HIV is linked not only with a reduced life expectancy but also a greater proportion of life spent with various illnesses, known as comorbidities. This is according to analysis of people with and without HIV in British Columbia (B.C.) during the modern era of antiretroviral treatment for the virus.
Publishing their findings in The Lancet HIV, researchers from the Comparative Outcomes and Service Utilization Trends (COAST) study analyzed 1996 to 2012 data on B.C. residents age 20 and older, including all people known to have HIV (9,310 people) and a random sample of the general HIV-negative population (510,313 people).
The investigators looked at rates of diseases common among people with HIV, including cardiovascular, respiratory, liver and kidney diseases, as well as non-AIDS-defining cancers. They obtained information about deaths from a B.C. registry.
Between them, the cohort members contributed a cumulative 5.58 million years of follow-up. A total of 49,605 of them died during the study period. After adjusting the data for various factors, the study authors found that the death rate per cumulative 1,000 years of life was 30 and 36.5 deaths among HIV-positive men and women, respectively, and 8.3 and 5.8 deaths among HIV-negative men and women, respectively.
The researchers calculated what is known as a health-adjusted life expectancy (HALE) for the cohort members, which in the case of this study reflected the projected number of years individuals were expected to live past age 20 without comorbidities as well as the expected proportion of their life they were expected to spend with comorbidities.
Among men, the respective adjusted proportions of people with and without HIV experiencing various comorbidities were 3.2 percent and 1.9 percent for non-AIDS-defining cancers (a 1.6-fold increased risk for people with HIV, compared with those without HIV), 5.5 percent and 7.3 percent for cardiovascular disease (30 percent reduced risk), 13.2 percent and 1.8 percent for liver disease (7.3-fold increased risk), 6.3 percent and 1.2 percent for kidney disease (5.1-fold increased risk) and 4.4 percent and 4.8 percent for respiratory disease (10 percent reduced risk).
Among women, the respective adjusted proportions of people with and without HIV experiencing various comorbidities were 1.6 percent and 1.8 percent for cancers (a 20 percent decreased risk for people with HIV, compared with those without HIV), 2.8 percent and 5.2 percent for cardiovascular disease (50 percent reduced risk), 14.5 percent and 1.5 percent for liver disease (9.8-fold increased risk) and 7.7 percent and 5.8 percent for respiratory disease (1.3-fold increased risk).
Among men, the HALE for those with HIV was 24.4 years of comorbid-free life past age 20 with 28 percent of life spent with comorbid illnesses and a respective 47.4 years and 22 percent of life for those without HIV. Among women the corresponding respective figures were 20 years and 31 percent of life for those with HIV and 51.9 years and 21 percent of life for those without HIV.
To read the study abstract, click here.