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Closing the Gap: Increases in Life Expectancy among Treated HIV-Positive Individuals in the United States and Canada

Authors: Samji, Hasina; Cescon, Angela; Hogg, Robert S; Modur, Sharada P; Althoff, Keri N; Buchacz, Kate; Burchell, Ann N; +20 Authors

Closing the Gap: Increases in Life Expectancy among Treated HIV-Positive Individuals in the United States and Canada

Abstract

BackgroundCombination 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.MethodsParticipants 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.ResultsThe 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 ConclusionsA 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.

Countries
Canada, United States
Subjects by Vocabulary

Microsoft Academic Graph classification: Gerontology Men who have sex with men Epidemiology Young adult Mortality rate medicine.medical_specialty Epidemiological method Acquired immunodeficiency syndrome (AIDS) medicine business.industry Public health medicine.disease Life expectancy business Demography

Keywords

Male, Aging, North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of IeDEA, Non-Clinical Medicine, Epidemiology, HIV Infections, Epidemiological Methods, Multidisciplinary, Q, R, HIV diagnosis and management, Middle Aged, AIDS, Infectious Diseases, HIV epidemiology, 6.1 Pharmaceuticals, Medicine, HIV/AIDS, Female, Public Health, Infection, Research Article, Adult, Canada, General Science & Technology, Science, Clinical Sciences, Sexually Transmitted Diseases, Viral diseases, Infectious Disease Epidemiology, Young Adult, Life Expectancy, Clinical Research, Health Sciences, Humans, Health Care Policy, Biomedical and Clinical Sciences, Prevention, HIV, Evaluation of treatments and therapeutic interventions, United States, Human Society, Good Health and Well Being, Health Statistics

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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1K
Top 0.1%
Top 0.1%
Top 0.1%
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