Image copyright jimmy isaacs Image caption Jimmy Isaacs, 28, can look forward to a long and healthy life on HIV drug treatment 
 
 Young people on the latest HIV drugs now have near-normal life expectancy because of improvements in treatments, a study in The Lancet suggests. 
 
 Twenty-year-olds who started antiretroviral therapy in 2010 are projected to live 10 years longer than those first using it in 1996, it found. 
 
 Doctors say that starting treatment early is crucial to achieve a long and healthy life. 
 
 Charities say there are still too many people unaware they have the virus. 
 
 This is particularly true in the developing world, where the majority of HIV deaths occur because access to drugs is limited. 
 
 More effective prevention 
 
 The study authors, from the University of Bristol, said the extraordinary success of HIV treatments was a result of newer drugs having fewer side effects and being better at preventing the virus from replicating in the body. 
 
 It is also more difficult for the virus to build up a resistance to the most recent drugs. 
 
 Improved screening and prevention programmes and better treatment of health problems caused by HIV are thought to have helped, too. 
 
 But many people with HIV still do not live as long as expected, especially those infected through injecting drugs. 
 
 Antiretroviral therapy involves a combination of three or more drugs which block the normal progress of HIV (human immunodeficiency virus). 
 
 They have been called "one of the greatest public health success stories of the past 40 years". 
 
 Drugs 'do work' 
 
 Jimmy Isaacs, 28, discovered he had been infected with HIV by a former partner nearly three years ago. 
 
 He takes three drugs once a day at 18:00 and will continue to do so for the rest of his life. 
 
 "My health is absolutely fine. I'm eating healthily and drinking healthily," he said. 
 
 "It doesn't impact on my job and hasn't impacted on my social life either." 
 
 Although it took two changes of medication to find the right combination for him, he says he now has no side effects at all. 
 
 "I had heard a lot of bad stories about the drugs back in the '90s - but when I did some research, I realised the drugs had completely changed." 
 
 Not all his employers have been supportive since his diagnosis and he says that is down to ignorance. 
 
 His current employer has given him time off to tour the country and speak to students and school pupils about HIV prevention and treatment. 
 
 The researchers looked at 88,500 people with HIV from Europe and North America who had been involved in 18 studies. 
 
 They based their life-expectancy predictions on death rates during the first three years of follow-up after drug treatment was started. 
 
 They found that fewer people who started treatment between 2008 and 2010 died during this period compared with those who began treatment between 1996 and 2007. 
 
 The expected age at death of a 20-year-old patient starting antiretroviral therapy (ART) after 2008, with a low viral load and after the first year of treatment, was 78 years - similar to the general population. 
 
 What is antiretroviral therapy? 
 
 Image copyright Science Photo Library Image caption Antiretroviral therapy combines three or more drugs which stop the HIV virus from progressing 
 
 First used in 1996, it involves a combination of three or more drugs that stop the HIV virus from replicating 
 
 This means damage to the immune system caused by HIV can be prevented and it stops the disease spreading to others 
 
 More recent drugs are even more efficient and have fewer side effects 
 
 The World Health Organization recommends that antiretroviral therapy is started as soon as possible after diagnosis 
 
 Dr Michael Brady, medical director at the Terrence Higgins Trust, said the study showed how much things had changed since the start of the HIV epidemic in the 1980s. 
 
 But he said it also meant people aged over 50 now represented one in three of all those living with HIV. 
 
 "As it stands, the healthcare, social care and welfare systems simply aren't ready to support the increasing numbers of people growing older with HIV. 
 
 "We need a new model of care to better integrate primary care with HIV specialist services, and we need a major shift in awareness and training around HIV and ageing, so that we're ready to help older people live well in later life," he said. 
 
 'Medical achievement' 
 
 Prof Helen Stokes-Lampard, who chairs the Royal College of GPs, said: "It's a tremendous medical achievement that an infection that once had such a terrible prognosis is now so manageable, and that patients with HIV are living significantly longer. 
 
 "We hope the results of this study go a long way to finally removing any remaining stigma associated with HIV, and ensuring that patients with HIV can live long and healthy lives without experiencing difficulties in gaining employment and - in countries where it is necessary - obtaining medical insurance." 
 
 She said steps were being taken to increase appropriate HIV testing by GPs. 
 
 The proportion of people with undiagnosed HIV has fallen steadily over the past 20 years. 
 
 But one in eight people with HIV is still thought to remain undiagnosed. 
 
 Get news from the BBC in your inbox, each weekday morning ||||| Life expectancy for young HIV-positive adults has risen by 10 years in the United States and Europe thanks to improvements in AIDS drugs known as antiretroviral therapy, researchers said on Thursday. 
 
 This meant many patients can expect to live as long as those without HIV, according to their study published in The Lancet medical journal. 
 
 The scientists said the improvements were likely to be largely due to the transition to less toxic medicine combinations, with more drug options for people infected with drug-resistant HIV strains, and better adherence to treatment. 
 
 "Our research illustrates a success story of how improved HIV treatments coupled with screening, prevention and treatment of health problems associated with HIV infection can extend the lifespan," said Adam Trickey, who led the research at Britain's University of Bristol. 
 
 Antiretroviral therapy, or ART, first became widely used in the mid 1990s. It involves a combination of three or more drugs that block the HIV virus' replication. This helps prevent and repair damage to the immune system caused by the HIV, and also prevents onward spread of the disease. 
 
 The World Health Organisation (WHO) now recommends ART should be given as soon as possible after diagnosis to everyone with HIV. ||||| Life expectancy of 20-year-olds starting treatment for HIV has increased by around a decade in the EU and North America since the introduction of antiretroviral therapy in the mid-1990s, according to a study published in The Lancet HIV. These increases are among treated individuals, and are in addition to dramatic life expectancy improvements that occurred after the introduction of antiretroviral therapy compared with untreated individuals. 
 
 The authors of the study propose that their findings could help to reduce stigmatisation and help people with HIV gain employment and obtain medical insurance, as well as encouraging those diagnosed to start treatment as soon as possible and continue it fully. 
 
 Their projections suggest that life expectancy of a 20-year-old who began treatment from 2008 onwards and had a low viral load after a year of treatment may approach that of the general population (around 78 years old). 
 
 However, life expectancy for people with HIV mostly remains lower than that of the general population. 
 
 "Our research illustrates a success story of how improved HIV treatments coupled with screening, prevention and treatment of health problems associated with HIV infection can extend the lifespan of people diagnosed with HIV. However, further efforts are needed if life expectancy is to match that of the general population," said lead author Adam Trickey, from the School of Social and Community Medicine at the University of Bristol. "Combination antiretroviral therapy has been used to treat HIV for 20 years, but newer drugs have fewer side effects, involve taking fewer pills, better prevent replication of the virus and are more difficult for the virus to become resistant to." [1] 
 
 The improvements are likely to be a result of the transition to less toxic antiretroviral therapy with more drug options for people infected with a drug-resistant HIV strain, better adherence to treatment, improved treatment of co-occurring conditions and opportunistic infections, and increased use of screening and prevention programmes for conditions such as cardiovascular disease and cancer. 
 
 Antiretroviral therapy first became widely used in 1996. It involves a combination of three or more drugs that block the HIV virus from replicating, in order to prevent and repair damage to the immune system caused by HIV infection. It also prevents onward spread of the disease. The WHO now recommends antiretroviral therapy to be given as soon as possible after diagnosis to all people with HIV. 
 
 The study used data for 88,504 people with HIV who started antiretroviral treatment between 1996 and 2010 from 18 European and North American studies. In order to estimate life expectancy, it tracked how many people died during the first three years of their treatment, their cause of death, HIV viral load, immune cell (CD4 cell) count and whether they were infected through injecting drugs. 
 
 Fewer people who started treatment between 2008-2010 died during their first three years of treatment than those who started treatment between 1996-2007. When looking specifically at deaths due to AIDS, the number of deaths during treatment declined over time between 1996 and 2010, likely as a result of newer drugs being more effective in restoring the immune system. 
 
 During this time, measures of HIV improved – with the average immune cell count (of CD4 cells in the blood) after a year of treatment increasing from 370 cells per microlitre of blood in 1996-1999, to 430 cells per microlitre in 2008-2010, while the proportion of people with a low HIV viral load increased from 71 per cent to 93 per cent. 
 
 As a result of these improvements, between 1996 and 2013, the life expectancy of 20-year-olds treated for HIV increased by nine years for women and 10 years for men in the EU and North America. 
 
 Projections based on death rates in the second and third year of treatment for Europeans and North Americans, estimated that 20-year-olds starting therapy between 2008-2010 who survived the first year of treatment would live to 73 for men and 76 for women. 
 
 However, the improvements were not seen in all people with HIV, with life expectancy of people who were infected through injecting drugs not increasing as much as in other groups. 
 
 "Since modern treatment is highly effective with low toxicity, deaths in people living with HIV are unlikely to be reduced by further development of drugs. Now we need to focus on the issues surrounding drug adherence, late diagnosis of HIV, and diagnosis and treatment of co-occurring conditions. In drug users we must promote therapy and improve access to therapy to treat addictions as well as increasing access to hepatitis C treatment for people with both infections," said Trickey. "Although most people are likely to start treatment soon after diagnosis of HIV, this will only result in improved survival overall if the problems of late diagnosis and treatment access are addressed." [1] 
 
 Limitations of the study include that the results could also be affected by changing behaviour over time too – for example, fewer people starting treatment in recent years were infected through injection drug use. The study's results apply only to people who take antiretroviral therapy, while the majority of HIV deaths occur in people who are not treated. The life expectancy estimates are based on death rates, and there were few data for those in the oldest age group, meaning that death rates in these individuals could not be precisely estimated. 
 
 Writing in a linked Comment, Ingrid T Katz, Brigham and Women's Hospital, USA, said: "The introduction of combination antiretroviral therapy (ART) has been one of the great public health success stories of the past 40 years. ART has led to increased survival in people living with HIV, and subsequently to individual and societal gains worldwide, because of the marked improvements in its potency, side-effect profile, and simplicity of use… Despite these improvements, cohort studies show a small but persistent gap in the lifespan between HIV-positive and HIV-negative individuals, particularly within key affected populations… The concern is greatest in the world's most vulnerable populations, which include people who inject drugs in Europe and North America, and individuals living in resource-constrained settings globally, where access to early ART initiation has been limited." 
 
 Paper: 
 
 
 
 'Survival of HIV-positive patients starting antiretroviral therapy between 1996 and 2013: a collaborative analysis of cohort studies' by Adam Tricket et al in The Lancet HIV
– The average American born in 2015 is expected to live to 78.8 years of age. HIV patients aren't far behind. A Lancet study finds a 20-year-old who begins treatment for HIV today can live to an estimated 78 years due in part to advances in antiretroviral therapy, reports the BBC. The latest drugs are better at keeping the virus from replicating and prevent resistance, are less toxic, have fewer side effects, and are more likely to be taken effectively as they often involve only one daily pill, the study notes. Young HIV patients are also starting treatment sooner and benefit from improved screening and prevention programs, say University of Bristol researchers, who reviewed 18 studies involving 88,500 patients in Europe and North America. They found patients who began treatment between 2008 and 2010 were less likely to die over the next three years than those who began treatment between 1996 and 2007, per a release. Twenty-year-olds who started treatment between 2008 and 2010 and survived their first year were also expected to live to 73 for men and 76 for women, compared to 63 for men and 67 for women who started treatment years earlier. If those same 20-year-olds had a higher than average immune cell count, they were predicted to live to 78, though those who acquired HIV from injecting drugs had a lower life expectancy, per the Telegraph. One doctor calls it "a tremendous medical achievement." Another warns new challenges await as one in three HIV patients is over age 50. (An antibody could stop up to 90% of HIV strains.)