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WHEN FIRST DIAGNOSED: UNDERSTANDING AND COMMUNICATING ABOUT
HIV-WHAT YOU NEED TO KNOW: THE PROGNOSIS
A blood test that shows the presence of antibodies to HIV means that HIV itself is also in the blood. Unlike antibodies for other infections, the antibodies for HIV cannot kill the virus. This means that once HIV is in the blood, it will always be in the blood.
There have been occasional reports of individuals with positive tests that subsequently became negative?in other words, reports indicate that the virus was once present and then was somehow eliminated. So far, these reports have nearly always turned out to be the result of errors in the test. We are aware of possibly three cases of a person who was once infected becoming uninfected. This is disappointing, but it should be faced. People with positive tests should consider themselves infectious to others for the indefinite future.
HIV infection causes the gradual weakening of the body’s immune system. This process takes years or even decades. The person with HIV infection usually feels entirely well and has no symptoms of infection for years. When symptoms of a weakened immune system begin to occur, the person is sometimes said to have AIDS-related complex, or ARC. When the immune system becomes even weaker, certain opportunistic infections?common infections usually fought off by the immune system?appear, and the person is said to have AIDS. HIV infection, ARC, and AIDS.
Current studies indicate that about half the people with positive blood tests for HIV will develop AIDS within eight to ten years after infection takes place, and that people diagnosed with AIDS live a year or longer. This is an estimate based on studies of people who became
infected with HIV in San Francisco as early as 1978. Some of these people who were studied have weakened immune systems but remain well ten or twelve years later. So no one knows how long any individual person with HIV will take to develop AIDS; the upper limit is clearly well over ten years.
The most important thing to understand is this: what we know about the progression of the whole course of HIV infection comes from those studies, and those studies were done when no one knew much about the benefits of therapy.
We do not understand all the factors that govern how fast HIV infection progresses or how fast the immune system weakens or how fast AIDS itself progresses. But paying attention to wellness?good nutrition, exercise, regular medical check-ups?apparently helps to slow down the progression of the course of HIV infection through the body.
We do know that people with AIDS live substantially longer than they once did, and that current treatments delay the average time between initial infection with HIV and the development of AIDS. We think medical treatment will eventually prevent HIV infection from leading almost inevitably to AIDS. We think HIV infection will become a chronic and manageable disease. Like diabetes, HIV infection will be a persistent medical problem that will always need attention, but it will not drastically interfere with quality or length of life. With early detection and new treatments, we believe, many people will be able to count on an indefinite period of good health.
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