Barcelona 2013
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| Abstract #297 - E-Posters English | ||||
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Session: 50.132: E-Posters English (Poster) on Sunday in Chaired by Authors: Presenting Author: Dr Anna Esteve - Agència de Salut Pública de Catalunya-ICO, Spain |
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| Additional Authors: Dr. Jordi Casabona, Sra Cristina Sanclemente, Dra. Anna Esteve, Dra. Victoria Gonzalez, Grupo HIVITS TS, | ||||
| Aim: Antiretroviral therapy (ART) has led to consistent improvements in survival among HIV-infected individuals. Estimates of life expectancy (LE) and potential years of life lost (PYLL) are important for policy makers and healthcare providers in order to assess future treatment and care needs. These estimates are also important for individual patients since favorable prognoses should allow an easier access to mortgages and life insurance, in line with other chronic illnesses. We describe changes over time in the mortality and LE of HIV-positive individuals on ART between 1998-2011 in the PISCIS Cohort. | ||||
| Method / Issue: The PISCIS Cohort is a prospective study of 14613 HIV-positive patients (73726.8 person-years (PY) of followup) aged 16 years or over, who have attended participating centres (12 in Catalonia and 2 in the Balearic Islands) since 1998. Periodic linkage with the mortality register is undertaken. Patients were included in this analysis if they were antiretroviral-naïve and initiated ART between 01/01/1998 and 31/12/2011. Abridged life tables were constructed to estimate LE for individuals on ART during 3 follow-up periods: 1998-2000, 2001-2005 and 2006- 2011. PYLL from 20 to 64 years of age, crude and age-specific death rates were calculated, expressed per 1000 PY of follow-up. All indicators were stratified by sex, transmission group, region of origin and CD4 count on ART initiation. | ||||
| Results / Comments: 7415 patients were included in the analysis (mean follow-up 5.1 years) of whom 563 (7.6%) died during the study period. Death rates and PYLL decreased from 19.6 and 421 in 1998-2000 to 8.8 and 170 in 2006-2011, respectively. Global LE at age 20 years was estimated to be 40.5 years, increasing from 37.7 to 47.2 years during the study period. LE was higher among heterosexual women (50.2) and men who have sex with men (49.4) compared to heterosexual men (36.6) and injection drug users (28.7). LE was higher in patients born outside Spain (48.0 vs 38.7) and in HIV monoinfected patients (48.0), but lower in HCV coinfected (HBV negative) patients (29.2) and in patients with a low CD4 count at ART initiation (32.1 at CD4<200 vs 46.4 at CD4≥350). | ||||
| Discussion: Despite a 10 year increase in overall LE among HIV patients on ART from 1998 to 2011, it remains 14 years lower than that of the Spanish general population and lower in heterosexual men compared to MSM. | ||||
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