Life expectancy in HIV-positive persons in Switzerland: matched comparison with general population.

Güler, Aysel; Moser, André; Calmy, Alexandra; Günthard, Huldrych F; Bernasconi, Enos; Furrer, Hansjakob; Fux, Christoph A; Battegay, Manuel; Cavassini, Matthias; Vernazza, Pietro; Zwahlen, Marcel; Egger, Matthias (2017). Life expectancy in HIV-positive persons in Switzerland: matched comparison with general population. AIDS, 31(3), pp. 427-436. Lippincott Williams & Wilkins 10.1097/QAD.0000000000001335

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OBJECTIVES To estimate life expectancy (LE) over 25 years in HIV-positive people and compare their LE with recent estimates for the general population, by education. METHODS Patients aged 20 years or older enrolled in the Swiss HIV Cohort Study 1988-2013 were eligible. Patients alive in 2001 were matched to up to 100 Swiss residents, by sex, year of birth, and education. LE at age 20 was estimated for monotherapy (1988-1991), dual therapy (1992-1995), early combination antiretroviral therapy (cART, 1996-1998), later cART (1999-2005) and recent cART (2006-2013) eras. Parametric survival regression was used to model life expectancy. RESULTS 16,532 HIV-positive patients and 927,583 residents were included. LE at age 20 of HIV-positive individuals increased from 11.8 years (95% CI 11.2-12.5) in the monotherapy era to 54.9 years (95% CI 51.2-59.6) in the most recent cART era. Differences in LE across educational levels emerged with cART. In the most recent cART period, LE at age 20 years was 52.7 years (95% CI 46.4-60.1) with compulsory education, compared to 60.0 years (53.4-67.8) with higher education. Estimates for the general population were 61.5 years and 65.6 years, respectively. Male sex, smoking, injection drug use and low CD4 counts at enrolment were also independently associated with mortality. CONCLUSION In Switzerland educational inequalities in LE were larger among HIV-infected persons than in the general population. Highly educated HIV-positive people have an estimated LE similar to Swiss residents with compulsory education. Earlier start of cART and effective smoking cessation programs could improve HIV-positive LE further and reduce inequalities.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Geriatric Clinic
04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Infectiology

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Güler, Aysel; Moser, André; Furrer, Hansjakob; Zwahlen, Marcel and Egger, Matthias

Subjects:

300 Social sciences, sociology & anthropology > 360 Social problems & social services
600 Technology > 610 Medicine & health

ISSN:

0269-9370

Publisher:

Lippincott Williams & Wilkins

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

09 Dec 2016 17:16

Last Modified:

09 Feb 2018 10:08

Publisher DOI:

10.1097/QAD.0000000000001335

PubMed ID:

27831953

BORIS DOI:

10.7892/boris.91347

URI:

https://boris.unibe.ch/id/eprint/91347

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