British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada.
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada ; Simon Fraser University, Burnaby, British Columbia, Canada.
PLoS One. 2013 Dec 18;8(12):e81355. doi: 10.1371/journal.pone.0081355. eCollection 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).
A 20-year-old HIV-positive adult on ART in the U.S. or Canada is expected to live into their early 70 s, a life expectancy approaching that of the general population. Differences by sex, race, HIV transmission risk group, and CD4 count remain.
联合抗逆转录病毒疗法（ART）显著提高了美国和加拿大艾滋病毒阳性成年人的存活率，但该地区的预期寿命增长情况尚未得到充分描述。我们旨在评估 2000-2007 年美国和加拿大接受 ART 的艾滋病毒阳性成年人的预期寿命的时间变化。
参与者来自北美艾滋病队列合作研究和设计（NA-ACCORD），年龄≥20 岁，正在接受 ART 治疗。死亡率是通过参与者从 2000 年 1 月 1 日或开始接受 ART 治疗之日起至 2007 年 12 月 31 日死亡、失访或行政截止的个人时间计算得出的。20 岁时的预期寿命定义为特定年龄的人在当前特定年龄死亡率保持不变的情况下预期还能再活的平均年数，使用简略寿命表进行估计。
22937 名参与者中有 1622 人死亡，共提供 82022 人年，粗死亡率为 19.8/1000 人年。从 2000-2002 年到 2006-2007 年，预期寿命从 36.1[标准误差（SE）0.5]岁增加到 51.4[SE 0.5]岁。男性和女性在所有时期的预期寿命都相当，除了最后一个时期（2006-2007 年）。有注射吸毒史、非白人以及基线 CD4 计数<350 个细胞/mm3的个体的预期寿命较低。
在美国或加拿大，接受 ART 的 20 岁艾滋病毒阳性成年人预计能活到 70 岁出头，接近普通人群的预期寿命。性别、种族、HIV 传播风险组和 CD4 计数的差异仍然存在。
