Hasina Samji 1 , Angela Cescon 1 , Robert S. Hogg 1 , 2 , * , Sharada P. Modur 3 , Keri N. Althoff 3 , Kate Buchacz 4 , Ann N. Burchell 5 , Mardge Cohen 6 , Kelly A. Gebo 3 , M. John Gill 7 , Amy Justice 8 , Gregory Kirk 3 , Marina B. Klein 9 , P. Todd Korthuis 10 , Jeff Martin 11 , Sonia Napravnik 12 , Sean B. Rourke 5 , Timothy R. Sterling 13 , Michael J. Silverberg 14 , Stephen Deeks 15 , Lisa P. Jacobson 3 , Ronald J. Bosch 16 , Mari M. Kitahata 17 , James J. Goedert 18 , Richard Moore 3 , Stephen J. Gange 3 , for The North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD) of IeDEA
18 December 2013
Combination antiretroviral therapy (ART) has significantly increased survival among HIV-positive adults in the United States (U.S.) and Canada, but gains in life expectancy for this region have not been well characterized. We aim to estimate temporal changes in life expectancy among HIV-positive adults on ART from 2000–2007 in the U.S. and Canada.
Participants were from the North American AIDS Cohort Collaboration on Research and Design (NA-ACCORD), aged ≥20 years and on ART. Mortality rates were calculated using participants' person-time from January 1, 2000 or ART initiation until death, loss to follow-up, or administrative censoring December 31, 2007. Life expectancy at age 20, defined as the average number of additional years that a person of a specific age will live, provided the current age-specific mortality rates remain constant, was estimated using abridged life tables.
The crude mortality rate was 19.8/1,000 person-years, among 22,937 individuals contributing 82,022 person-years and 1,622 deaths. Life expectancy increased from 36.1 [standard error (SE) 0.5] to 51.4 [SE 0.5] years from 2000–2002 to 2006–2007. Men and women had comparable life expectancies in all periods except the last (2006–2007). Life expectancy was lower for individuals with a history of injection drug use, non-whites, and in patients with baseline CD4 counts <350 cells/mm 3.