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HIV patients' life expectancy up by 13 years

25/07/2008

People with HIV in high income countries now live some 13 years longer than over a decade ago thanks to improvements in treatment, research published today reveals.

The study, published in the Lancet journal, also said that there has been an accompanying drop in mortality of nearly 40 per cent in the same period.

But life expectancy in these patients remains well short of the general population, and patients treated late in the course of their infection have worse life expectancy.

A team of international researchers analysed 18,587, 13,914, and 10,584 patients who started combination antiretroviral therapy (Cart) in 1996-99, 2000-02, and 2003-05 respectively.

Total life expectancy for a person aged exactly 20 years on Cart increased from 56.1 years in 1996-99 to 69.4 years in 2003-05, an increase of more than 13 years.

Patients treated later in the course of their infection, with lower CD4+ cell counts (immune system cells) had shorter total life expectancy, at 52.4 years, compared with 70.4 years in patients treated at earlier stages with higher CD4 loads.

Despite these positive results, an HIV-positive person starting Cart at age 20 will live another 43 years (to age 63) on average, while a 20-year-old HIV-negative person in a high income country can expect to live to around 80 years.

As such the study's authors call on health planners to improve health services and living conditions for HIV-infected patients to reduce this gap.

"The progressive reductions in mortality and gains in life expectancy over the three periods studied here are probably the result of both improvements in therapy during the first decade of Cart and continuing declines in mortality rates among individuals on such treatment for long periods," they conclude.

"These advances have transformed HIV from being a fatal disease, which was the reality for patients before the advent of combination treatment, into a long-term chronic condition."