20th International AIDS Conference - Melbourne, Australia

Abstract

MOPE091 - Poster Exhibition


Life expectancy (LE) of HIV-positive individuals in the HAART era (1996-2010) compared to LE in the general population: a longitudinal analysis of the COAST cohort from British Columbia (BC), Canada

O. Eyawo1,2, K. Chan2, D. Shopin2, A. Cescon2, G. Colley2, H. Samji2, M. Hull2, S.A. Lear1, J.S. Montaner2,3, R.S. Hogg1,2

1Simon Fraser University, Faculty of Health Sciences, Burnaby, Canada, 2British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada, 3University of British Columbia, Faculty of Medicine, Vancouver, Canada

Background: We characterized the life expectancy (LE) of a population-based cohort of HIV-positive adults (≥19 years) compared to a random sample of the general BC population from 1996-2010.
Methods: The Comparative Outcomes And Service utilization Trends (COAST) study was constructed from de-identified health-related data from the BC Centre for Excellence in HIV/AIDS and Population Data BC for the period 1996-2010. Our analysis involved a random 1% sample of the general BC adult population (cohort 1) and HIV-positive individuals ever having accessed at least one ARV or HAART (cohort 2). LE, defined as the average number of additional years that an individual in a given age category will live assuming the current age-specific mortality rate remains constant over the course of the individual''s lifetime, was estimated using abridged life tables.
Results: 47,683 and 8,620 individuals contributed 472,443 and 66,601 person-years(PY) in cohort 1 (51% men) and cohort 2 (83% men), with a crude mortality rate (/1,000 PY) of 8.4 (95% CI: 8.1, 8.7) and 30.5 (95% CI: 29.2, 31.9) respectively. Over the study period, LE at 20 years was lower in the HIV-positive cohort (+32.1 years, SE=0.6) compared to the general population (+61.3 years, SE=0.1). HIV-positive men had a higher LE at 20 years (+32.2 years, SE=0.8) compared to HIV-positive women (+29.4 years, SE=0.8). Conversely, men in the general population had a lower LE at 20 years (+59.1 years, SE=0.1) compared to women (+63.4 years, SE=0.1). Across time (1996-2000, 2001-2005, 2006-2010), LE at 20 years increased from +26.4 (SE=1.0) to +33.4 (SE=0.7) to +36.3 (SE=1.6)years in the HIV-positive cohort. The general population LE at 20 years was relatively stable changing from +61.7 (SE=0.2) to +62.1 (SE=0.1) to +61.5 (SE=0.2)years during this time.
Conclusions: LE improved over time with increasing use of HAART from 1996 onwards. Our estimates for the HIV-positive cohort are attenuated compared to recent LE analyses in other cohorts, because we have not restricted to those just initiating HAART and included individuals who started on suboptimal regimens in 1996. Future analyses will consider ARV-naïve individuals initiating modern HAART with the aim of creating estimates more relevant to the current context of antiretroviral care.


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