15 YEAR HIV LIFE EXPECTANCY INCREASE IN UK

New research has found the life expectancy of HIV-positive individuals in the UK has increased by over 15 years since 1996 but warns that late treatment results in a lower life expectancy.

The findings, published on Wednesday in the British Medical Journal, suggest that improvements in antiretroviral therapy treatment has helped people with the disease to live longer.

Until now, few studies have estimated how long those with HIV in the UK are likely to live. The Medical Research Council (MRC)-funded study, led by academics at the University of Bristol and UCL, examined the life expectancy for individuals treated for HIV in comparison with the rest of the UK population.

Using data from a study of 17,661 patients who started antiretroviral therapy between 1996-2008, the researchers estimated the additional years that will be lived by an HIV-positive individual after age 20.

The team found that the average life expectancy in HIV-positive individuals has increased from 30 years in 1996 to 1999 to just under 46 years in 2006 to 2008 although this is still 13 years less than that of the UK population.

Starting treatment later than guidelines suggest resulted in up to 15-years loss of life: at age 20, life expectancy was 53 years in those starting antiretroviral therapy with CD4 count between 200 and 350 cells compared with 38 years in those with CD4 count below 100 cells.

The findings also reveal a ten-year higher life expectancy of women compared with men who are treated for HIV-infection. 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.

“We should expect further improvements for patients starting antiretroviral therapy now with improved modern drugs and new guidelines recommending earlier treatment,” said Dr Margaret May, lead author and Senior Research Fellow in the University’s School of Social and Community Medicine.

“However, the results show a 15-year loss in life expectancy of those who start antiretroviral therapy at a more advanced stage of disease so there is a need to identify HIV-positive individuals early in the course of their infection before substantial CD4 loss has occurred to avoid the very large negative impact this has.”

Mortality rates have decreased such that, compared with the general population, the risk of death in successfully treated HIV-positive patients is similar to that of persons with unhealthy lifestyles (e.g. heavy smoking, drinking or obesity) or other chronic conditions such as diabetes.

Dr May added: “Our findings strongly support the concept of more widespread HIV testing. It is also of clear benefit to patients to have the prognosis made in terms of their life expectancy and this might have considerable impact on patients’ uptake of testing.”