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Life Expectancy & Comorbidities in HIV:
 
 
  "early death from comorbid conditions".."policy implications"
 
from Jules: this first link immediately below takes you to the latest published study on life excpectancy in HIV. This study performed by the CDC examined patients diagnosed while the 2nd link is to a study examining patients on HAART so you have to be careful in comparing results & consider these differences. Of particular note is the 4th link below which is to a study finding that HIV+ individuals will die prematurely on average from comorbidities: an estimated 41% of patients eventually die of non-HIV-related causes. Of these patients, 35% were estimated to die of cardiovascular causes, 26% of cancer, 12% of liver failure, and 28% of other causes." ......The projected risk from comorbid disease has clinical and policy implications for future delivery of care to HIV-infected patients."...These studies report IDUs and Blacks & Latinos will sufffer less life expectancy. SO WHERE Is our Federal NIH policy? As we spend hundreds of millions on vaccines and globally and eradication, some think a pipedream, USA patients get 'dissed' because this problem of early premature death facing HIV+ in the USA is NOT prioritized because we are not as important as these other NIH priorities. There are many factors that apparently lead to premature death & comorbidities. A crucial concern is that several studies find HIV accelerates aging due to activation & senescence causing inflammation, we need more research on this to understand it and to try to find a way to intervene. We need to declare this a priority and to form an organized effort with funding dedicated and selected leadership in the NIH to address this real problem. At this time 20% of HIV+ in the USA are over 50 yrs old, it's estimated 50% by 2015, and for the first time a significant number of HIV+ are now in the 60s. .....The MACS Study reported HIV+ are at a 10-times greater risk for experiencing frailty and experience it 10 years earlier than for HIV-negatives also study suggests people with HIV for 20-30 are at much greater risk for frailty.....Studies show bone loss and osteopenia & osteoporosis are present at much higher rates IN HIV+ and at much earlier age and this DOES lead to greater fracture risk, in the general population fractures increase mortality & frailty which also leads to mortality......"Cognitive and neurologic disease is another key problem in HIV....
 
HIV Life Expectancy Study Published - pdf attached - (01/19/09) Life Expectancy After HIV Diagnosis Based on National HIV Surveillance Data From 25 States, United States
JAIDS Journal of Acquired Immune Deficiency Syndromes: January 2010 "Disparity in life expectancy for females and both black and Hispanic males, compared with males and white males, respectively, persists and should be addressed."
 
Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies - (01/19/09)
The Lancet, Volume 372, Issue 9635, Pages 293 - 299, 26 July 2008
The Antiretroviral Therapy Cohort Collaboration
"Life expectancy at age 20 years increased from 36·1 (SE 0·6) years to 49·4 (0·5) years. Women had higher life expectancies than did men...... Life expectancy was lower in patients with lower baseline CD4 cell counts than in those with higher baseline counts (32·4 [1·1] years for CD4 cell counts below 100 cells per µL vs 50·4 [0·4] years for counts of 200 cells per µL or more).....Women had higher life expectancies than did men. Patients with presumed transmission via injecting drug use had lower life expectancies than did those from other transmission groups (32·6 [1·1] years vs 44·7 [0·3] years in 2003-05)."
 
Estimating the proportion of patients infected with HIV who will die of comorbid diseases - pdf attached - (01/20/09)
Am J Med Volume 118, Issue 8, Pages 890-898 (August 2005)
R. Scott Braithwaite, MD, Amy C. Justice, MD
"large proportions of patients with HIV will die of causes that are not directly attributable to HIV"...."HIV is increasingly a disease that people die with rather than a disease that people die from. The results of our simulation suggest that a substantial proportion of deaths among HIV-infected patients in the current treatment era will not be directly attributable to HIV. Indeed, for many of the groups examined, the simulation estimates that a majority of deaths will be from nonattributable causes"......"For patients with newly diagnosed HIV infections, CD4 counts of 500 cells/mm3, and viral loads of 10000 copies/mL, the median estimated survival was 26.8 years for 30-year-olds, 24.4 years for 40-year-olds and 14.6 years for 50-year-olds....For 30-year-old patients with CD4 counts of 800 cells/mm3 and viral loads of 10000 copies/mL, median life expectancy was 31.3 years. In contrast, for patients of the same age with CD4 counts of 200 cells/mm3 and viral loads of 1000000 copies/mL, estimated median life expectancy was only 12.2 years......Using baseline estimates obtained from CHORUS, the projected median age at death was 60.4 years, and an estimated 41% of patients eventually die of non-HIV-related causes. Of these patients, 35% were estimated to die of cardiovascular causes, 26% of cancer, 12% of liver failure, and 28% of other causes."
 
HIV-1 Infection Is Associated With an Earlier Occurrence of a Phenotype Related to Frailty: HIV+ men in MACS 10-Times More Likely to Exhibit Frailty than HIV-negative Men. - (04/20/09)
The Journals of Gerontology Series A: Biological Sciences and Medical Sciences (2007)
 
Survival of Persons with and without HIV Infection in Denmark, 1995-2005 - (01/26/07)
Annals of Internal Medicine
16 January 2007 | Volume 146 Issue 2 | Pages 87-95
Nicolai Lohse
"....people with HIV infection still have a shorter life expectancy than do people in the general population ... the proportion of known causes of death that were related to HIV infection decreased from 76% in 1995 to 1996, to 57% in 1997 to 1999, and to 43% in 2000 to 2005..... In 2000 to 2005, life expectancy at age 25 years was 51 years in the general population and 39 years for HIV-infected persons without hepatitis C virus infection (HCV).... Persons with HIV and HCV coinfection had considerably higher mortality rates than those who were HCV-negative...."
 
Will HIV Drug Resistance Rates Increase? Improved Virological Outcomes in British Columbia Concomitant with Decreasing Incidence of HIV Type 1 Drug Resistance Detection - (01/17/09)
 
HIV Drug Resistance Set to Rise? Publication Pdf attached - (01/15/10)
 
 
 
 
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