HIV has changed significantly over the past 30 years from an acute, life-limiting illness to a chronic condition that, if diagnosed and treated effectively, can be controlled and managed into old age with the use of effective antiretroviral therapy (ART).
From the mid-1980s to the late 1990s, the average life expectancy for someone diagnosed with HIV was less than five years. Today, people diagnosed early with HIV and treated will have a normal life expectancy and some, especially men, may outlive their non-HIV peers as they enter lifelong care where they are regularly checked and monitored for the rest of their lives.1,2 However, late diagnosis (when the CD4 count is less than 350 on diagnosis) can mean a tenfold increase in the risk of dying within one year of diagnosis. Most of the 613 people with HIV who died in 2014 were diagnosed late.3
The aim of ART is to suppress HIV as soon as possible after diagnosis. In the UK, there are an estimated 103,700 people living with HIV, most of whom are in care and on ART, and there are now over 24,000 people aged over 50 living with HIV in the UK.3 An ageing HIV positive population requires support, and changes to health and social care and HIV specialist services mean that general practice and other primary care services will be the first port of call for illnesses that specialist HIV services would have monitored and treated in the past.