BOSTON — Although the life expectancy gap between HIV patients and noninfected adults with access to health care has narrowed significantly, a sizable difference remains that might be lessened by mitigating risk factors, according to research presented at CROI 2016.
“Most of the prior studies on this topic have compared HIV patients to the general population, meaning that they haven’t been able to account for important differences between HIV-infected and uninfected individuals in access to health care, and in risk factors that we know affect survival,” Julia L. Marcus, PhD, MPH, postdoctoral fellow in the division of research at Kaiser Permanente Northern California, said during a press event.
Julia L. Marcus
Marcus and colleagues conducted a cohort study using data from 1996 to 2011 that compared 24,768 HIV-infected adult members of Kaiser Permanente California with 257,600 noninfected adult members, with the second group being matched at a 10:1 ratio on age, gender, medical center and year.
The researchers found that the expected years of life remaining at age 20 years for HIV patients was 19 in 1996 to 1997, compared to 63 in uninfected adults, for a gap of 44 years. The gap narrowed to 13.1 years from 2008 to 2011 as the expected years of life remaining at age 20 years for HIV patients jumped to 49.3 years, with the lowest numbers seen among blacks (46 years) and those with a history of IV drug use (46 years).
In 2008-2011, HIV patients who initiated ART with ≥500 cells/μL could be expected to have 54.5 years of life remaining at age 20 years, a 7.9-year gap compared with noninfected adults (P < .001). Marcus and colleagues noted a gap of 5 to 7 years in subgroups of these optimally treated HIV patients and uninfected adults without a history of hepatitis B virus or hepatitis C virus, drug or alcohol abuse, or smoking.
“I think our work highlights the importance of getting HIV patients on treatment early, as well as mitigating non-HIV risk factors such as smoking,” Marcus told Infectious Disease News. – by Gerard Gallagher
Marcus JL, et al. Abstract #54. Presented at: Conference on Retroviruses and Opportunistic Infections; Feb. 22-25, 2016; Boston.
Disclosure: Marcus reports receiving research grant support from Merck.