title: Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada.
abstract: BACKGROUND
  Combination antiretroviral therapy (ART) has significantly increased survival among HIV-positive adults in the United States (U.S.) and Canada, but gains in life expectancy for this region have not been well characterized. We aim to estimate temporal changes in life expectancy among HIV-positive adults on ART from 2000-2007 in the U.S. and Canada.
  
  
  METHODS
  Participants were from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), aged ≥20 years and on ART. Mortality rates were calculated using participants' person-time from January 1, 2000 or ART initiation until death, loss to follow-up, or administrative censoring December 31, 2007. Life expectancy at age 20, defined as the average number of additional years that a person of a specific age will live, provided the current age-specific mortality rates remain constant, was estimated using abridged life tables.
  
  
  RESULTS
  The crude mortality rate was 19.8/1,000 person-years, among 22,937 individuals contributing 82,022 person-years and 1,622 deaths. Life expectancy increased from 36.1 [standard error (SE) 0.5] to 51.4 [SE 0.5] years from 2000-2002 to 2006-2007. Men and women had comparable life expectancies in all periods except the last (2006-2007). Life expectancy was lower for individuals with a history of injection drug use, non-whites, and in patients with baseline CD4 counts <350 cells/mm(3).
  
  
  CONCLUSIONS
  A 20-year-old HIV-positive adult on ART in the U.S. or Canada is expected to live into their early 70 s, a life expectancy approaching that of the general population. Differences by sex, race, HIV transmission risk group, and CD4 count remain.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
authors.forename: Hasina
authors.initials: H
authors.lastname: Samji
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
authors.forename: Angela
authors.initials: A
authors.lastname: Cescon
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada ; Simon Fraser University, Burnaby, British Columbia, Canada.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Hogg
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Sharada P
authors.initials: SP
authors.lastname: Modur
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Keri N
authors.initials: KN
authors.lastname: Althoff
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America.
authors.forename: Kate
authors.initials: K
authors.lastname: Buchacz
authors.affiliation: Ontario HIV Treatment Network, Toronto, Ontario, Canada.
authors.forename: Ann N
authors.initials: AN
authors.lastname: Burchell
authors.affiliation: The Core Center, Bureau of Health Services of Cook County, Chicago, Illinois, United States of America.
authors.forename: Mardge
authors.initials: M
authors.lastname: Cohen
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Gebo
authors.affiliation: University of Calgary, Calgary, Alberta, Canada.
authors.forename: M John
authors.initials: MJ
authors.lastname: Gill
authors.affiliation: Veterans Administration Connecticut Healthcare System and Yale University, West Haven, Connecticut, United States of America.
authors.forename: Amy
authors.initials: A
authors.lastname: Justice
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Gregory
authors.initials: G
authors.lastname: Kirk
authors.affiliation: McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Marina B
authors.initials: MB
authors.lastname: Klein
authors.affiliation: Oregon Health and Science University, Portland, Oregon, United States of America.
authors.forename: P Todd
authors.initials: PT
authors.lastname: Korthuis
authors.affiliation: University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Jeff
authors.initials: J
authors.lastname: Martin
authors.affiliation: University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America.
authors.forename: Sonia
authors.initials: S
authors.lastname: Napravnik
authors.affiliation: Ontario HIV Treatment Network, Toronto, Ontario, Canada.
authors.forename: Sean B
authors.initials: SB
authors.lastname: Rourke
authors.affiliation: Vanderbilt University, Nashville, Tennessee, United States of America.
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Sterling
authors.affiliation: Kaiser Permanente Northern California, Oakland, California, United States of America.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Silverberg
authors.affiliation: San Francisco General Hospital, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Stephen
authors.initials: S
authors.lastname: Deeks
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Jacobson
authors.affiliation: Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Bosch
authors.affiliation: University of Washington, Seattle, Washington, United States of America.
authors.forename: Mari M
authors.initials: MM
authors.lastname: Kitahata
authors.affiliation: National Cancer Institute, Rockville, Maryland, United States of America.
authors.forename: James J
authors.initials: JJ
authors.lastname: Goedert
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Richard
authors.initials: R
authors.lastname: Moore
authors.affiliation: Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Gange
mesh_terms: D000328:Adult; D002170:Canada; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000401:mortality*; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D014481:United States; D055815:Young Adult