November 16, 2016
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Life expectancy for HIV patients approaches that of general population

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Patients with HIV who receive optimal care are now expected to live as long as their peers without HIV, according to recent study results from Denmark published in Annals of Internal Medicine.

“In 2007, we and others reported encouraging survival estimates for persons receiving HIV care in the Danish HIV Cohort Study,” Nicolai Lohse, MD, PhD, DMSc, and Niels Obel, MD, DMSc, both from Copenhagen University, wrote. “We estimated that 25-year-old persons with HIV infection not coinfected with hepatitis C virus would survive to a median age of 63.9 years. Despite these encouraging findings, median survival was still 12.2 years short of that observed in a sex- and age-matched sample of persons from the general population.”

To update their 2007 report, Lohse and Obel evaluated 5,701 patients with HIV, without HCV coinfection, and 28,505 controls matched for age and sex. They utilized the same methods from their 2007 study. Most participants were men (77%), and the median age at study entry was 37.1 years (interquartile range, 30.5 to 45.5 years).

Overall, the median age at death for a patient with HIV aged 25 years has increased over the past 20 years from 34.5 years (95% CI, 32.2- 35.9) in 1995-1996 to 52.2 years (95% CI, 49-57.5) in 1997-1999, 62.8 years (95% CI, 60.4- 64.9) in 2000-2004, 66.8 years (95% CI, 65.7-68.5) in 2005-2009, and 73.9 years (95% CI, 72.2-76.7) in 2010-2015, compared with 80 years (95% CI, 79.4-80.8 years) for the general population.

According to the researchers, these results correlate with those from multiple studies around the world. They noted that lifestyle factors not necessarily related to the infection are the main barriers to a long life for patients with HIV and access to care.

“We believe that the main drivers of this success are the continuous advent of new drug classes, better management of comorbidity, stronger focus on lifestyle-related risk factors, and more effective HIV detection leading to earlier presentation for care,” Lohse and Obel wrote.

“Despite these advances, many persons with HIV infection globally lack access to care and treatment and many others are not reaping the possible benefits even when they do have access,” they concluded. “We should address these limitations because this report and others like it document the benefits we can expect with a strong focus on timely diagnosis, integrated solutions, and new therapies.” – by Alaina Tedesco

 

Disclosure: Lohse reports no relevant financial disclosures. Obel reports unconditional research grants from Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, GlaxoSmithKline and Janssen paid to his institution.