Trends in life expectancy of HIV-positive adults on antiretroviral therapy across the globe: comparisons with general population.

Wandeler, Gilles; Johnson, Leigh F; Egger, Matthias (2016). Trends in life expectancy of HIV-positive adults on antiretroviral therapy across the globe: comparisons with general population. Current Opinion in HIV and AIDS, 11(5), pp. 492-500. Lippincott Williams & Wilkins 10.1097/COH.0000000000000298

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PURPOSE OF REVIEW

Improved virological and immunological outcomes and reduced toxicity of antiretroviral combination therapy (ART) raise the hope that life expectancy of HIV-positive persons on ART will approach that of the general population. We systematically review the literature and summarize published estimates of life expectancy of HIV-positive populations on ART. We compare their life expectancy with the life expectancy of the general or, in sub-Saharan Africa, HIV-negative populations, by time period and gender.

RECENT FINDINGS

Ten relevant studies were published from 2006 to 2015. Three studies were from Canada, two from European countries, three from sub-Saharan Africa and two were multicountry studies. Life expectancy increased over time in all studies and regions. Expressed as the percentage of life expectancy in the HIV-negative or general population, estimated life expectancy at age 20 years in HIV-positive people on ART ranged from 60.3% (95% CI 58.0-62.6%) in Rwanda (2008-2011) to 89.1% (95% CI 84.7-93.6%) in Canada (2008-2012). The percentage of life expectancy in the HIV-negative or general population achieved was higher in HIV-positive women than in HIV-positive men in all countries, except for Canada wherein the opposite was the case.

SUMMARY

Life expectancy in HIV-positive people on ART has improved worldwide in recent years, but important gaps remain compared with the general and HIV-negative population, and between regions and genders.

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