title: Survival following HIV infection of a cohort followed up from seroconversion in the UK.
abstract: OBJECTIVE
  To estimate changes over calendar time in survival following HIV seroconversion in the era of HAART and to provide updated survival estimates.
  
  
  METHODS
  Using data from a UK cohort of persons with well estimated dates of HIV seroconversion, we analysed time from seroconversion to death from any cause using Cox models, adjusted for prognostic factors. Kaplan-Meier methods were then used to determine the expected survival in each calendar period.
  
  
  RESULTS
  2275 seroconverters were included with 18 695 person-years of follow up. A total of 444 (20%) died. The relative risk of death, compared with pre-1996, decreased over time to 0.63 [95% confidence interval (CI), 0.48-0.81], 0.24 (0.17-0.34), 0.14 (0.10-0.21), 0.08 (0.05-0.13) and 0.03 (0.02-0.06) in 1996-1997, 1998-1999, 2000-2001, 2002-2003 and 2004-2006, respectively. An elevated risk of death was associated with older age at seroconversion [hazard ratio (HR), 1.49; 95% CI, 1.34-1.66 per 10-year increase] and HIV infection through injecting drug use (HR, 1.53; 95% CI, 1.17-2.00). In 2000-2006, the proportion of individuals expected to survive 5, 10 and 15 years following seroconversion was 99%, 94% and 89%, respectively.
  
  
  CONCLUSIONS
  Survival following HIV seroconversion has continued to improve over calendar time in our cohort, even in the more recent years of HAART availability. HIV seroconverters, by definition identified early in their infection, are likely to have the greatest opportunity for intervention; if similar high survival expectations are to be seen in the wider HIV-infected population, early diagnosis is likely to be crucial.
authors: MRC Clinical Trials Unit, London, UK.
authors: Fiona M
authors: FM
authors: Ewings
authors: Krishnan
authors: K
authors: Bhaskaran
authors: Ken
authors: K
authors: McLean
authors: David
authors: D
authors: Hawkins
authors: Martin
authors: M
authors: Fisher
authors: Sarah
authors: S
authors: Fidler
authors: Richard
authors: R
authors: Gilson
authors: Demelza
authors: D
authors: Nock
authors: Ray
authors: R
authors: Brettle
authors: Margaret
authors: M
authors: Johnson
authors: Andrew
authors: A
authors: Phillips
authors: Kholoud
authors: K
authors: Porter
mesh_terms: D000328:Adult; D000375:Aging; D019380:Anti-HIV Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000401:mortality / Q000639:trends; D015331:Cohort Studies; D005260:Female; D006678:HIV; D006679:HIV Seropositivity / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality; D006801:Humans; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors; D015819:Substance Abuse, Intravenous; D016019:Survival Analysis; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents