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HIV ‘chronic’ but ‘manageable’: expert

By Stefania Seccia

Dr. Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS.
File photo

Dr. Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS. File photo

HIV is no longer a death sentence in B.C.

While experts view it as a “chronic manageable condition,” stigma and an increase in non-AIDS-related illness and mortality remain a concern.

That’s why on Dec. 1 — to coincide with World AIDS Day — Dr. Julio Montaner, director of the BC Centre for Excellence in HIV/AIDS, will unveil his group’s “Healthy Aging with HIV” initiative to boost the longevity of people living with HIV.

“This is an evolving science,” he said. “I can tell you with a great deal of confidence that we are still improving on treatments of today; newer and better treatments about to be licensed that one at a time are getting rid of known challenges associated with earlier treatment.”

In 1996, if you were diagnosed at age 20 you had at least one decade to live, by the early 2000s life expectancy was two to three decades — to today’s additional 55 years, said Montaner. Back in 1995 they were diagnosing two cases per day, but new cases in B.C. have reduced by two-thirds.

“A 20-year-old diagnosed today with recently acquired HIV infection, who immediately starts antiretroviral therapy, will see a life expectancy of another 50 years of near-normal quality,” he said. “It used to be that our patients were young, because the epidemic suddenly affected a number of people in the prime of their sexual life. Now that group is aging.

“As of this year, it’s estimated that 50% of people with HIV in Canada are over the age of 50.”

But that aging population is facing a different challenge. While there’s been a decrease in people progressing to AIDS and dying from related conditions, there’s been an uptick in non-AIDS-related illness and mortality: liver disease, due to hepatitis C infection, cardiac disease, renal disease, chronic obstructive pulmonary disease and arthrosclerosis.

“Guess what, you have problems when you get old and therefore you have to hit the gym, watch your diet — just like anybody else has to do it if they want to have healthy aging,” he said.

Montaner said lifestyle modification plays an important role to managing HIV infection today.

Although there have been strides made to improve longevity, carrying the virus still comes with stigma.

“I think I need to be clear that the stigma, discrimination and the issues associated with an HIV diagnosis have improved over the last three decades, but they are still present,” he said. “Think about a loved one with HIV going into a seniors’ home.”