The yearly expense for treatment averages $34,000 for people in the advanced stage of illness compared with $14,000 for those infected who are keeping the virus at bay with a combination of anti-retroviral medications known as the AIDS drug cocktail, the report found.
The $20,000 differential in care for healthy vs. sick patients covers far more than HIV medications.
About 60 percent of the cost difference comes from drugs used to treat infections such as pneumonia, tuberculosis and certain cancers that affect people with weakened immune systems, said Dr. Michael Saag of the University of Alabama at Birmingham.
"The greatest single variable is non-HIV medications ranging from $1,800 to $14,000 a year," Saag said.
Hospitalization is the second largest expense for ill patients, accounting for $6,000 or 30 percent of the cost difference.
The rest of the difference is made up of clinic and diagnostic expenses such as lab tests, procedures and imaging.
The cost of treatment is the major barrier for getting medications to developing countries, where the majority of people are infected with HIV.
Research presented at this week's AIDS conference confirms that it is impossible to eradicate HIV from the body with the medicines currently available and so patients must take the drugs for the rest of their lives.
As a result, Dr. Anthony Fauci of the U.S. National Institutes of Health said, treatment and prevention in developing countries is essential.
However, at an average of $14,000 a year for healthy patients, treatment that has become standard in wealthy nations remains out of reach for developing countries, where less than $100 is spent per capita annually on health care.
The focus of the Barcelona conference remains how to get as much treatment as possible to needy countries with the limited resources available.
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