HIV: is it now a thing of the past?

Abstract

Effective antiviral therapy for human immunodeficiency virus (HIV) has substantially reduced HIV-associated morbidity and mortality for people living with HIV (PLWH). The use of antiviral therapies as prevention, most notably pre-exposure prophylaxis (PrEP) as well as treatment as prevention (TasP), has significantly reduced the number of new infections in those using these biomedical prevention approaches (PrEP) and their sexual partners (TasP). However, nearly one-quarter of new HIV infections globally occur in the Asia-Pacific region (approximately 300 000 per annum) with a substantial number of deaths annually. Despite therapeutic advances, the total number of PLWH has increased worldwide. Although antiviral therapy has substantially reduced HIV-specific morbidity and mortality and is associated with significantly increased longevity, PLWH experience higher rates of chronic comorbidities than the general population. It is important that preventative approaches such as immunisation against specific conditions, lifestyle modification, smoking cessation and cancer screening are optimised for PLWH. Physicians are likely to care for PLWH in almost all subspecialties including aged care. Recent data support the use of organ transplantation in PLWH including from donors who also have HIV infection. HIV is most certainly not 'a thing of the past'.