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Do not fill this in! == Prognosis == [[File:HIV-AIDS world map-Deaths per million persons-WHO2012.svg|upright=1.3|thumb|Deaths due to HIV/AIDS per million people in 2012: {{Div col|small=yes|colwidth=10em}}{{legend|#ffff20|0}}{{legend|#ffe820|1β4}}{{legend|#ffd820|5β12}}{{legend|#ffc020|13β34}}{{legend|#ffa020|35β61}}{{legend|#ff9a20|62β134}}{{legend|#f08015|135β215}}{{legend|#e06815|216β458}}{{legend|#d85010|459β1,402}}{{legend|#d02010|1,403β5,828}}{{div col end}}]] HIV/AIDS has become a [[Chronic (medicine)|chronic]] rather than an acutely fatal disease in many areas of the world.<ref name=Knoll2007/> Prognosis varies between people, and both the CD4 count and viral load are useful for predicted outcomes.<ref name=M118/> Without treatment, average survival time after infection with HIV is estimated to be 9 to 11 years, depending on the HIV subtype.<ref name=UNAIDS2007/> After the diagnosis of AIDS, if treatment is not available, survival ranges between 6 and 19 months.<ref name=Morgan2>{{cite journal | vauthors = Morgan D, Mahe C, Mayanja B, Okongo JM, Lubega R, Whitworth JA | title = HIV-1 infection in rural Africa: is there a difference in median time to AIDS and survival compared with that in industrialized countries? | journal = AIDS | volume = 16 | issue = 4 | pages = 597β603 | date = March 2002 | pmid = 11873003 | doi = 10.1097/00002030-200203080-00011 | s2cid = 35450422 | doi-access = free }}</ref><ref>{{cite report|title=Progression and mortality of untreated HIV-positive individuals living in resource-limited settings: update of literature review and evidence synthesis |vauthors=Zwahlen M, Egger M |url=http://data.unaids.org/pub/Periodical/2006/zwahlen_unaids_hq_05_422204_2007_en.pdf |year=2006|access-date=March 19, 2008 |version=UNAIDS Obligation HQ/05/422204|archive-url=https://web.archive.org/web/20080409065844/http://data.unaids.org/pub/Periodical/2006/zwahlen_unaids_hq_05_422204_2007_en.pdf|archive-date=April 9, 2008|url-status=live}}</ref> [[HAART|ART]] and appropriate prevention of opportunistic infections reduces the death rate by 80%, and raises the life expectancy for a newly diagnosed young adult to 20β50 years.<ref name=Knoll2007>{{cite journal | vauthors = Knoll B, Lassmann B, Temesgen Z | title = Current status of HIV infection: a review for non-HIV-treating physicians | journal = International Journal of Dermatology | volume = 46 | issue = 12 | pages = 1219β28 | date = December 2007 | pmid = 18173512 | doi = 10.1111/j.1365-4632.2007.03520.x | s2cid = 26248996 }}</ref><ref name=LifeExpecr2008>{{cite journal |author=Antiretroviral Therapy Cohort Collaboration | title = Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies | journal = The Lancet | volume = 372 | issue = 9635 | pages = 293β99 | date = July 2008 | pmid = 18657708 | pmc = 3130543 | doi = 10.1016/S0140-6736(08)61113-7 }}</ref><ref name=Schack2006>{{cite journal | vauthors = Schackman BR, Gebo KA, Walensky RP, Losina E, Muccio T, Sax PE, Weinstein MC, Seage GR, Moore RD, Freedberg KA | title = The lifetime cost of current human immunodeficiency virus care in the United States | journal = Medical Care | volume = 44 | issue = 11 | pages = 990β97 | date = November 2006 | pmid = 17063130 | doi = 10.1097/01.mlr.0000228021.89490.2a | s2cid = 21175266 }}</ref> This is between two thirds<ref name=LifeExpecr2008/> and nearly that of the general population.<ref name=Deut2010/><ref>{{cite journal | vauthors = van Sighem AI, Gras LA, Reiss P, Brinkman K, de Wolf F | title = Life expectancy of recently diagnosed asymptomatic HIV-infected patients approaches that of uninfected individuals | journal = AIDS | volume = 24 | issue = 10 | pages = 1527β35 | date = June 2010 | pmid = 20467289 | doi = 10.1097/QAD.0b013e32833a3946 | s2cid = 205987336 | doi-access = free }}</ref> If treatment is started late in the infection, prognosis is not as good:<ref name=Deut2010/> for example, if treatment is begun following the diagnosis of AIDS, life expectancy is ~10β40 years.<ref name=Deut2010/><ref name=Knoll2007/> Half of infants born with HIV die before two years of age without treatment.<ref name=UN2011ONESIXTY/><ref>{{cite web |title=Early diagnosis and treatment save babies from AIDS-related death |url=https://www.unaids.org/en/resources/presscentre/featurestories/2009/may/20090527unicef |access-date=June 3, 2023 |website=[[UNAIDS]] |archive-date=June 3, 2023 |archive-url=https://web.archive.org/web/20230603211811/https://www.unaids.org/en/resources/presscentre/featurestories/2009/may/20090527unicef |url-status=live }}</ref> [[File:HIV-AIDS world map - DALY - WHO2004.svg|thumb|left|upright=1.3|alt=A map of the world where much of it is colored yellow or orange except for sub Saharan Africa which is colored red or dark red|[[Disability-adjusted life year]] for HIV and AIDS per 100,000 inhabitants as of 2004: {{Col-begin}} {{Col-break}} {{legend|#b3b3b3|<small>no data</small>}} {{legend|#ffff65|<small>β€ 10</small>}} {{legend|#fff200|<small>10β25</small>}} {{legend|#ffdc00|<small>25β50</small>}} {{legend|#ffc600|<small>50β100</small>}} {{Col-break}} {{legend|#ffb000|<small>100β500</small>}} {{legend|#ff9a00|<small>500β1000</small>}} {{legend|#ff8400|<small>1,000β2,500</small>}} {{legend|#ff6e00|<small>2,500β5,000</small>}} {{legend|#ff5800|<small>5,000β7500</small>}} {{Col-break}} {{legend|#ff4200|<small>7,500β10,000</small>}} {{legend|#ff2c00|<small>10,000β50,000</small>}} {{legend|#cb0000|<small>β₯ 50,000</small>}} {{col-end}}]] The primary causes of death from HIV/AIDS are [[opportunistic infections]] and [[cancer]], both of which are frequently the result of the progressive failure of the immune system.<ref name=InfectionBook2008>{{cite book|editor-last=Smith|editor-first=Blaine T.|title=Concepts in immunology and immunotherapeutics|year=2008|publisher=American Society of Health-System Pharmacists|location=Bethesda, MD|isbn=978-1-58528-127-5|page=143|url=https://books.google.com/books?id=G46DrdlxNJAC&pg=PA143|edition=4th|access-date=June 27, 2015|archive-url=https://web.archive.org/web/20151128082820/https://books.google.com/books?id=G46DrdlxNJAC&pg=PA143|archive-date=November 28, 2015|url-status=live}}</ref><ref name=Cancer2005>{{cite journal | vauthors = Cheung MC, Pantanowitz L, Dezube BJ | title = AIDS-related malignancies: emerging challenges in the era of highly active antiretroviral therapy | journal = The Oncologist | volume = 10 | issue = 6 | pages = 412β26 | date = JunβJul 2005 | pmid = 15967835 | doi = 10.1634/theoncologist.10-6-412 | citeseerx = 10.1.1.561.4760 | s2cid = 24329763 }}</ref> Risk of cancer appears to increase once the CD4 count is below 500/ΞΌL.<ref name=Deut2010/> The rate of clinical disease progression varies widely between individuals and has been shown to be affected by a number of factors such as a person's susceptibility and immune function;<ref name=Tang>{{cite journal | vauthors = Tang J, Kaslow RA | title = The impact of host genetics on HIV infection and disease progression in the era of highly active antiretroviral therapy | journal = AIDS | volume = 17 | issue = Suppl 4 | pages = S51β60 | year = 2003 | pmid = 15080180 | doi = 10.1097/00002030-200317004-00006 | doi-access = free }}</ref> their access to health care, the presence of co-infections;<ref name=Morgan2/><ref name=Lawn>{{cite journal | vauthors = Lawn SD | title = AIDS in Africa: the impact of coinfections on the pathogenesis of HIV-1 infection | journal = The Journal of Infection | volume = 48 | issue = 1 | pages = 1β12 | date = January 2004 | pmid = 14667787 | doi = 10.1016/j.jinf.2003.09.001 }}</ref> and the particular strain (or strains) of the virus involved.<ref name=Campbell>{{cite journal | vauthors = Campbell GR, Pasquier E, Watkins J, Bourgarel-Rey V, Peyrot V, Esquieu D, Barbier P, de Mareuil J, Braguer D, Kaleebu P, Yirrell DL, Loret EP | title = The glutamine-rich region of the HIV-1 Tat protein is involved in T-cell apoptosis | journal = The Journal of Biological Chemistry | volume = 279 | issue = 46 | pages = 48197β204 | date = November 2004 | pmid = 15331610 | doi = 10.1074/jbc.M406195200 | doi-access = free }}</ref><ref name=Campbell2>{{cite journal | vauthors = Campbell GR, Watkins JD, Esquieu D, Pasquier E, Loret EP, Spector SA | title = The C terminus of HIV-1 Tat modulates the extent of CD178-mediated apoptosis of T cells | journal = The Journal of Biological Chemistry | volume = 280 | issue = 46 | pages = 38376β82 | date = November 2005 | pmid = 16155003 | doi = 10.1074/jbc.M506630200 | doi-access = free }}</ref> [[Tuberculosis]] co-infection is one of the leading causes of sickness and death in those with HIV/AIDS being present in a third of all HIV-infected people and causing 25% of HIV-related deaths.<ref>{{cite web |title=Tuberculosis |url=https://www.who.int/mediacentre/factsheets/fs104/en/ |publisher=World Health Organization |date=March 2012 |access-date=August 29, 2012 |url-status=live |archive-url=https://web.archive.org/web/20120823143802/http://www.who.int/mediacentre/factsheets/fs104/en/ |archive-date=August 23, 2012 }}</ref> HIV is also one of the most important risk factors for tuberculosis.<ref name=WHO2011>{{cite book |title=Global tuberculosis control 2011 |author=World Health Organization |url=https://www.who.int/tb/publications/global_report/2011/gtbr11_executive_summary.pdf |year=2011 |publisher=World Health Organization |isbn=978-92-4-156438-0 |access-date=August 29, 2012 |url-status=dead |archive-url=https://web.archive.org/web/20120906223650/http://www.who.int/tb/publications/global_report/2011/gtbr11_executive_summary.pdf |archive-date=September 6, 2012 }}</ref> [[Hepatitis C]] is another very common co-infection where each disease increases the progression of the other.<ref>{{cite book |veditors=Rubin R, Strayer DS, Rubin E |title=Rubin's pathology: clinicopathologic foundations of medicine |publisher=Wolters Kluwer Health/Lippincott Williams & Wilkins |location=Philadelphia |isbn=978-1-60547-968-2 |page=154 |url=https://books.google.com/books?id=wb2TzY9AgJ0C&pg=PA154 |edition=Sixth |year=2011 |access-date=June 27, 2015 |archive-url=https://web.archive.org/web/20150924074740/https://books.google.com/books?id=wb2TzY9AgJ0C&pg=PA154 |archive-date=September 24, 2015 |url-status=live }}</ref> The two most common cancers associated with HIV/AIDS are [[Kaposi's sarcoma]] and AIDS-related [[non-Hodgkin's lymphoma]].<ref name=Cancer2005/> Other cancers that are more frequent include [[anal cancer]], [[Burkitt's lymphoma]], [[primary central nervous system lymphoma]], and [[cervical cancer]].<ref name=Deut2010/><ref>{{cite journal |vauthors=Nelson VM, Benson AB |title=Epidemiology of Anal Canal Cancer |journal=Surgical Oncology Clinics of North America |volume=26 |issue=1 |pages=9β15 |date=January 2017 |pmid=27889039 |doi=10.1016/j.soc.2016.07.001}}</ref> Even with anti-retroviral treatment, over the long term HIV-infected people may experience [[AIDS dementia complex|neurocognitive disorders]],<ref name="Woods2009">{{cite journal |vauthors=Woods SP, Moore DJ, Weber E, Grant I |title=Cognitive neuropsychology of HIV-associated neurocognitive disorders |journal=[[Neuropsychology Review]] |volume=19 |issue=2 |pages=152β68 |date=June 2009 |pmid=19462243 |pmc=2690857 |doi= 10.1007/s11065-009-9102-5}}</ref><!-- Woods2009 covers neurocognitive --> [[osteoporosis]],<ref name="Brown2006">{{cite journal |vauthors=Brown TT, Qaqish RB |title=Antiretroviral therapy and the prevalence of osteopenia and osteoporosis: a meta-analytic review |journal=AIDS |volume=20 |issue=17 |pages=2165β74 |date=November 2006 |pmid=17086056 |doi=10.1097/QAD.0b013e32801022eb|s2cid=19217950 |doi-access=free }}</ref><!-- Brown2006 covers osteoarthritis --> [[peripheral neuropathy|neuropathy]],<ref name="Nicholas2007">{{cite journal |vauthors=Nicholas PK, Kemppainen JK, Canaval GE, Corless IB, Sefcik EF, Nokes KM, Bain CA, Kirksey KM, Eller LS, Dole PJ, Hamilton MJ, Coleman CL, Holzemer WL, Reynolds NR, Portillo CJ, Bunch EH, Wantland DJ, Voss J, Phillips R, Tsai YF, Mendez MR, Lindgren TG, Davis SM, Gallagher DM |title=Symptom management and self-care for peripheral neuropathy in HIV/AIDS |journal=AIDS Care |volume=19 |issue=2 |pages=179β89 |date=February 2007 |pmid=17364396 |doi=10.1080/09540120600971083|s2cid=30220269 }}</ref><!-- Nicholas2007 covers neuropathy --> cancers,<ref name="Boshoff2002">{{cite journal |vauthors=Boshoff C, Weiss R |title=AIDS-related malignancies |journal=Nature Reviews. Cancer |volume=2 |issue=5 |pages=373β82 |date=May 2002 |pmid=12044013 |doi=10.1038/nrc797|s2cid=13513517 }}</ref><ref name="Yarchoan2005">{{cite journal |vauthors=Yarchoan R, Tosato G, Little RF |title=Therapy insight: AIDS-related malignancies β the influence of antiviral therapy on pathogenesis and management |journal=Nature Clinical Practice Oncology |volume=2 |issue=8 |pages=406β15; quiz 423 |date=August 2005 |pmid=16130937 |doi=10.1038/ncponc0253 |s2cid=23476060 |url=https://zenodo.org/record/1233371 |access-date=December 7, 2019 |archive-date=October 31, 2021 |archive-url=https://web.archive.org/web/20211031110334/https://zenodo.org/record/1233371 |url-status=live }}</ref><!-- Boshoff2002 and Yarchoan2005 cover cancer --> [[nephropathy]],<ref name="Post2009">{{cite journal |vauthors=Post FA, Holt SG |title=Recent developments in HIV and the kidney |journal =Current Opinion in Infectious Diseases |volume=22 |issue=1 |pages=43β48 |date=February 2009 |pmid=19106702 |doi=10.1097/QCO.0b013e328320ffec|s2cid=23085633 }}</ref><!-- Post2009 covers HIV/kidney --> and [[cardiovascular disease]].<ref name="Burgoyne2008"/><!-- Burgoyne2008 covers cardiovascular --> Some conditions, such as [[lipodystrophy]], may be caused both by HIV and its treatment.<ref name="Burgoyne2008"/> Summary: Please note that all contributions to Christianpedia may be edited, altered, or removed by other contributors. 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