Antiretroviral Therapy Outcomes in HIV-Infected Populations

Since the advent of combination antiretroviral therapy (ART) in the mid-1990s, the prognosis of people living with HIV has improved dramatically, with substantial reductions in both AIDS-related and all-cause mortality. Modern regimens achieve durable viral suppression in the majority of treated individuals, enabling near-normal life expectancy for those who initiate therapy early and maintain adherence. Nevertheless, important challenges persist. Late diagnosis and treatment initiation, gaps in adherence and care engagement, co-infection with tuberculosis and other comorbidities, nutritional deficits and social determinants of health contribute to persistent regional and demographic disparities in outcomes. In high-income settings, non-AIDS causes of morbidity and death—particularly non-AIDS malignancies, cardiovascular and liver disease—are increasingly prominent. In resource-limited regions, high early mortality remains linked to advanced immunodeficiency, opportunistic infections and undernutrition. Continued optimisation of drug regimens, improved access to testing and treatment, reinforced adherence support, integrated management of comorbid conditions and attention to social and nutritional support are essential to close remaining gaps and extend the full benefits of ART to all populations living with HIV.

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Antiretroviral Therapy Outcomes in HIV-Infected Populations publication trend

The graph below shows the total number of articles in antiretroviral therapy outcomes in hiv-infected populations across all publications each year (not limited to Nature Index journals).

Technical terms

Antiretroviral therapy (ART): A combination of drugs that suppresses HIV replication, prevents progression to AIDS, and reduces mortality.

CD4 cell count: A measure of immune system health, indicating the number of CD4+ T lymphocytes per microlitre of blood; higher counts reflect better immune function.

Viral load: The quantity of HIV RNA in the blood; sustained low or undetectable levels indicate successful treatment.

Immunologic-virologic status (IVS): A composite category reflecting both CD4 cell count and viral load, used to stratify treatment response and prognosis.

References

1. All-cause and AIDS-related mortality among people with HIV across Europe from 2001 to 2020: impact of antiretroviral therapy, tuberculosis and regional differences in a multicentre cohort study. The Lancet Regional Health - Europe (2024).
2. Life expectancy after 2015 of adults with HIV on long-term antiretroviral therapy in Europe and North America: a collaborative analysis of cohort studies. The Lancet HIV (2023).
3. Effects of undernutrition on mortality and morbidity among adults living with HIV in sub-Saharan Africa: a systematic review and meta-analysis. BMC Infectious Diseases (2021).