Life Expectancy Increases for North Americans Living With HIV
March 26, 2012
A 20-year-old, HIV-infected individual on treatment who is living in the U.S. or Canada can reasonably expect to live into his or her early 70s, which is slightly lower than the U.S. general average of 78 years, according to a study presented at CROI 2012. However, there were notable differences in life expectancy depending on several factors, including transmission group, race and baseline CD4+ cell count.
The study, entitled "Temporal Changes in Life Expectancy in HIV-Positive Individuals in North America" and presented by Robert Hogg, Ph.D., of the BC Centre for Excellence in HIV/AIDS, is the first to characterize life expectancy numbers for people living with HIV in the U.S. and Canada. Last year, a European study found an average life expectancy for a person living with HIV was 71.5 to 75 years. And a collaborative study published in 2009 found that, across Canada, Western Europe and the U.S., average life expectancy for a person who began HIV treatment between 2003 and 2005 was approximately 70 years.
For the current study, researchers analyzed NA-ACCORD data from 23,739 people, all of whom were treatment naive and at least 20 years old when they started HAART. They found that the average life expectancy for a person living with HIV at age 20 gradually increased from 1996 to 2007, going from 34.4 years in 1996-1999 to 47.1 years in 2006-2007. This increase is significant but still lower than the 58.8-year average for the U.S. general population, according to the U.S. Centers for Disease Control and Prevention.
However, there were some confounding factors, which included race, transmission group and baseline CD4+ cell count.
Among the population studied, African-American life expectancy at age 20 (41.0 years) was lower than that of whites (50.0 years) and Hispanics (52.6 years).
Among transmission groups, life expectancy at age 20 for injection drug users was the lowest at 28.1 years, while it was 51.6 years for MSM (men who have sex with men) and 47.7 for heterosexuals. (The study did not differentiate between HIV-related and non-HIV-related causes of death for injection drug users.)
In terms of baseline CD4+ cell count, all groups that started treatment with a CD4+ cell count above 200 cells/mm3 were found to have similarly high numbers for life expectancy at age 20. The best numbers were seen in those who had a baseline CD4+ cell count between 200 and 349 (52.4 years) or between 350 and 499 (52.6 years), followed by those who started treatment with a baseline CD4+ cell count above 500 (46.4 years).
Concerning the slight drop in life expectancy for those who started treatment at a high CD4+ cell count, lead researcher Hogg noted: "Those that started over 350 in this analysis did so prior to recent changes in guidelines and are likely people starting because of other health issues."
Unsurprisingly, those who started treatment with a baseline CD4+ cell count below 200 had a lower life expectancy. Those who started with a CD4+ cell count between 100 and 199 had a life expectancy at age 20 of 44.2 years, which is comparable to the other groups. But for those with a baseline CD4+ cell count below 100, life expectancy at age 20 was significantly lower, at 29.0 years.
The study did not indicate whether these numbers had implications for the "when to start" and "test and treat" debates.
Overall, the study concluded that life expectancy for those on HIV treatment has increased over time. But Hogg noted that more research still needs to be done to address the differences among transmission groups, race and baseline CD4+ cell counts. "Over the next few months, we hope to complete this paper -- other work will look at disease burden," he said.
CORRECTION : An earlier version of this article stated that the 47.1-year life expectancy for a person living with HIV at age 20 was "slightly" lower than the 58.8-year U.S. general population average. We have corrected the text to reflect that while the life expectancy increase from 34.4 to 47.1 years is significant, it is still lower than the 58.8-year average for the general population.
Warren Tong is the research editor for TheBody.com and TheBodyPRO.com.
Follow Warren on Twitter: @WarrenAtTheBody.
Copyright © 2012 Remedy Health Media, LLC. All rights reserved.
This article was provided by TheBodyPRO. It is a part of the publication The 19th Conference on Retroviruses and Opportunistic Infections
Comment by: Kendall
Thu., Jan. 31, 2013 at 8:52 am UTC
I think a lot of you are missing the point here. lol I know everyone has their frustrations about being diagnosed (TRUST ME I KNOW) but I believe this article is to keep everyone positive and show how far things have come from ppl dying in less than six months and now living to be an old man or woman. Rather than complain I think we should be appreciative for the knowledge we've gotten from Warren and prove that its possible to live to be in our 70's. Thanks Warren for the knowledge :-)
Comment by: kristy
Wed., Jan. 9, 2013 at 11:31 pm UTC
im 20 yrs old i was diagnosed last yr , there should be a CURE FOR HIV / AIDS .
Comment by: James
Thu., Apr. 12, 2012 at 3:15 pm UTC
These finding were all based upon individuals who were at the age of 20 infected and taking Meds. How about an individual who becomes infected with H.I.V. at a later age like 40 years of age? Would it be similar or drastically different? Referring to the years expected to life?
Comment by: Bernard
Thu., Apr. 5, 2012 at 3:51 pm UTC
57, HIV for approx. 30 years, taking Atripla for 3/4 years now, non-drinker & non-smoker (gave up both 3 years ago. Organic & low fat diet, good t-cell count & undetectable viroal load. Problem now is elevated "ALT" levels (250+/-) with liver pain, and possibly r/h side kidney "activity". Any suggestion perhaps as change of venue for time to an HIV drug therapy switch !? Thank you for caring. B.
Comment by: Rhiannon
Thu., Apr. 5, 2012 at 2:09 pm UTC
People still do not understand that when you get to a certain part in your life with AIDS , you have no choice but to try to do a few things that you can and pop pain pills and smoke weed just to live from day to day. I see all these articles about persons with HIV/AIDS are living it well , well that them, it only speaks for themselves, HIV/AIDS effects " EVERYONE" differently. Just because you canlive with it , doesnt mean the other person can, even if they tried. it seems that the ones living on a string in life are never talked about. It's always about those making it , and living life , having fun , blah blah.. One never reads about those like us who are almost bed ridden and or so close to it and still have many more years of life to us. Thanks for the nice article, yet again , keep in mind that not everyone is the same and can re-act to such things in life may work for you , yet will not work for others. - Always a Friend , Rain
Comment by: Anonymous
Sat., Mar. 31, 2012 at 1:34 pm UTC
I agree with Michael. We are all thankful for modern anti-retrovirals. But you would be naive to think that pharmaceutical companies and investors support curative research. Their business model is predicated on sustainability and profit, which translates to lifelong therapies. They will not help to develop a cure, which is why we must take action. The capability is already here, believe it or not. Ever heard of DRACO(http://www.ll.mit.edu/news/DRACO.html? It's been in development for over 11 years by MIT, and has proven to eliminate all 15 viruses tested thus far while being non-toxic in 11 different cell types. It has the potential to eradicate ALL viruses -- it simply needs funding for FDA human clinical trials. For anyone reading this who cares, I strongly recommend you visit the link below and sign the petition to the federal government to increase funding for DRACO. https://wwws.whitehouse.gov/petitions#!/petition/fund-research-draco-mit-developed-drug-might-safely-and-quickly-kill-all-viruses-including-hiv/gDwVkjzv
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Comment by: Dr. Duke
Tue., Apr. 3, 2012 at 11:29 am UTC
DRACO is for ds-RNA (double stranded RNA) viruses. HIV is a retrovirus, it packages ss-RNA and reverse transcribes its genome to DNA which is then integrated into the host cell chromosomes. So DRACO will not work on HIV and other retroviruses.
Comment by: Randy
Fri., Mar. 30, 2012 at 8:27 pm UTC
This article is confusing. Are the numbers how many years they have left or the age they can expect to live to? e.i. 58.8 years to live from 20 or age 58.8?
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Comment by: Warren
Tue., Apr. 3, 2012 at 6:10 pm UTC
Randy, sorry for the confusion. All the numbers are average numbers of years left to live from age 20. so 58.8 years from age 20, or til age 78.8.
Comment by: Andrew
Thu., Mar. 29, 2012 at 3:33 pm UTC
I can understand you're frustration with pharmaceutical companies, but let's give atleast some credit where credit's due. Their drugs work. Obviously we've all faced some very difficult times in the past, and we can only try to make ourselves more educated in the future. We've allowed to become rich off of the poor and sick, but don't they deserve it more than any celebrity you see on television? It's like biting the hand that feeds you. Perhaps you haven't really felt your disease yet. I can deal with itchy dry skin, I can deal with being a bit forgetful every now and then, I can deal with a little tingling in the toes. What I can't deal with is my skin feeling like it's on fire from the lack of cd4 cell's to regulate my immune response, I can't deal with the carposi sarcoma's that were developing on my hands, I can't deal with the juvenile warts I caught from my nephews fingers on my face. So, sure if they could really figure out a better a way to help us help them make more money and fund better treatment, sign me up. And as for those people facing stigma's or prejudice's, I have this to say. Unfortunately we are looking at a day in the future where HIV transmission will become as common as losing at the casino. It's already a pretty common diagnosis in medicine, about one in every fifteen patients know they're positive. It may be higher now, it's been a while since the hospital I worked for fired me because I'd have a tendency to be sick more often than other employees while I was up for suspension, with two physicians excuses. One of them being one of their own physicians. My former title...RN.
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Comment by: Susan
Fri., Mar. 30, 2012 at 4:34 am UTC
But who can afford these miracle drugs? Most of them have extended their patents so they can continue to charge enormous prices for them. There was even an article long ago of some of these pharmacies trying to shut down companies in India that create life saving generics of these medications. That is the work of "the hand that feeds you".
ADAP's waiting list continues to grow. What happens when, not if, the next politician in charge decides it is no longer cost effective to give funds to the HIV cause, for reasons that may or may not be driven by personal beliefs.
No one is doubting that the medicines work. They have tremendous upsides and some downsides. But charging what can be considered an entire income for most people just to stay alive....what becomes with the other aspects of living, such as food and shelter?
Comment by: John
Fri., Mar. 30, 2012 at 4:50 am UTC
Rather than wait for the day when HIV transmission will become as common as losing at the casino, why not demand for a day when the cost of HIV meds become as cheap as aspirin.
Comment by: Paul G.
Thu., Mar. 29, 2012 at 2:33 pm UTC
The author thinks that a difference in life expectancy of 11.7 years between someone starting ARV at age 20 (47.1 yrs) and the average 20 year old (58.8 yrs) is only "slightly lower." Maybe he should re-write the column when he is 70!
Why is it that the report on this study (and Hogg's earlier work) provides the estimates only for 20 year olds. I wish I were 20 but haven't been there for a long time. Where are the estimates for those of us who are somewhat "riper"?
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Comment by: Warren
Fri., Mar. 30, 2012 at 5:16 pm UTC
Thank you for pointing this out. I wanted to optimistic about the estimate. As in, hey, life expectancy for people living with HIV is getting closer to the general population average. But I see what you're saying and we've amended the text accordingly.
Comment by: Paul G.
Thu., Apr. 5, 2012 at 3:13 pm UTC
Thanks, Warren for responding to my comment. I very much appreciate your actions and response.
Comment by: Tim
Thu., Mar. 29, 2012 at 1:25 pm UTC
So when are the life insurance carriers goign to recognize the resarch data that shows little significant impact of HIV infection on life expectancy (assumign proper treatment and regimens). Certainly there are other health factors (smoking, obesity, high blood pressure, extremely high cholesterol, severe asthma, etc.) that would lower ones life expectancy as much or more than HIV infection! Yet HIV automatically excludes us from ever being able to purchase life insurance (except for group coverage through an employer).
Comment by: steve
Tue., Mar. 27, 2012 at 10:16 am UTC
good news for big pharma. that's more years of profits and hiv patients will live longer with diarrhea, failed kidneys, facial wasting, itchy skin, neurological disorders, insomnia.....on top of discrimination and criminalization. halleluiah.
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Comment by: Chuck
Thu., Mar. 29, 2012 at 6:12 pm UTC
Big Pharma? Those evil bloodsuckers! WOW, if I had only refused to take their poison pills, back in 1996, well, I'd be...OH YEAH: I'd be dead. DEAD. D E A D, like my partner, Jonathan, weighing 80 lbs., in '91, followed by partner #2, Ted, covered head-to-toe in ugly purple lesions, in '96. I'm so glad they were spared the skinny legs and gassy bowels of our fortunate selves.
I LOVE Big Pharma,for allowing you and me the luxury of complaining about such relatively benign challenges.
CRL, poz since mid-1980s
Comment by: Michael
Fri., Mar. 30, 2012 at 4:24 am UTC
Chuck. I think the poster's point is quite valid. There is little good will in what pharmacies do. If there is, then they should kindly remove the patent restrictions on the HIV meds. But they don't. They renew it and find ways to fight generic creations that could save many lives. It is not being doubted that the meds work. But not everyone can afford $1500 for a monthly prescription, attached to a premium health care cost and rising insurance costs (and that's if they can get one without the insurance companies kicking them out for pre-existing conditons). Having to choose food or meds, health or home......
It's not just a luxury of complaining as you put it....they are forcing having HIV to be a luxury that MOST who have it just cannot afford. What is the point in having meds that work when they are only available to a few?
DON'T TREAT US. CURE US!
Comment by: jadalynn
Wed., Jan. 9, 2013 at 11:37 pm UTC
well im twenty i have it and they should find a cure it would be my dream come true !!!
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