title: Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study.
abstract: OBJECTIVE
  To estimate life expectancy for people with HIV undergoing treatment compared with life expectancy in the general population and to assess the impact on life expectancy of late treatment, defined as CD4 count <200 cells/mm(3) at start of antiretroviral therapy.
  
  
  METHODS
  Cohort study.
  
  
  METHODS
  Outpatient HIV clinics throughout the United Kingdom. Population Adult patients from the UK Collaborative HIV Cohort (UK CHIC) Study with CD4 count ≤ 350 cells/mm(3) at start of antiretroviral therapy in 1996-2008.
  
  
  METHODS
  Life expectancy at the exact age of 20 (the average additional years that will be lived by a person after age 20), according to the cross sectional age specific mortality rates during the study period.
  
  
  RESULTS
  1248 of 17,661 eligible patients died during 91,203 person years' follow-up. Life expectancy (standard error) at exact age 20 increased from 30.0 (1.2) to 45.8 (1.7) years from 1996-9 to 2006-8. Life expectancy was 39.5 (0.45) for male patients and 50.2 (0.45) years for female patients compared with 57.8 and 61.6 years for men and women in the general population (1996-2006). Starting antiretroviral therapy later than guidelines suggest resulted in up to 15 years' loss of life: at age 20, life expectancy was 37.9 (1.3), 41.0 (2.2), and 53.4 (1.2) years in those starting antiretroviral therapy with CD4 count <100, 100-199, and 200-350 cells/mm(3), respectively.
  
  
  CONCLUSIONS
  Life expectancy in people treated for HIV infection has increased by over 15 years during 1996-2008, but is still about 13 years less than that of the UK population. The higher life expectancy in women is magnified in those with HIV. Earlier diagnosis and subsequent timely treatment with antiretroviral therapy might increase life expectancy.
authors: School of Social and Community Medicine, Bristol University, Bristol BS8 2PS, UK. m.t.may@bristol.ac.uk
authors: Margaret
authors: M
authors: May
authors: Mark
authors: M
authors: Gompels
authors: Valerie
authors: V
authors: Delpech
authors: Kholoud
authors: K
authors: Porter
authors: Frank
authors: F
authors: Post
authors: Margaret
authors: M
authors: Johnson
authors: David
authors: D
authors: Dunn
authors: Adrian
authors: A
authors: Palfreeman
authors: Richard
authors: R
authors: Gilson
authors: Brian
authors: B
authors: Gazzard
authors: Teresa
authors: T
authors: Hill
authors: John
authors: J
authors: Walsh
authors: Martin
authors: M
authors: Fisher
authors: Chloe
authors: C
authors: Orkin
authors: Jonathan
authors: J
authors: Ainsworth
authors: Loveleen
authors: L
authors: Bansi
authors: Andrew
authors: A
authors: Phillips
authors: Clifford
authors: C
authors: Leen
authors: Mark
authors: M
authors: Nelson
authors: Jane
authors: J
authors: Anderson
authors: Caroline
authors: C
authors: Sabin
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D003299:Cooperative Behavior; D057210:Delayed Diagnosis / Q000009:adverse effects / Q000401:mortality*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000401:mortality*; D015497:HIV-1; D006801:Humans; D008017:Life Expectancy / Q000639:trends*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D013997:Time Factors; D006113:United Kingdom; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents