infections
Human Immunodeficiency Virus (HIV) Infection
Prognosis for HIV Infection
Exposure to HIV does not always lead to infection, and some people who have had repeated exposures over many years remain uninfected. Moreover, many people who are treated with antiretroviral medications can manage HIV infection as a chronic illness, without developing AIDS. With effective treatment, the HIV RNA level decreases to undetectable levels, CD4 counts increase significantly, and people can continue to lead productive, active lives. The risk of illness and death decreases but remains higher than that of people who are of similar age and who are not infected with HIV. However, if people cannot tolerate or take medications consistently, HIV infection and immune deficiency progresses, causing serious symptoms and complications. Many untreated people with HIV infection remain well for more than a decade. A very few untreated people have remained well for over 20 years. Why some people become ill so much sooner than others is not fully understood, but a number of genetic factors appear to influence both susceptibility to infection and progression to AIDS after infection. If infected people are not treated, AIDS develops in most of them. How quickly the number of CD4 cells decreases and HIV infection progresses toward AIDS varies greatly from person to person. Generally, experts estimate that if untreated, people develop AIDS at the following rates: For the first several years after infection: 1 to 2% each year Each year thereafter: 5 to 6% Within 10 to 11 years: 50% Eventually: More than 95%, possibly all if they live long enough Usually, HIV infection does not directly cause death. Instead, HIV infection leads to a substantial loss of weight (wasting), opportunistic infections, cancers, and other disorders, which then lead to death. Cure has been thought to be impossible, although intensive research on how to eliminate all of the latent HIV from infected people continues. 