Millions of life-years saved with potent antiretroviral drugs in the United States: a celebration, with challenges.

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Abstract
In this issue of the Journal Walensky et al. estimate the benefits that have been gained from multidrug antiretroviral therapies (ARTs) since 1989 [1]. Their finding of ∼3 million years of life saved in the United States quantifies ART benefits at the population level, complementing the well-known data on plummeting US death rates and lower AIDS case report rates noted in the era of potent therapy [2, 3]. The authors’ detailed sensitivity analyses, varying key estimated parameters in their models, indicate that less-conservative assumptions generate an estimate of >5 million years of life saved, a plausible “higher-end” estimate of benefit. The typical HIV-infected person now receiving potent combination ART lives at least 13–14 years longer than if he or she were to forego this therapy or if it were otherwise unavailable [1]. Quantifying the survival benefits of expanded diagnosis and modern care suggests that the economic and humanitarian benefits are greater than were hitherto appreciated

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