title: Life expectancy after initiation of combination antiretroviral therapy in Thailand.
abstract: Access to combination antiretroviral therapy (cART) has decreased mortality in HIV-positive people. We aimed to estimate the expected additional years of life in HIV-positive Thai people after starting cART through the National AIDS Program (NAP), administered by the Thai National Health Security Office (NHSO).
  
  
  
  The NHSO database collects characteristics of all Thai HIV-infected patients through the National AIDS Program, including linkage with the National Death Registry for vital status. This study included patients aged ≥15 years at cART initiation between 2008 and 2014. The abridged life table method was used to construct life tables stratified by sex and baseline CD4+T-cell count. Life expectancy was defined as the additional years of life from age at starting cART.
  
  
  
  201,688 eligible patients were included in analyses, contributing 618,837 person-years of follow-up. Median CD4+T-cell count was 109 cells/mm3and median age 37 years. The overall life expectancy after cART initiation at age 20 was 25.4 (95% CI, 25.3, 25.6) years and 20.6 (95% CI, 20.5, 20.7) at age 35 years. Life expectancy at baseline CD4+T-cell count ≥350 cells/mm3was 51.9 (95% CI, 51.0, 52.9) years for age 20 years and 43.2 (95% CI, 42.4, 44.1) years for age 35 years, close to life expectancy in the general Thai population.
  
  
  
  Increasing life expectancy with higher baseline CD4+T-cell counts supports the guideline recommendations to start cART irrespective of CD4+T-cell count. These results are beneficial to forecast the treatment cost and develop health policies for people living with HIV in Thailand and Asia.
authors.affiliation: HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.|Kirby Institute, University of New South Wales, Sydney, Australia.
authors.forename: Sirinya
authors.initials: S
authors.lastname: Teeraananchai
authors.affiliation: The HIV/AIDS, Tuberculosis and Infectious Diseases Program, National Health Security Office (NHSO), Bangkok, Thailand.
authors.forename: Suchada
authors.initials: S
authors.lastname: Chaivooth
authors.affiliation: HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.|Kirby Institute, University of New South Wales, Sydney, Australia.|Department of Global Health, Academic Medical Center, University of Amsterdam, Amsterdam Institute of Global Health and Development, Amsterdam, the Netherlands.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Kerr
authors.affiliation: The HIV/AIDS, Tuberculosis and Infectious Diseases Program, National Health Security Office (NHSO), Bangkok, Thailand.
authors.forename: Sorakij
authors.initials: S
authors.lastname: Bhakeecheep
authors.affiliation: HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.|Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Anchalee
authors.initials: A
authors.lastname: Avihingsanon
authors.affiliation: Thailand MOPH - US CDC Collaboration, Nonthaburi, Thailand.
authors.forename: Achara
authors.initials: A
authors.lastname: Teeraratkul
authors.affiliation: Ministry of Public Health, Nonthaburi, Thailand.
authors.forename: Petchsri
authors.initials: P
authors.lastname: Sirinirund
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, Australia.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Law
authors.affiliation: HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand.|Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
authors.forename: Kiat
authors.initials: K
authors.lastname: Ruxrungtham
mesh_terms: D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000821:virology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D062486:Public Health Surveillance; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome; D019562:Viral Load; D055815:Young Adult