“How Much Time Do I Have Doc?” Reflections on the Lifespan of People with HIV

Scientists love to quantify; it is in our nature, if not in our training, to measure everything around us. Imagine my interest and disgust that there is even a scoring rubric for quantifying the liquidity and/or solidness of stool called the Bristol Stool Scale [1]. Yuk!!! But I find the area of predicting lifespans, especially for those with a particular disease, interesting and at times baffling. Predicting the lifespan of a mayfly is one thing (by the way, it is just a day), but predicting the lifespan of people with HIV is entirely different. Despite excellent prognosis, thanks to the advances of combination Antiretroviral Therapy (cART), many adults with HIV have experienced Lazarus Syndrome; once they were expecting to die but now they are expecting to live and even retire. But is that to say everyone with HIV will retire? In fact, can that be said of any of us? Yet, insurance companies, actuaries, and yes, scientists, pursue these passionately and derive predictions that at times are perceived as gospel. But is it? Well it depends on who you ask.