Narrowing the Gap in Life Expectancy Between HIV-Infected and HIV-Uninfected Individuals With Access to Care.

Autor:	Marcus JL; Division of Research, Kaiser Permanente Northern California, Oakland, CA; †Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA; ‡Kaiser Permanente San Leandro Medical Center, Kaiser Permanente Northern California, San Leandro, CA; §Department of Research and Evaluation, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA; and ‖Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic, Rockville, MD., Chao CR, Leyden WA, Xu L, Quesenberry CP Jr, Klein DB, Towner WJ, Horberg MA, Silverberg MJ
Jazyk:	angličtina
Zdroj:	Journal of acquired immune deficiency syndromes (1999) [J Acquir Immune Defic Syndr] 2016 Sep 01; Vol. 73 (1), pp. 39-46.
DOI:	10.1097/QAI.0000000000001014
Abstrakt:	Background: It is unknown if a survival gap remains between HIV-infected and HIV-uninfected individuals with access to care. Methods: We conducted a cohort study within Kaiser Permanente California during 1996-2011, using abridged life tables to estimate the expected years of life remaining ("life expectancy") at age 20. Results: Among 24,768 HIV-infected and 257,600 HIV-uninfected individuals, there were 2229 and 4970 deaths, with mortality rates of 1827 and 326 per 100,000 person-years, respectively. In 1996-1997, life expectancies at age 20 for HIV-infected and HIV-uninfected individuals were 19.1 and 63.4 years, respectively, corresponding with a gap of 44.3 years (95% confidence interval: 38.4 to 50.2). Life expectancy at age 20 for HIV-infected individuals increased to 47.1 years in 2008 and 53.1 years by 2011, narrowing the gap to 11.8 years (8.9-14.8 years) in 2011. In 2008-2011, life expectancies at age 20 for HIV-infected individuals ranged from a low of 45.8 years for blacks and 46.0 years for those with a history of injection drug use to a high of 52.2 years for Hispanics. HIV-infected individuals who initiated antiretroviral therapy with CD4 ≥500 cells per microliter had a life expectancy at age 20 of 54.5 years in 2008-2011, narrowing the gap relative to HIV-uninfected individuals to 7.9 years (5.1-10.6 years). For these HIV-infected individuals, the gap narrowed further in subgroups with no history of hepatitis B or C infection, smoking, drug/alcohol abuse, or any of these risk factors. Conclusions: Even with early treatment and access to care, an 8-year gap in life expectancy remains for HIV-infected compared with HIV-uninfected individuals.
Databáze:	MEDLINE
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