Life expectancy of recently diagnosed asymptomatic HIV-infected patients approaches that of uninfected individuals

Sighem, A. van; Gras, L.; Reiss, P.; Brinkman, K.; Wolf, F. de; ATHENA Natl Observational Cohort S (2010)

Article / Letter to editor

Objective: To compare life expectancies between recently diagnosed HIV-infected patients and age and sex-matched uninfected individuals from the general population. Design: National observational HIV cohort in the Netherlands. Methods: Four thousand, six hundred and twelve patients diagnosed with HIV between 1998 and 2007 and still antiretroviral therapy-naive as of 24 weeks after diagnosis were selected. Progression to death compared to the age and sex-matched general population was studied with a multivariate hazards model in 4174 (90.5%) patients without AIDS events at 24 weeks. Life expectancy and number of life years lost were calculated using the predicted survival distribution. Results: During 17 580 person-years of follow-up since 24 weeks after diagnosis [median follow-up 3.3 years, interquartile range (IQR) 1.6-5.8], 118 deaths occurred, yielding a mortality rate of 6.7 [95% confidence interval (CI) 5.5-8.0] per 1000 person-years. Median CD4 cell counts at 24 weeks were 480 cells/mu l (IQR 360-650). According to the model, the median number of years lived from age 25 was 52.7 (IQR 44.2-59.3; general population 53.1) for men and 57.8 (49.2-63.7; 58.1) for women without CDC-B event. The number of life years lost varied between 0.4 if diagnosed with HIV at age 25 and 1.4 if diagnosed at age 55; for patients with a CDC-B event this range was 1.8-8.0 years. Conclusion: The life expectancy of asymptomatic HIV-infected patients who are still treatment-naive and have not experienced a CDC-B or C event at 24 weeks after diagnosis approaches that of non-infected individuals. However, follow-up time is short compared to the expected number of years lived. (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins

• cohort study death HIV life expectancy standardized mortality ratio statistical model active antiretroviral therapy high-income countries hiv-1-infected patients collaborative analysis general-population initial response mortality aids survival cohort

• All authors: Sighem, A. van; Gras, L.; Reiss, P.; Brinkman, K.; Wolf, F. de; ATHENA Natl Observational Cohort S
• Date: 2010-06-19
• Journal: AIDS
• Volume: 24
• Issue: 10
• Pages: 1527 - 1535