Impact on life expectancy of late diagnosis and treatment of HIV-1 positive individuals
Publication details: 2011ISSN:- 09598138
- Brtish Medical Journal
| Item type | Home library | Collection | Class number | Status | Date due | Barcode | |
|---|---|---|---|---|---|---|---|
| Book | Ferriman information and Library Service (North Middlesex) Shelves | Staff publications for NMDX | Available |
NMUH Staff Publications
343
<div><span style="font-size: 8pt;"><strong>Objectives </strong>To estimate life expectancy for people with HIV undergoing&nbsp;</span><span style="font-size: 8pt;">treatment compared with life expectancy in the general population and</span><span style="font-size: 8pt;">to assess the impact on life expectancy of late treatment, defined as&nbsp;</span><span style="font-size: 8pt;">CD4 count &lt;200 cells/mm3&nbsp;</span><span style="font-size: 8pt;">at start of antiretroviral therapy.</span></div><div><span style="font-size: 8pt;"><strong>Design</strong> Cohort study.</span></div><div><span style="font-size: 8pt;"><strong>Setting</strong> Outpatient HIV clinics throughout the United Kingdom.</span></div><div><span style="font-size: 8pt;"><strong>Population </strong>Adult patients from the UK Collaborative HIV Cohort (UK</span><span style="font-size: 8pt;">CHIC) Study with CD4 count ≤350 cells/mm3</span><span style="font-size: 8pt;">at start of antiretroviral&nbsp;</span><span style="font-size: 8pt;">therapy in 1996-2008.</span></div><div><span style="font-size: 8pt;"><strong>Main outcome measures</strong> Life expectancy at the exact age of 20 (the&nbsp;</span><span style="font-size: 8pt;">average additional years that will be lived by a person after age 20),&nbsp;</span><span style="font-size: 8pt;">according to the cross sectional age specific mortality rates during the&nbsp;</span><span style="font-size: 8pt;">study period.</span></div><div><span style="font-size: 8pt;"><strong>Results</strong> 1248 of 17 661 eligible patients died during 91 203 person&nbsp;</span><span style="font-size: 8pt;">years’ follow-up. Life expectancy (standard error) at exact age 20&nbsp;</span><span style="font-size: 8pt;">increased from 30.0 (1.2)to 45.8 (1.7) years from 1996-9 to 2006-8. Life&nbsp;</span><span style="font-size: 8pt;">expectancy was 39.5 (0.45) for male patients and 50.2 (0.45) years for&nbsp;</span><span style="font-size: 8pt;">female patients compared with 57.8 and 61.6 years for men and women&nbsp;</span><span style="font-size: 8pt;">in the general population (1996-2006). Starting antiretroviral therapy&nbsp;</span><span style="font-size: 8pt;">later than guidelines suggest resulted in up to 15 years’ loss of life: at&nbsp;</span><span style="font-size: 8pt;">age 20, life expectancy was 37.9 (1.3), 41.0 (2.2), and 53.4 (1.2) years&nbsp;</span><span style="font-size: 8pt;">in those starting antiretroviral therapy with CD4 count &lt;100, 100-199,&nbsp;</span><span style="font-size: 8pt;">and 200-350 cells/mm3&nbsp;</span><span style="font-size: 8pt;">, respectively.</span></div><div><div><span style="font-size: 8pt;"><strong>Conclusions</strong> Life expectancy in people treated for HIV infection has&nbsp;</span><span style="font-size: 8pt;">increased by over 15 years during 1996-2008, but is still about 13 years&nbsp;</span><span style="font-size: 8pt;">less than that of the UK population.The higher life expectancy in women&nbsp;</span><span style="font-size: 8pt;">is magnified in those with HIV. Earlier diagnosis and subsequent timely&nbsp;</span><span style="font-size: 11px;">treatment with antiretroviral therapy might increase life expectancy.</span></div></div><div><br /></div>
There are no comments on this title.