fifteen patients are currently taking part in the trials, and ithe first results from the trial are expected to presented in the second half of 2013.

Dr Søgaard stressed that a cure is not the same as a preventative vaccine, and that raising awareness of unsafe behaviour, including unprotected sex and sharing needles, remains of paramount importance in combating HIV.

With modern HIV treatment, a patient can live an almost normal life, even into old age, with limited side effects.

However, if medication is stopped, HIV reservoirs become active and start to produce more of the virus, meaning that symptoms can reappear within two weeks.

Finding a cure would free a patient from the need to take continuous HIV medication, and save health services billions of pounds.

The technique is being researched in Britain, but studies have not yet moved on to the clinical trial stage. Five universities — Oxford, Cambridge, Imperial College, London, University College, London and King’s College, London — have jointly formed the Collaborative HIV Eradication of Reservoirs UK Biomedical Research Centre group (CHERUB), which is dedicated to finding an HIV cure.

They have applied to the Medical Research Council for funding to conduct clinical trials, which will seek to combine techniques to release the reservoirs of HIV with "immunotherapy", which gives patients a better chance of destroying the virus.

In addition, they are focusing on patients that have only recently been infected, as they believe this will improve chances of a cure. The group hopes to receive a funding decision in May.

“When the first patient is cured in this way it will be a spectacular moment,” says Dr John Frater, a clinical research fellow at the Nuffield School of Medicine, Oxford University, and a member of the CHERUB group.

“It will prove that we are heading in the right direction and demonstrate that a cure is possible. But I think it will be five years before we see a cure that can be offered on a large scale.”

The Danish team’s research is among the most advanced and fast moving in the world, as that they have streamlined the process of putting the latest basic science discoveries into clinical testing.

This means that researchers can progress more quickly to clinical trials, accelerating the process and reaching reliable results sooner than many others.

The technique uses drugs called HDAC Inhibitors, which are more commonly used in treating cancer, to drive out the HIV from a patient’s DNA and onto the surface of infected cells. The Danish researchers are using a particularly powerful type of HDAC inhibitor.

Five years ago, the general consensus was that HIV could not be cured. But then Timothy Ray Brown, an HIV sufferer — who has become known in the field as the Berlin Patient — developed leukaemia.

He had a bone marrow transplant from a donor with a rare genetic mutation that made his cells resistant to HIV. As a result, in 2007 Mr Brown became the first man to ever be fully cured of the disease.

Replicating this procedure on a mass scale is impossible. Nevertheless, the Brown case caused a sea change in research, with scientists focusing on finding a cure as well as suppressing the symptoms.

Two principal approaches are currently being pursued. The first, gene therapy, aims to make a patient’s immune system resistant to HIV. This is complex and expensive, and not easily transferrable to diverse gene pools around the world.

The second approach is the one being pursued by Dr Søgaard and his colleagues in Denmark, the CHERUB group in Britain, and by other laboratories in the United States and Europe.


Saturday, 20 April 2013


These are just words but it means a lot for the HIV community!

Lets do away with stigma!

No discrimination!


ako si BONG


Thursday, 11 April 2013

Life Expectancy for PLHIV

Many patients taking HIV drugs can now expect to live into their 70s

Michael Carter

Published: 25 July 2008

A large international study has provided evidence that people taking HIV treatment can now expect to live into their 60s and beyond. The study is published in the July 26th edition of The Lancet, and showed that an individual starting successful HIV treatment aged 20 would be expected to live to be 63, and that a patient initiating an anti-HIV drugs regimen aged 35 could live to the age of 67. It also provided evidence of the dramatic and continued decline in the risk of death amongst people with HIV since effective HIV treatment became available.

What is more, the researchers found that starting treatment with a CD4 cell count above 200 cells/mm3 would mean that a person aged 20 could expect to live to be 70, and that a 35 year-old could survive into their 72nd year.

Nevertheless, they still found that even in their most optimistic estimates, the life-expectancy of HIV-positive individuals was approximately ten years shorter than that of an HIV-negative individual. Furthermore injecting drug users and patients who started HIV treatment with lower CD4 cell counts had lower life-expectancies.

The author of an accompanying editorial calls these findings “exciting” and believes that they underline the importance of prompt diagnosis and treatment of HIV. He also suggests that the risk of death would be diminished and overall prognosis further improved by starting anti-HIV drugs with a CD4 cell count of 500 cells/mm3.

Almost immediately after multi-drug antiretroviral therapy became available in 1996, doctors observed dramatic reductions in rates of illness and death in HIV-positive patients treated with such drugs. A number of studies have shown that antiretroviral therapy has the potential to dramatically improve the prognosis of HIV-positive patients, but they have only considered patients in single cohorts or countries.

Therefore researchers from the Antiretroviral Cohort Collaboration which involves 14 large HIV cohort studies in Canada, Europe and the USA, looked at rates of mortality and the life-expectancy of over 43,000 patients who started HIV treatment for the first time between 1996 – 99, 2000 – 02 and 2002 – 05. They also looked at whether there were any patient characteristics which affected the risk of death or prognosis.

A total of 2056 (5%) patients died. The mortality rate fell from 16 deaths per 1000 person years between 1996- 99 to 10 per 1000 person years between 2002 – 05.

They also noted significant improvements in the prognosis for HIV-positive patients in the ten years of the study. Overall, a 20 year-old starting HIV treatment between 1996 and 2005 would be expected to live another 43 years. Between 1996 and 1999, they calculated that such a patient would live to be 56 years old, but in the period 2002 to 2005 this had improved to a little under 70 years.

There were also impressive improvements in the prognosis of 35 year-olds starting treatment, with an expectation of a further 32 years in life after HIV therapy was initiated. But, once more, prognosis improved over time from an expectation of a further 25 years of life in 1996 – 99, to 32 years by 2002- 05.

Patients who started HIV treatment with a low CD4 cell count (below 100 cells/mm3) had much higher mortality rates than patients initiating antiretroviral therapy with a CD4 cell count above 200 cells/mm3 (aged 20 – 44, 20 per 1000 person years vs. five per 1000 person years).

Furthermore a 20 year-old starting treatment with a CD4 cell count below 100 cells/mm3 would have a life-expectancy of 54 years compared to a life-expectancy of 70 years for a 20 year-old starting treatment with a CD4 cell count above 200 cells/mm3. The importance of CD4 cell count at the time of therapy initiation to prognosis was also seen in 35 year-olds, with patients with a CD4 cell count below 100 cells/mm3 expected to live until they were 62 compared to a prognosis of 72 years for patients with a CD4 cell count above 200 cells/mm3.

The investigators also found that women had a better prognosis than men, but that injecting drug users had a life-expectancy that was up to 20 years shorter than non-injecting drug users.

“There has been an improvement of outcomes with combination antiretroviral therapy between 1996 and 2005, characterised by a marked decrease in mortality rates” write the investigators. They attribute such reductions in mortality and improvements in life-expectancy to “improvements in therapy during the first decade of combination therapy.”

But they note that their study suggests that the prognosis of people taking antiretroviral therapy is still not normal. Picking up on this point, the author of the accompanying editorial highlights the findings of the SMART study which showed that patients with lower CD4 cell counts had a higher risk of serious non-HIV-related illnesses. The SMART study’s conclusions were one of the factors leading to HIV treatment guidelines recommending that antiretroviral therapy should be started at a CD4 cell count of 350 cells/mm3. The author notes the “clinical mischief of untreated HIV infection” and looks forward to the results of a clinical trial which could show if there is any benefit in starting HIV treatment at a CD4 cell count of 500 cells/mm3.


The Antiretroviral Cohort Collaboration. Life expectancy of individuals on combination therapy in high-income countries: a collaborative analysis of 14 cohort studies. The Lancet 372: 293 – 299, 2008.

Cooper DA. Life and death in the cART era. The Lancet 372: 266 – 267, 2008.