Format

Send to

Choose Destination
See comment in PubMed Commons below
PLoS One. 2013 Dec 18;8(12):e81355. doi: 10.1371/journal.pone.0081355. eCollection 2013.

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

Author information

1
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
2
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada ; Simon Fraser University, Burnaby, British Columbia, Canada.
3
Johns Hopkins University, Baltimore, Maryland, United States of America.
4
Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
5
Ontario HIV Treatment Network, Toronto, Ontario, Canada.
6
The Core Center, Bureau of Health Services of Cook County, Chicago, Illinois, United States of America.
7
University of Calgary, Calgary, Alberta, Canada.
8
Veterans Administration Connecticut Healthcare System and Yale University, West Haven, Connecticut, United States of America.
9
McGill University Health Centre, Montreal, Quebec, Canada.
10
Oregon Health and Science University, Portland, Oregon, United States of America.
11
University of California San Francisco, San Francisco, California, United States of America.
12
University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
13
Vanderbilt University, Nashville, Tennessee, United States of America.
14
Kaiser Permanente Northern California, Oakland, California, United States of America.
15
San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America.
16
Harvard School of Public Health, Boston, Massachusetts, United States of America.
17
University of Washington, Seattle, Washington, United States of America.
18
National Cancer Institute, Rockville, Maryland, United States of America.

Abstract

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.

PMID:
24367482
PMCID:
PMC3867319
DOI:
10.1371/journal.pone.0081355
[Indexed for MEDLINE]
Free PMC Article

Publication types, MeSH terms, Grant support

Publication types

MeSH terms

Grant support

PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Public Library of Science Icon for PubMed Central
    Loading ...
    Support Center