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Impact on life expectancy of HIV-1 positive individuals of CD4(+) cell count and viral load response to antiretroviral therapy

May, MT; Gompels, M; Delpech, V; Porter, K; Orkin, C; Kegg, S; Hay, P; Johnson, M; Palfreeman, A; Gilson, R; et al. May, MT; Gompels, M; Delpech, V; Porter, K; Orkin, C; Kegg, S; Hay, P; Johnson, M; Palfreeman, A; Gilson, R; Chadwick, D; Martin, F; Hill, T; Walsh, J; Post, F; Fisher, M; Ainsworth, J; Jose, S; Leen, C; Nelson, M; Anderson, J; Sabin, C; UK Collaborative HIV Cohort (UK CHIC) Study (2014) Impact on life expectancy of HIV-1 positive individuals of CD4(+) cell count and viral load response to antiretroviral therapy. AIDS, 28 (8). 1193 - 1202. ISSN 0269-9370 https://doi.org/10.1097/QAD.0000000000000243
SGUL Authors: Hay, Phillip Edward

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Abstract

Objective:The objective of this study is to estimate life expectancies of HIV-positive patients conditional on response to antiretroviral therapy (ART). Methods: Patients aged more than 20 years who started ART during 2000–2010 (excluding IDU) in HIV clinics contributing to the UK CHIC Study were followed for mortality until 2012. We determined the latest CD4+ cell count and viral load before ART and in each of years 1–5 of ART. For each duration of ART, life tables based on estimated mortality rates by sex, age, latest CD4+ cell count and viral suppression (HIV-1 RNA <400copies/ml), were used to estimate expected age at death for ages 20–85 years. Results: Of 21388 patients who started ART, 961 (4.5%) died during 110697 person-years. At start of ART, expected age at death [95% confidence interval (CI)] of 35-year-old men with CD4+ cell count less than 200, 200–349, at least 350cells/μl was 71 (68–73), 78 (74–82) and 77 (72–81) years, respectively, compared with 78 years for men in the general UK population. Thirty-five-year-old men who increased their CD4+ cell count in the first year of ART from less than 200 to 200–349 or at least 350cells/μl and achieved viral suppression gained 7 and 10 years, respectively. After 5 years on ART, expected age at death of 35-year-old men varied from 54 (48–61) (CD4+ cell count <200cells/μl and no viral suppression) to 80 (76–83) years (CD4+ cell count ≥350cells/μl and viral suppression). Conclusion: Successfully treated HIV-positive individuals have a normal life expectancy. Patients who started ART with a low CD4+ cell count significantly improve their life expectancy if they have a good CD4+ cell count response and undetectable viral load.

Item Type: Article
Additional Information: Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
Keywords: Science & Technology, Life Sciences & Biomedicine, Immunology, Infectious Diseases, Virology, IMMUNOLOGY, INFECTIOUS DISEASES, VIROLOGY, HIV-1 RNA, HIV, CD4+ cell count, life expectancy, antiretroviral therapy, viral load, HIV-1-INFECTED PATIENTS, COLLABORATIVE ANALYSIS, GENERAL-POPULATION, INFECTED ADULTS, PROGNOSTIC IMPORTANCE, COHORT, MORTALITY, DIAGNOSIS, UK, IMMUNODEFICIENCY, 11 Medical And Health Sciences, 06 Biological Sciences, 17 Psychology And Cognitive Sciences
SGUL Research Institute / Research Centre: Academic Structure > Infection and Immunity Research Institute (INII)
Journal or Publication Title: AIDS
ISSN: 0269-9370
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Dates:
DateEvent
15 May 2014Published
Web of Science ID: WOS:000335654000012
URI: https://openaccess.sgul.ac.uk/id/eprint/107161
Publisher's version: https://doi.org/10.1097/QAD.0000000000000243

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