{"id":5741,"date":"2008-03-19T12:12:37","date_gmt":"2008-03-19T17:12:37","guid":{"rendered":"http:\/\/blogs.nejm.org\/PaulSax\/index.php\/2008\/03\/19\/how-long-have-i-got-doc\/"},"modified":"2008-03-19T12:12:37","modified_gmt":"2008-03-19T17:12:37","slug":"how-long-have-i-got-doc","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/how-long-have-i-got-doc\/2008\/03\/19\/","title":{"rendered":"How long have I got, Doc?"},"content":{"rendered":"

Some aspects of seeing a patient newly-diagnosed with HIV haven’t changed much over the years — for example, the emotions in the room remain a mix of fear, shame (note to world: this is still<\/em> a highly stigmatized disease), incredulity, and ultimately relief in finding a clinician who is comfortable with the condition.<\/p>\n

But a lot has<\/em> changed, of course, due to the availability of effective antiretroviral therapy. To illustrate, here’s a commonly-asked question, especially from newly-diagnosed patients and their loved ones — in fact, I heard it just last week:<\/p>\n

How long can a person live with HIV these days?<\/p>\n

It’s also a popular question I get from my friends, family, non-HIV\/ID colleagues, medical students, cab drivers, and anyone else who happens to find out what I do for a living. You’d think with so many people asking, I might have a better idea of the answer, but for now all I can manage is an estimate.<\/p>\n

I work with a group that does computer simulations of HIV disease; a paper published a couple of years ago conservatively estimated the survival time after a patient enters care to be 24.2 years. <\/a>For the super patients — never miss a pill, quit smoking, wear seat belts, and remind us<\/em> about scheduled health maintenance tasks — this is no doubt an underestimate. But it might be an overestimate for their Goofus<\/a> counterparts, especially if they are coinfected with hepatitis C, engage in various insalubrious addictions, and have that selective inability to understand the words on the pill bottles dispensed by the pharmacy.<\/p>\n

So what do I say when asked this question? One thing I emphatically do not<\/span> say is “24.2 years — that’s 8,833 days, in case you’re wondering, so plan your magazine subscriptions accordingly.” First, this estimate was derived from averaging a million “patients” going through a computer model, and do not apply to an individual; second, who knows what’s going to happen 5, 10, 20+ years from now? Instead, I provide some reassuring generalization, such as, “No one should die of AIDS anymore — treatment today is that<\/span> good.”<\/p>\n

This usually does the trick. But any other advice for managing this tough question would be most welcome.<\/p>\n","protected":false},"excerpt":{"rendered":"

Some aspects of seeing a patient newly-diagnosed with HIV haven’t changed much over the years — for example, the emotions in the room remain a mix of fear, shame (note to world: this is still a highly stigmatized disease), incredulity, and ultimately relief in finding a clinician who is comfortable with the condition. But a […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,5,8],"tags":[423,563,756],"class_list":["post-5741","post","type-post","status-publish","format-standard","hentry","category-hiv","category-infectious-diseases","category-patient-care","tag-hiv","tag-life-expactancy","tag-prognosis"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/5741","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=5741"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/5741\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=5741"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=5741"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=5741"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}