Stichting HIV Monitoring, Academic Medical Centre of the University of Amsterdam, Amsterdam, The Netherlands.
AIDS. 2010 Jun 19;24(10):1527-35. doi: 10.1097/QAD.0b013e32833a3946.
To compare life expectancies between recently diagnosed HIV-infected patients and age and sex-matched uninfected individuals from the general population.
: National observational HIV cohort in the Netherlands.
Four thousand, six hundred and twelve patients diagnosed with HIV between 1998 and 2007 and still antiretroviral therapy-naive as of 24 weeks after diagnosis were selected. Progression to death compared to the age and sex-matched general population was studied with a multivariate hazards model in 4174 (90.5%) patients without AIDS events at 24 weeks. Life expectancy and number of life years lost were calculated using the predicted survival distribution.
During 17 580 person-years of follow-up since 24 weeks after diagnosis [median follow-up 3.3 years, interquartile range (IQR) 1.6-5.8], 118 deaths occurred, yielding a mortality rate of 6.7 [95% confidence interval (CI) 5.5-8.0] per 1000 person-years. Median CD4 cell counts at 24 weeks were 480 cells/microl (IQR 360-650). According to the model, the median number of years lived from age 25 was 52.7 (IQR 44.2-59.3; general population 53.1) for men and 57.8 (49.2-63.7; 58.1) for women without CDC-B event. The number of life years lost varied between 0.4 if diagnosed with HIV at age 25 and 1.4 if diagnosed at age 55; for patients with a CDC-B event this range was 1.8-8.0 years.
The life expectancy of asymptomatic HIV-infected patients who are still treatment-naive and have not experienced a CDC-B or C event at 24 weeks after diagnosis approaches that of non-infected individuals. However, follow-up time is short compared to the expected number of years lived.
比较近期诊断的 HIV 感染者与普通人群中年龄和性别匹配的未感染者的预期寿命。
荷兰全国性 HIV 观察队列。
选择 1998 年至 2007 年间诊断为 HIV 且在诊断后 24 周仍未接受抗逆转录病毒治疗的 4612 例患者。在 4174 例（90.5%）未发生 AIDS 事件的患者中，采用多变量风险模型比较从诊断后 24 周开始至死亡的进展情况。使用预测生存分布计算预期寿命和失去的预期寿命年数。
在诊断后 24 周开始的 17580 人年随访期间[中位随访时间 3.3 年，四分位间距（IQR）1.6-5.8]，发生 118 例死亡，死亡率为 6.7[95%置信区间（CI）5.5-8.0]/1000 人年。24 周时的 CD4 细胞计数中位数为 480 个/µl（IQR 360-650）。根据模型，从 25 岁开始，男性的中位预期寿命为 52.7（IQR 44.2-59.3；普通人群为 53.1），女性为 57.8（49.2-63.7；58.1），无 CDC-B 事件。如果在 25 岁时诊断为 HIV，则预期寿命损失 0.4 年；如果在 55 岁时诊断为 HIV，则预期寿命损失 1.4 年；对于有 CDC-B 事件的患者，该范围为 1.8-8.0 年。
在诊断后 24 周仍未接受治疗且未发生 CDC-B 或 C 事件的无症状 HIV 感染者的预期寿命接近未感染者。然而，与预期寿命相比，随访时间较短。
