Mar. 4 - "We who have lived through the AIDS epidemic of the 80s and 90s are not too keen on claiming that HIV positive patients don’t feel the repercussions of the disease on their life expectancy. Precisely, we always stress that these results can be achieved only in patients starting antiretroviral therapy at an early stage, which allows them to benefit from a full immune recovery." Dr. Giovanni Guaraldi, a researcher at the University of Modena and Reggio Emilia, refers to an all-Italian research that examined the long-term effectiveness of highly active antiretroviral therapies (HAART) on the life expectancy of HIV positive patients. The results were published in the February issue of the International Journal of Acquired Immune Deficiency Syndrome (JAIDS). The authors documented that an HIV-positive patient of 40, if subjected to adequate therapy, can expect to live for 38 more years, a figure not too distant from the 41 years indicated by ISTAT for Italian citizens of the same age. The figures for an HIV positive patient of the same age who did not achieve the same immunological target, life expectancy stops at 23 further years. The study, retrospective and observational, is the work of the Italian Collaborative HIV Aging Cohort - ICHAC, a network of four reference centers for the treatment of HIV: the Infectious Diseases Structure of the University of Modena Hospital, directed by Professor Cristina Mussini; the San Paolo Hospital of Milan; the San Raffaele Hospital in Milan; and the Cancer Center of Aviano (Pordenone). Given the geographical location of the four hospitals, the authors compared the life expectancy of a group of HIV-positive patients treated in their respective centers and subjected to HAART to that of the general population of the same age living in Northern Italy (obtained from ISTAT). The Ethics Committee of the Province approved the study, which is the first in Italy to provide accurate numerical life expectancy estimates for HIV positive patients. The study led by Guaraldi opens the door to a new interpretation of the epidemic disease. It shows that HAART is essential but not sufficient to achieve a significant increase in life expectancy equal to or close to the expectations of the healthy population. Only patients who achieve an adequate immune recovery after the initiation of the therapy will reach a life expectancy comparable to that of the general population.

MODENA AT THE CENTER        

The epidemiological analysis, performed on nearly 10,000 patients, showed that immune recovery, estimated by the attainment of a certain number of lymphocytes, has become prevalent among the HIV positive population since 2005, thus explaining their increase in life expectancy. The study is part of a research area established at the Structure for Infectious Diseases of the University Hospital of Modena, which - for some years - has held a leadership role in carrying out research with HIV positive patients. The Emilia Romagna Region has recently funded the research on "COPD and emphysema in HIV / AIDS: an example of chronic inflammation, with major gene, environment , public health implications leading to premature aging," which will once again see the Modena University Hospital take the lead.