HIV Patients Living Longer
Friday, July 25, 2008; 12:00 AM
THURSDAY, July 24 (HealthDay News) -- Since 1996, the life expectancy of HIV patients in developed countries taking antiviral therapy has increased more than 13 years, and deaths have dropped by almost 40 percent, researchers report.
Despite these gains, life expectancy still falls short by some 20 years, compared with people in the general population. Life expectancy among injection drug users and those who start their treatment late is even shorter.
"People on [antiretroviral therapy] can live a fairly long life," said lead researcher Robert Hogg, from the British Colombia Centre for Excellence in HIV/AIDS in Vancouver. "If they are a woman, they can marry and have a child, and see the child grow up. If they're going to school, they can graduate from university, or they can continue to have a full adult life expectancy."
The report was published in this week's special HIV/AIDS issue ofThe Lancet.
For the study, Hogg's team collected data on 43,355 HIV patients from Europe and North America who participated in 14 studies. Among these patients, 18,587 started treatment in 1996 to 1999, another 13,914 began treatment in 2000 to 2002, and 10,584 started treatment between 2003 and 2005.
During the study period, 2,056 patients died. However, mortality decreased from 16.3 deaths per 1,000 person-years in 1996 to 1999 to 10 deaths per 1,000 person-years in 2003 to 2005. In addition, life expectancy for someone starting treatment at age 20 increased more than 13 years, from 56.1 years in 1996 to 1999 to 69.4 years in 2003 to 2005, the researchers found.
For some HIV patients, life expectancy is even shorter. For example, those who start treatment later in disease progression, life expectancy is 52.4 years, compared with 70.4 years for patients treated early. In addition, life expectancy among injection drug users is also lower at 52.6 years, compared with people who acquired HIV is another way at 64.7 years.
In addition, women had a longer life expectancy compared with men (64.2 versus 62.8 years). This may be due to women starting their treatment earlier, Hogg's group suggests.
"This sort of a mind shift for people, even physicians and researchers, that when you look at this life expectancy for these people is even longer than expected," Hogg said.
Rowena Johnston, vice president for research at the Foundation for AIDS Research, thinks that antiretroviral treatment has transformed HIV/AIDS from an early death sentence to a manageable chronic illness.
"One of the most striking successes of HIV/AIDS research has been the development of antiretroviral therapy that significantly extends the lives of people living with HIV," Johnston said.
Increasingly longer life expectancy is obviously a boon to patients and doctors, but it comes with increased risk of side effects and other difficulties associated with taking these medications for long periods of time, Johnston said. "Clearly, though, the benefits outweigh the risks," she added.
"Longer life expectancies are shifting what has been the traditional portrait of AIDS, such as body-wasting along with numerous rare infections, into a condition that is increasingly associated with some of the manifestations we traditionally think of with older age, like cancers, heart disease, kidney and liver disease, and insulin resistance," Johnston said.
However, Johnston thinks that many HIV patients continue to fall through the cracks. "What we haven't managed to do as well is to increase numbers of people getting tested, so that they find out about their HIV infection early enough to reap these benefits," she said.
For more on HIV/AIDS, visit the U.S. National Library of Medicine.
SOURCES: Robert Hogg, Ph.D., British Colombia Centre for Excellence in HIV/AIDS, Vancouver; Rowena Johnston, Ph.D., vice president, research, Foundation for AIDS Research, New York City; July 26, 2008,The Lancet