Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada.

Autor: Samji H; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada., Cescon A; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada., Hogg RS; British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada ; Simon Fraser University, Burnaby, British Columbia, Canada., Modur SP; Johns Hopkins University, Baltimore, Maryland, United States of America., Althoff KN; Johns Hopkins University, Baltimore, Maryland, United States of America., Buchacz K; Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America., Burchell AN; Ontario HIV Treatment Network, Toronto, Ontario, Canada., Cohen M; The Core Center, Bureau of Health Services of Cook County, Chicago, Illinois, United States of America., Gebo KA; Johns Hopkins University, Baltimore, Maryland, United States of America., Gill MJ; University of Calgary, Calgary, Alberta, Canada., Justice A; Veterans Administration Connecticut Healthcare System and Yale University, West Haven, Connecticut, United States of America., Kirk G; Johns Hopkins University, Baltimore, Maryland, United States of America., Klein MB; McGill University Health Centre, Montreal, Quebec, Canada., Korthuis PT; Oregon Health and Science University, Portland, Oregon, United States of America., Martin J; University of California San Francisco, San Francisco, California, United States of America., Napravnik S; University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America., Rourke SB; Ontario HIV Treatment Network, Toronto, Ontario, Canada., Sterling TR; Vanderbilt University, Nashville, Tennessee, United States of America., Silverberg MJ; Kaiser Permanente Northern California, Oakland, California, United States of America., Deeks S; San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America., Jacobson LP; Johns Hopkins University, Baltimore, Maryland, United States of America., Bosch RJ; Harvard School of Public Health, Boston, Massachusetts, United States of America., Kitahata MM; University of Washington, Seattle, Washington, United States of America., Goedert JJ; National Cancer Institute, Rockville, Maryland, United States of America., Moore R; Johns Hopkins University, Baltimore, Maryland, United States of America., Gange SJ; Johns Hopkins University, Baltimore, Maryland, United States of America.
Jazyk: angličtina
Zdroj: PloS one [PLoS One] 2013 Dec 18; Vol. 8 (12), pp. e81355. Date of Electronic Publication: 2013 Dec 18 (Print Publication: 2013).
DOI: 10.1371/journal.pone.0081355
Abstrakt: Background: Combination antiretroviral therapy (ART) has significantly increased survival among HIV-positive adults in the United States (U.S.) and Canada, but gains in life expectancy for this region have not been well characterized. We aim to estimate temporal changes in life expectancy among HIV-positive adults on ART from 2000-2007 in the U.S. and Canada.
Methods: Participants were from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), aged ≥20 years and on ART. Mortality rates were calculated using participants' person-time from January 1, 2000 or ART initiation until death, loss to follow-up, or administrative censoring December 31, 2007. Life expectancy at age 20, defined as the average number of additional years that a person of a specific age will live, provided the current age-specific mortality rates remain constant, was estimated using abridged life tables.
Results: The crude mortality rate was 19.8/1,000 person-years, among 22,937 individuals contributing 82,022 person-years and 1,622 deaths. Life expectancy increased from 36.1 [standard error (SE) 0.5] to 51.4 [SE 0.5] years from 2000-2002 to 2006-2007. Men and women had comparable life expectancies in all periods except the last (2006-2007). Life expectancy was lower for individuals with a history of injection drug use, non-whites, and in patients with baseline CD4 counts <350 cells/mm(3).
Conclusions: A 20-year-old HIV-positive adult on ART in the U.S. or Canada is expected to live into their early 70 s, a life expectancy approaching that of the general population. Differences by sex, race, HIV transmission risk group, and CD4 count remain.
Databáze: MEDLINE
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