Life expectancy of recently diagnosed asymptomatic HIV-infected patients approaches that of uninfected individuals.
OBJECTIVE
To compare life expectancies between recently diagnosed HIV-infected patients and age and sex-matched uninfected individuals from the general population.


METHODS
: National observational HIV cohort in the Netherlands.


METHODS
Four thousand, six hundred and twelve patients diagnosed with HIV between 1998 and 2007 and still antiretroviral therapy-naive as of 24 weeks after diagnosis were selected. Progression to death compared to the age and sex-matched general population was studied with a multivariate hazards model in 4174 (90.5%) patients without AIDS events at 24 weeks. Life expectancy and number of life years lost were calculated using the predicted survival distribution.


RESULTS
During 17 580 person-years of follow-up since 24 weeks after diagnosis [median follow-up 3.3 years, interquartile range (IQR) 1.6-5.8], 118 deaths occurred, yielding a mortality rate of 6.7 [95% confidence interval (CI) 5.5-8.0] per 1000 person-years. Median CD4 cell counts at 24 weeks were 480 cells/microl (IQR 360-650). According to the model, the median number of years lived from age 25 was 52.7 (IQR 44.2-59.3; general population 53.1) for men and 57.8 (49.2-63.7; 58.1) for women without CDC-B event. The number of life years lost varied between 0.4 if diagnosed with HIV at age 25 and 1.4 if diagnosed at age 55; for patients with a CDC-B event this range was 1.8-8.0 years.


CONCLUSIONS
The life expectancy of asymptomatic HIV-infected patients who are still treatment-naive and have not experienced a CDC-B or C event at 24 weeks after diagnosis approaches that of non-infected individuals. However, follow-up time is short compared to the expected number of years lived.
van Sighem
Ard I
AI
Stichting HIV Monitoring, Academic Medical Centre of the University of Amsterdam, Amsterdam, The Netherlands. A.I.vanSighem@amc.uva.nl
Gras
Luuk A J
LA
Reiss
Peter
P
Brinkman
Kees
K
de Wolf
Frank
F
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000401:mortality*; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends