Q and A

Question

How long can I live without HIV drugs?

Can you please tell me how long can someone live without taking HIV medication?

Answer

The best way to answer this is to say that modern HIV treatment (ART) means that life expectancy is not affected by being HIV positive. HIV positive people with access to treatment can be expected to live as long as before they became positive.

Without using HIV treatment, life expectancy is related to how quickly your CD4 count drops and how low it gets.

Without treatment, some people see their CD4 count drop to under 200 within a few years of infection, while others people can go for  5-10 years or longer before they need treatment.

See also: Your CD4 count and the risk of becoming ill.

This is different to saying how long you could live. However, without treatment, once your CD4 count falls below 200 life expectancy drops very dramatically.

Note: This answer was updated in January 2017 from a question first posted in November 2011.

175 comments

  1. Simon Collins

    Hi Kim, thanks for your comment, although I am sorry that you are upset by good news.

    In general, if you have access to modern ART and you do sensible things to look after your health, then you are likely to have normal or near-normal life expectancy. These things include stopping smoking, eating a balanced diet, keeping mentally and physically active, reducing stress, sleeping well and having a good network of friends etc.

    The time you take to start treatment is a factor, but ART generally lets your immune system become strong enough to overcome most damage from previously untreated infection. This can be true even if you started treatment with a very low CD4 count. Other aspects of your medical history, including co-oinfections are also important in normalising life expectancy, but this doesn’t take away from the broadly positive news.

    Also, even when we are at slightly higher risk of some complications, this is balanced in a positive way by us being engaged in closer medical care much earlier in life than the general population.

    Untreated, HIV is still very serious. ART does reverse this, especially if started early, but also when started later. Taking the virus to undetectable levels might not quite normalise your health, but it gets close enough for some studies to predict that life expectancy might even be slightly longer than the general population.

    Balancing benefits and risks is sometimes difficult, but the information on the i-Base website is based on evidence from many studies.

  2. Kim

    I think to say that “HIV positive people with access to treatment can be expected to live as long as before they became positive” is pure folly!
    To begin with it depends on so many different factors:
    How long was the person HIV positive before they started taking treatment?
    In some cases in the not too distant past people didn’t start treatment until their CD4 count dropped to below 300-400, during which time HIV can have wreaked havoc with their general health and could have damaged organs.
    ART is amazing, but it is not “a cure all”
    We still don’t know some of the longer 20 years + term affects of some of these drugs:Advanced Osteoporosis just being one.
    I would therefore respectfully request that you do a little bit more research before writing and publishing answers as flippant as the one above.

  3. Lisa Thorley

    Hi Kalpesh,

    Yes its very possible for someone to have HIV for this length of time and not be on medication. Its not however very common, nor is it advised.

  4. Kalpesh

    Hi this is kalpesh can any hiv patient live 23 yrs without medicine

  5. Roy Trevelion

    Hi Janice,

    Have you recently been diagnosed with HIV? Please can you send us more information about your question.

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