Advancements in antiretroviral therapy have increased life expectancy for patients with human immunodeficiency virus (HIV) by more than 13 years since the late 1990s, according to research conducted at UAB and Simon Fraser University in Vancouver, British Columbia, and published in the British medical journal The Lancet.
A nearly 40 percent drop in AIDS deaths among HIV-positive study participants in Europe and North America has bolstered the call for improved anti-HIV efforts worldwide, according to study authors, who belong to The Antiretroviral Therapy Cohort Collaboration, which includes UAB and more than a dozen other research sites around the world. Improved testing and access to care could increase those numbers, they say.
Cocktail of drugs
The authors looked at changes in life expectancy and mortality among the 43,355 patients in 14 studies taking a cocktail of drugs called combination antiretroviral therapy (cART).
“Since their introduction in 1996 cART regimens have become more effective, better tolerated and easier to follow,” said Michael Mugavero, M.D., an assistant professor in UAB’s Division of Infectious Diseases and a co-author on the study.
“We now are seeing the benefits of years of research, hard work and efforts to make these medications widely available. This has led to dramatic improvements in life expectancy, but patients who start cART with more advanced HIV infection do not have the same level of benefit,” Mugavero said.
The new Lancet study found cART yielded a 13.8-year life-expectancy increase – from 36.1 years in study participants who began therapy during the 1996-1999 period to 49.9 years in participants who began therapy during the 2003-2005 period.
Despite the good results, the study found the average life expectancy for HIV patients is far lower than the general population, which includes those with other chronic illnesses. For example, an HIV-positive patient starting cART at age 20 will live to 63, about 20 years shorter than the average life span of non-infected adults.
With nearly half of all patients diagnosed with advanced HIV infection, the life expectancy benefits of cART are not fully realized, said Mugavero and lead study author Robert Hogg, Ph.D., of Simon Fraser University. Improved AIDS testing and increased access to care is needed.