AIDS Vol. 26; No. 3: P. 335-343 (01.28.12) - Tuesday, February
"Effective antiretroviral therapy has contributed greatly
toward survival for people with HIV, yet many remain
undiagnosed until very late. Our aims were to estimate the
life expectancy of an HIV-infected MSM [man who has sex with
men] living in a developed country with extensive access to
ART and health care, and to assess the effect of late
diagnosis on life expectancy," the researchers wrote.
A stochastic computer simulation model of HIV infection and
ART's effect was used to estimate life expectancy and
determine the distribution of potential lifetime outcomes of a
30-year-old MSM who becomes HIV-positive in 2010. The effect
of altering the diagnosis rate was investigated.
Projected median age at death (life expectancy) was 75.0
years, assuming a high rate of HIV diagnosis (median CD4 cell
count at diagnosis, 432 cells/microliter); this implies an
average of 7.0 years of life lost due to HIV. Cumulative risks
of death by five and 10 years after infection were 2.3 percent
and 5.2 percent, respectively. "The 95 percent uncertainty
bound for life expectancy was (68.0, 77.3) years. When a low
diagnosis rate was assumed (diagnosis only when symptomatic,
median CD4 cell count 140 cells/microliter), life expectancy
was 71.5 years, implying an average 10.5 years of life lost
due to HIV," according to the results.
"If low rates of virologic failure observed in treated
patients continue, predicted life expectancy is relatively
high in people with HIV who can access a wide range of
antiretrovirals. The greatest risk of excess mortality is due
to delays in HIV diagnosis," concluded the researchers.