Life Expectancy for People Living With HIV Increases by 15 Years

Life expectancy estimates broken down by groups. Adapted from R.S. Hogg et al. IAS 2013; abstract TUPE260.

A person living with HIV who is on treatment in the U.S. or Canada can expect to live almost a normal life span, according to a study presented at IAS 2013. The study, conducted by the NA-ACCORD (North American AIDS Cohort Collaboration on Research and Design), estimated the average life span to be 71.4 years in 2006-2007, an increase of 15 years from 56.1 in 2000-2002.

The researchers followed 22,937 people from the U.S. and Canada; 77% were male and 62% were white. About 39% were men who have sex with men. All participants were at least 20 years old and treatment-naive before starting meds.

The estimates were given in terms of life expectancy at age 20, defined as the average number of additional years a person at age 20 could expect to live (assuming the current age-specific mortality rates remained constant).

Overall, average life expectancy at age 20 jumped from 36.1 in 2000-2002 to 45.2 in 2003-2005, and then to 51.4 in 2006-2007. Depending on demographics and clinical characteristics, these estimates varied.

For men, life expectancy at age 20 increased from 35.9 in 2000-2002 to 44.4 in 2003-2005 and 53.4 in 2006-2007. For women, there was actually a slight decrease in the most recent time period studied, from 48.4 in 2003-2005 to 47.3 in 2006-2007.

For men who have sex with men, the estimate increased from 57.4 in 2003-2005 to 69.3 in 2006-2007 (the highest estimate for any group). By contrast, another high-risk transmission group, injection drug users, saw a virtually unchanged life expectancy change over the course of the study, from 29.5 in 2000-2002 to 31.0 in 2003-2005 and 28.8 in 2006-2007.

The CD4+ cell count at the time of starting treatment also made a big difference. For those with a CD4+ cell count greater than 350, life expectancy at 20 jumped from 48.8 in 2000-2002 to 58.4 in 2003-2005 and 68.6 in 2006-2007. Meanwhile, for those with a CD4+ cell count below 350, the estimate went up from 31.4 in 2000-2002 to 40.8 in 2003-2005 and 46.9 in 2006-2007.

Race was also a significant factor, as whites had a life expectancy at age 20 of 56.9 in 2006-2007, compared to 48.4 for non-whites.

Nonetheless, despite disparities based on sex, race, mode of transmission and CD4+ cell count, the general trend was an increase in life expectancy for anyone on treatment. Given that the most recent data available in this study were from 2007, it can be hoped that in the years since we have come even closer to matching the life expectancy of the general population. Other recent research suggests this may indeed be the case.