The fact that HIV-positive people can live long, healthy lives comes as a surprise to some people. Many patients have now been on HIV medication for 20 years or more. Medication is extremely effective and patients have viral loads which are often undetectable. However now this landmark has been reached both patients and physicians need to think beyond mere survival  - people living with HIV, must consider other challenges when it comes to long-term living with the virus—and its treatment. It is increasingly acknowledged that people with HIV may be at an increased risk for age-related health problems, such as cardiovascular disease, and need to take steps to prevent and treat them. According to a recent study by an international team of researchers, an HIV-positive 20-year-old starting treatment for the first time can expect to live to about age 69 i.e.just 11 years short of the average life expectancy for HIV negative people. Life expectancy for a person starting HIV treatment today is about 13 years longer than it was when combination therapy became the standard-of care in 1996. As HIV-positive people live longer, they’re prone to the effects of aging, which can include bone loss and a rising risk of heart disease, diabetes and cancer. If they have hepatitis B or C, they also need to worry about their liver. Hepatitis C can now be “cured” and a newly approved HIV backbone may offer physicians and patients better options, including treatment at a much-lower dose, which could potentially reduce the impact of current HIV treatments in an aging patient population.