Increase In Life Expectancy for People Living With HIV

People with HIV have a 15 years longer life expectancy thanks to improved treatments over the past 13 years, according to a new study published on the British Medical Journal website.

Researchers found that the life expectancy of these patients improved significantly between 1996 and 2008, and that earlier diagnosis and timely treatment can increase life expectancy.   HIV infection has become a chronic disease with a good prognosis if treatment begins sufficiently early in the course of the disease and the patient sticks to antiretroviral treatment. However life expectancy for people with the disease is lower than that of the general population.

Researchers led by Dr Margaret May of the University of Bristol’s School of Social and Community Medicine set out to estimate life expectancy of people treated for HIV infection and compare it with that of the UK general population.

They used data from the UK Collaborative HIV Cohort (UK CHIC) study, which in 2001 began collating routine data on HIV positive people attending some of the UK’s largest clinical centres since January 1996.  Patients included in the analysis were aged 20 years and over and started treatment with antiretroviral therapy with at least three drugs between 1996 and 2008.

The researchers studied data on 17,661 patients, of whom 1,248 (7%) died between 1996 and 2008.   Their analysis shows that life expectancy for an average 20-year-old infected with HIV increased from 30 years to almost 46 between the periods 1996-9 and 2006-8.

The findings also show that life expectancy for women treated for HIV is ten years’ higher than for men. During the period 1996 -2008, life expectancy was 40 years for male patients and 50 years for female patients compared with 58 years for men and nearly 62 years for women in the general UK population.   The point at which a person started treatment had an impact on their life expectancy, as the researchers also found that starting antiretroviral therapy later than guidelines suggest, resulted in up to 15 years loss of life.

Doctors use a test to count the number of CD4 cells in one cubic millimetre of blood. A normal CD4 count in a healthy, HIV-negative adult is usually between 600 and 1,200 CD4 cells/mm3.   The researchers found that life expectancy was 38 years, 41 years and 53 years in those starting antiretroviral therapy with CD4 counts less than 100, 100-199 and 200-350/mm3 cells respectively.

The improvement in life expectancy since 1996 was likely to be due to several factors, they say, including a greater proportion of patients with high CD4 counts, better antiretroviral therapy, more effective drugs, and an upward trend in the UK population life expectancy.

They conclude: “Life expectancy in the HIV-positive population has significantly improved in the UK between 1996 and 2008 and we should expect further improvements for patients starting antiretroviral therapy now with improved modern drugs and new guidelines recommending earlier treatment.  There is a need to identify HIV-positive individuals early in the course of disease in order to avoid the very large negative impact that starting antiretroviral therapy at a CD4 count below 200 cells/mm3 has on life expectancy.”

Dr Mark Gompels, lead clinician and co-author, North Bristol NHS Trust, said “These results are very reassuring news for current patients and will be used to counsel those recently found to be HIV-positive.”   In an accompanying editorial, researchers in Boston argue that, although these gains are encouraging, they have not been seen in everyone with HIV.

Nevertheless, this study “serves as an urgent call to increase awareness of the effectiveness of current HIV treatments in patients and providers,” they say. “In turn this should increase rates of routine HIV screening, with timely linkage to care and uninterrupted treatment. As these factors improve, the full benefits of treatment for all HIV infected people can be realised.”

The study also finds that women with HIV could expect to live a decade longer than men with HIV, perhaps because women are tested for HIV during pregnancy and are likely to start treatment earlier.

The data
  • Data on 17,661 patients, of whom 1,248 (7%) died between 1996 and 2008
  • Life expectancy for the average 20-year-old with HIV increased from 30 to almost 46 years between the periods 1996-9 and 2006-8
  • Life expectancy for women treated for HIV was 10 years’ higher than for men
  • Starting anti-retroviral therapy later than guidelines suggest resulted in up to 15 years’ loss of life
Dr. Anthony Fauci explains how advances in treatment research have dramatically increased the life expectancy for those infected with HIV.

The Terrence Higgins Trust says people at risk should get tested now.  Figures suggest more than 80,000 UK are living with HIV, and about 25% are unaware they have the infection however, it’s good news for people with HIV, their families and friends.

Sir Nick Partridge (CEO of THT) said: “It also demonstrates why it’s so much better to know if you have HIV. Late diagnosis and late treatment mean an earlier grave, so if you’ve been at risk for HIV, get tested now.   Of course, it’s not just length of life that’s important, but quality of life too, and having HIV can still severely damage your life’s chances.   While so much has changed 30 years on from the start of the epidemic, condoms continue to be the best way to protect yourself and your partner from HIV in the first place.”

Are you interested in having a HIV test?  We offer a completely free and confidential rapid HIV test and you’ll get the results within 60 seconds from a simple finger prick test. We use the Insti HIV test produced by BioLytical laboratories. The test is 99.96% accurate from 90 days post contact for detecting HIV 1 and 2 antibodies. We also have a mobile testing van which is often out in communities providing mobile rapid HIV tests. Appointments are not always necessary, if you would like a test, please contact us on 0116 2559995

Original Articles via BBC News and the British Medical Journal

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