PLOS ONE2014-01-12 11:46 PM

Closing the Gap: Increases in Life Expectancy among Treated HIV-Positive Individuals in the United States and Canada 缩小差距:提高美国和加拿大接受治疗的HIV阳性患者的预期寿命

Abstract 论文摘要 Background 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. 背景 抗逆转录病毒联合疗法(ART)已显著提高美国和加拿大HIV阳性成人群体的生存率,但该地区预期寿命的增长仍未被很好地表征。我们旨在估计美国和加拿大地区2000-2007年间接受ART 治疗的HIV阳性成人患者预期寿命的短时变化。 Methods 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. 方法 受测者筛选自北美艾滋病群体研究与设计协会(NA-ACCORD),他们年龄均不小于20岁且正接受ART治疗。我们使用自2000年1月1日开始或初始ART治疗直至死亡,随访丢失,或截至2007年12月31日行政审查的受测者人次来计算死亡率。据现有特定年龄死亡率维持恒定的情况下,我们使用简略生命表估计预期寿命为20岁,这被认定为特定年龄个体能活的额外平均寿命。 Results 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/mm3. 结果 粗略死亡率为19.8 / 1000人年,即22,937个个体达到82,022人-年和1,622例死亡。在2000-2002年间和2006-2007年间,预期寿命从36.1年[标准误差(SE)0.5]增长到51.4年[SE 0.5]。除了最后阶段(2006-2007年),男性和女性在所有时期都具有可比的预期寿命。有注射吸毒史的有色人种和那些基线CD4计数在350 细胞/毫升以下的患者具有较低预期寿命。 Conclusions 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. 结论 在美国或加拿大接受ART治疗的20岁HIV阳性成人患者预计可以活到70来岁,这和一般人口的寿命非常接近。由性别,种族,艾滋病病毒传播危险群,和CD4细胞计数造成的差异仍然存在。

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