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Sep21
Life expectancy of patients of HIV now considerably exceeds the average in some people with HIV in the USA provided ART is started earlier above 350
Life expectancy of patients of HIV now considerably exceeds the average in some people with HIV in the USA provided ART is started earlier above 350

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A study from the US has found that some groups of people with HIV, especially those treated before their CD4 count falls below 350 cells/mm3, now have life expectancies equal to or even higher than the US general population.
However, it also finds that life expectancy for some other groups – most notably women and non-white people – is still considerably below comparable members of the general population and that for people who inject drugs, life expectancy in the era of antiretroviral therapy (ART) has not improved at all.A second study, which looked at death rates among both HIV-positive and HIV-negative members of two cohorts of people with or at risk of HIV, has found that the death rate from non-AIDS-defining illnesses among people with HIV who started ART above the 350 cells/mm3 threshold was not, and never has been, any higher than among comparable HIV-negative people.
Life expectancy at age 20 in the US population is approximately 57 years in men (i.e. on average, and in the absence of further change, 50% will die by the age of 77) and 62 years in women (i.e. 50% chance of death by 82). In Canada, men can expect to live nearly three years longer than this and women just over two.The study found that for the group as a whole and over the full eight years, the average life expectancy in people with HIV was just under 43 years, i.e. 50% will die by the age of 63 – 15 years earlier than men and 19 years earlier than women in the general US population.

However, there were huge disparities in life expectancies between different groups. Whereas people who inject drugs only had a life expectancy of 29 more years at age 20, for white people it was 52 years, for those starting treatment with a CD4 count above 350 cells/mm3 it was 55 years and for gay men it was 57 years – the same (or slightly higher) than in US men in general.In other words, the sole contributor to the increased mortality in people who started ART early was AIDS. This was not, however, the case for people who started ART later, who had raised mortality due to non-AIDS-related causes as well as due to AIDS.


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