Abstract
Introduction: National cohort and intercohort studies have been set to describe the differences of life expectancy (LE) of HIV-infected individuals. Objective: The aim of this study was to assess the impact of immune recovery (IR) on LE of patients with HIV undergoing combination antiretroviral therapy. Methods: In this retrospective observational study, outcome measure was LE of patients with HIV compared with LE of northern Italian population. Group categorizations were as follows: patients with no immune recovery (nIR), patients with IR, patients who are immune maintained, and pre-highly active antiretroviral therapy (HAART) and post-HAART. Abridged life tables were constructed from age-specific mortality rates (per 1000 person years) to estimate LE from the age of 20-55 years. Results: A total of 9671 patients, 71% men, were included. After 2005, we assisted to a rapid increase in the overall rate of patients attaining IR in the community coupled with a progressive decrease of AIDS death, but not of non-AIDS deaths. In a 40-year-old patient, LE was 38.10 years [standard error (SE) = 2.60], 30.08 years (SE = 0.98), and 22.9 (SE = 0.69) in the IR, post-HAART group and nIR, respectively, compared with 41.38 years of the general Italian population. An approximately 5-year gap in LE was observed in IR patients. Discussion: We describe IR at a "community" level, related to calendar year and apparent 10 years after HAART introduction. HAART community IR is significantly influencing LE and is associated with the changing clinical picture of HIV disease. An increasing gradient of LE exists between nIR, post-HAART, and IR groups, with the latter, above the age of 40 years only, reaching LE of general population.
| Original language | English |
|---|---|
| Pages (from-to) | 175-181 |
| Number of pages | 7 |
| Journal | Journal of Acquired Immune Deficiency Syndromes |
| Volume | 65 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2014 |
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Keywords
- HAART era
- Immune recovery
- Immune recovery era
- Life expectancy
- Mortality
ASJC Scopus subject areas
- Infectious Diseases
- Pharmacology (medical)
Cite this
Life expectancy in the immune recovery era : The evolving scenario of the HIV epidemic in northern Italy. / Guaraldi, Giovanni; Cossarizza, Andrea; Franceschi, Claudio; Roverato, Alberto; Vaccher, Emanuela; Tambussi, Giuseppe; Garlassi, Elisa; Menozzi, Marianna; Mussini, Cristina; Monforte, Antonella D arminio.
In: Journal of Acquired Immune Deficiency Syndromes, Vol. 65, No. 2, 2014, p. 175-181.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Life expectancy in the immune recovery era
T2 - The evolving scenario of the HIV epidemic in northern Italy
AU - Guaraldi, Giovanni
AU - Cossarizza, Andrea
AU - Franceschi, Claudio
AU - Roverato, Alberto
AU - Vaccher, Emanuela
AU - Tambussi, Giuseppe
AU - Garlassi, Elisa
AU - Menozzi, Marianna
AU - Mussini, Cristina
AU - Monforte, Antonella D arminio
PY - 2014
Y1 - 2014
N2 - Introduction: National cohort and intercohort studies have been set to describe the differences of life expectancy (LE) of HIV-infected individuals. Objective: The aim of this study was to assess the impact of immune recovery (IR) on LE of patients with HIV undergoing combination antiretroviral therapy. Methods: In this retrospective observational study, outcome measure was LE of patients with HIV compared with LE of northern Italian population. Group categorizations were as follows: patients with no immune recovery (nIR), patients with IR, patients who are immune maintained, and pre-highly active antiretroviral therapy (HAART) and post-HAART. Abridged life tables were constructed from age-specific mortality rates (per 1000 person years) to estimate LE from the age of 20-55 years. Results: A total of 9671 patients, 71% men, were included. After 2005, we assisted to a rapid increase in the overall rate of patients attaining IR in the community coupled with a progressive decrease of AIDS death, but not of non-AIDS deaths. In a 40-year-old patient, LE was 38.10 years [standard error (SE) = 2.60], 30.08 years (SE = 0.98), and 22.9 (SE = 0.69) in the IR, post-HAART group and nIR, respectively, compared with 41.38 years of the general Italian population. An approximately 5-year gap in LE was observed in IR patients. Discussion: We describe IR at a "community" level, related to calendar year and apparent 10 years after HAART introduction. HAART community IR is significantly influencing LE and is associated with the changing clinical picture of HIV disease. An increasing gradient of LE exists between nIR, post-HAART, and IR groups, with the latter, above the age of 40 years only, reaching LE of general population.
AB - Introduction: National cohort and intercohort studies have been set to describe the differences of life expectancy (LE) of HIV-infected individuals. Objective: The aim of this study was to assess the impact of immune recovery (IR) on LE of patients with HIV undergoing combination antiretroviral therapy. Methods: In this retrospective observational study, outcome measure was LE of patients with HIV compared with LE of northern Italian population. Group categorizations were as follows: patients with no immune recovery (nIR), patients with IR, patients who are immune maintained, and pre-highly active antiretroviral therapy (HAART) and post-HAART. Abridged life tables were constructed from age-specific mortality rates (per 1000 person years) to estimate LE from the age of 20-55 years. Results: A total of 9671 patients, 71% men, were included. After 2005, we assisted to a rapid increase in the overall rate of patients attaining IR in the community coupled with a progressive decrease of AIDS death, but not of non-AIDS deaths. In a 40-year-old patient, LE was 38.10 years [standard error (SE) = 2.60], 30.08 years (SE = 0.98), and 22.9 (SE = 0.69) in the IR, post-HAART group and nIR, respectively, compared with 41.38 years of the general Italian population. An approximately 5-year gap in LE was observed in IR patients. Discussion: We describe IR at a "community" level, related to calendar year and apparent 10 years after HAART introduction. HAART community IR is significantly influencing LE and is associated with the changing clinical picture of HIV disease. An increasing gradient of LE exists between nIR, post-HAART, and IR groups, with the latter, above the age of 40 years only, reaching LE of general population.
KW - HAART era
KW - Immune recovery
KW - Immune recovery era
KW - Life expectancy
KW - Mortality
UR - http://www.scopus.com/inward/record.url?scp=84893727161&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84893727161&partnerID=8YFLogxK
U2 - 10.1097/QAI.0000000000000018
DO - 10.1097/QAI.0000000000000018
M3 - Article
C2 - 24442223
AN - SCOPUS:84893727161
VL - 65
SP - 175
EP - 181
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
SN - 1525-4135
IS - 2
ER -