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Antivir Ther. 2017;22(5):393-402. doi: 10.3851/IMP3121. Epub 2017 Jan 5.

Life expectancy after initiation of combination antiretroviral therapy in Thailand.

Author information

1
HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
2
Kirby Institute, University of New South Wales, Sydney, Australia.
3
The HIV/AIDS, Tuberculosis and Infectious Diseases Program, National Health Security Office (NHSO), Bangkok, Thailand.
4
Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands.
5
Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
6
Thailand MOPH - US CDC Collaboration, Nonthaburi, Thailand.
7
Ministry of Public Health, Nonthaburi, Thailand.

Abstract

BACKGROUND:

Access to combination antiretroviral therapy (cART) has decreased mortality in HIV-positive people. We aimed to estimate the expected additional years of life in HIV-positive Thai people after starting cART through the National AIDS Program (NAP), administered by the Thai National Health Security Office (NHSO).

METHODS:

The NHSO database collects characteristics of all Thai HIV-infected patients through the National AIDS Program, including linkage with the National Death Registry for vital status. This study included patients aged ≥15 years at cART initiation between 2008 and 2014. The abridged life table method was used to construct life tables stratified by sex and baseline CD4+ T-cell count. Life expectancy was defined as the additional years of life from age at starting cART.

RESULTS:

201,688 eligible patients were included in analyses, contributing 618,837 person-years of follow-up. Median CD4+ T-cell count was 109 cells/mm3 and median age 37 years. The overall life expectancy after cART initiation at age 20 was 25.4 (95% CI, 25.3, 25.6) years and 20.6 (95% CI, 20.5, 20.7) at age 35 years. Life expectancy at baseline CD4+ T-cell count ≥350 cells/mm3 was 51.9 (95% CI, 51.0, 52.9) years for age 20 years and 43.2 (95% CI, 42.4, 44.1) years for age 35 years, close to life expectancy in the general Thai population.

CONCLUSIONS:

Increasing life expectancy with higher baseline CD4+ T-cell counts supports the guideline recommendations to start cART irrespective of CD4+ T-cell count. These results are beneficial to forecast the treatment cost and develop health policies for people living with HIV in Thailand and Asia.

PMID:
28054931
DOI:
10.3851/IMP3121
[Indexed for MEDLINE]

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