Life expectancy of individuals on combination antiretroviral therapy in high-income countries: a collaborative analysis of 14 cohort studies.
Open accessAbstract
Background Combination antiretroviral therapy has led to significant increases in survival and quality of life, but at a population-level the effect on life expectancy is not well understood. Our objective was to compare changes in mortality and life expectancy among HIV-positive individuals on combination antiretroviral therapy.Methods The Antiretroviral Therapy Cohort Collaboration is a multinational collaboration of HIV cohort studies in Europe and North America. Patients were included in this analysis if they were aged 16 years or over and antiretroviral-naive when initiating combination therapy. We constructed abridged life tables to estimate life expectancies for individuals on combination antiretroviral therapy in 1996-99, 2000-02, and 2003-05, and stratified by sex, baseline CD4 cell count, and history of injecting drug use. The average number of years remaining to be lived by those treated with combination antiretroviral therapy at 20 and 35 years of age was estimated. Potential years of life lost from 20 to 64 years of age and crude mortality rates were also calculated.Findings 18 587, 13 914, and 10 854 eligible patients initiated combination antiretroviral therapy in 1996-99, 2000-02, and 2003-05, respectively. 2056 (4.7%) deaths were observed during the study period, with crude mortality rates decreasing from 16.3 deaths per 1000 person-years in 1996-99 to 10.0 deaths per 1000 person-years in 2003-05. Potential years of life lost per 1000 person-years also decreased over the same time, from 366 to 189 years. 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. 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). 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 muL vs 50.4 [0.4] years for counts of 200 cells per muL or more).Interpretation Life expectancy in HIV-infected patients treated with combination antiretroviral therapy increased between 1996 and 2005, although there is considerable variability between subgroups of patients. The average number of years remaining to be lived at age 20 years was about two-thirds of that in the general population in these countries.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
A 20-year-old adult starting ART may have already lost one-third of remaining life expectancy.
“It has been estimated that a 20 year-old adult initiating ART may already have lost one-third of the remaining life expectancy [61].”
From T-cell aging in rheumatoid arthritis (2014) · cites this paper as [61]
On average, a 20 year old initiating ART may have already lost one third of the expected remaining years of life compared to demographically similar HIV-uninfected persons.
“On average, a 20 year old initiating ART may have already lost 1/3 of the expected remaining years of life compared to demographically similar HIV-uninfected persons (5).”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Palella, F. J., Delaney, K. M., Moorman, A. C., Loveless, M. O., Fuhrer, J., Satten, G. A., Aschman, D. J., & Holmberg, S. D. (1998) · New England Journal of Medicine · doi:10.1056/nejm199803263381301 · Cited by 9,393 · see citing works
Egger, M., May, M., Chêne, G., Phillips, A. N., Ledergerber, B., Dabis, F., Costagliola, D. G., Monforte, A. D., de Wolf, F., Reiss, P., et al. (2002) · The Lancet · doi:10.1016/s0140-6736(02)09411-4 · Cited by 1,526 · see citing works
Changing patterns of mortality across Europe in patients infected with HIV-1
Mocroft, A., Vella, S., Benfield, T., Chiesi, A., Miller, V., Gargalianos, P., Monforte, A. D., Yust, I., Bruun, J., Phillips, A. N., et al. (1998) · The Lancet · doi:10.1016/s0140-6736(98)03201-2 · Cited by 1,269 · see citing works
Braitstein, P. K. A. (2006) · The Lancet · doi:10.1016/s0140-6736(06)68337-2 · Cited by 1,106 · see citing works
Treatment for Adult HIV Infection
Hammer, S. M., Saag, M. S., Schechter, M., Montaner, J. S. G., Schooley, R. T., Jacobsen, D. M., Thompson, M., Carpenter, C. C. J., Fischl, M. A., Gazzard, B., et al. (2006) · JAMA · doi:10.1001/jama.296.7.827 · Cited by 1,034 · see citing works
Staszewski, S., Morales-Ramirez, J. O., Tashima, K. T., Rachlis, A., Skiest, D. J., Stanford, J., Stryker, R., Johnson, P. C., Labriola, D., Farina, D., et al. (1999) · New England Journal of Medicine · doi:10.1056/nejm199912163412501 · Cited by 993 · see citing works
Tenofovir DF, Emtricitabine, and Efavirenz vs. Zidovudine, Lamivudine, and Efavirenz for HIV
Gallant, J. E., DeJesus, E., Arribas, J. R., Pozniak, A., Gazzard, B., Campo, R. E., Lu, B., McColl, D. J., Chuck, S. L., Enejosa, J., et al. (2006) · New England Journal of Medicine · doi:10.1056/nejmoa051871 · Cited by 880 · see citing works
Improved Survival Among HIV-Infected Individuals Following Initiation of Antiretroviral Therapy
Hogg, R. S. (1998) · JAMA · doi:10.1001/jama.279.6.450 · Cited by 840 · see citing works
Detels, R. (1998) · JAMA · doi:10.1001/jama.280.17.1497 · Cited by 750 · see citing works
. Survival of persons with and without HIV infection in Denmark, 1995-2005.
Lohse, N., Hansen, A.-B. E., Pedersen, G., Kronborg, G., Gerstoft, J., Sørensen, H. T., Væth, M., & Obel, N. (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-146-2-200701160-00003 · Cited by 748 · see citing works
van Leth, F., Phanuphak, P., Ruxrungtham, K., et al. (2004) · The Lancet · doi:10.1016/s0140-6736(04)15997-7 · Cited by 686 · see citing works
Egger, M., Hirschel, B. J., Francioli, P. B., Sudre, P., Wirz, M., Flepp, M., Rickenbach, M., Malinverni, R., Vernazza, P., & Battegay, M. (1997) · BMJ · doi:10.1136/bmj.315.7117.1194 · Cited by 615 · see citing works
The Survival Benefits of AIDS Treatment in the United States
Walensky, R. P., Paltiel, A. D., Losina, E., Mercincavage, L. M., Schackman, B. R., Sax, P. E., Weinstein, M. C., & Freedberg, K. A. (2006) · The Journal of Infectious Diseases · doi:10.1086/505147 · Cited by 580 · see citing works
Montaner, J. S. G., Hogg, R. S., Wood, E., Kerr, T. H., TYNDALL, M. W., Levy, A. R., & Harrigan, P. R. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69162-9 · Cited by 554 · see citing works
Sterne, J. A. C., Hernán, M. Á., Ledergerber, B., Tilling, K. M., Weber, R. K., Sendi, P., Rickenbach, M., Robins, J. M., & Egger, M. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67022-5 · Cited by 550 · see citing works
Arnsten, J. H., Demas, P., Grant, R. W., Gourevitch, M. N., Farzadegan, H., Howard, A. A., & Schoenbaum, E. E. (2002) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2002.10644.x · Cited by 501 · see citing works
Comparisons of Causes of Death and Mortality Rates Among HIV-Infected Persons
Crum, N. F., Riffenburgh, R. H., Wegner, S. A., Agan, B. K., Tasker, S. A., Spooner, K., Armstrong, A. W., Fraser, S. L., & Wallace, M. R. (2006) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/01.qai.0000179459.31562.16 · Cited by 456 · see citing works
Natural history of HIV infection in the_era of combination antiretroviral therapy
Moore, R. D., & Chaisson, R. E. (1999) · AIDS · doi:10.1097/00002030-199910010-00017 · Cited by 454 · see citing works
Grabar, S., Moing, V. L., Goujard, C., et al. (2000) · Annals of Internal Medicine · doi:10.7326/0003-4819-133-6-200009190-00007 · Cited by 417 · see citing works
Years of Potential Life Lost (YPLL)—What Does it Measure?
Gardner, J. W., & Sanborn, J. S. (1990) · Epidemiology · doi:10.1097/00001648-199007000-00012 · Cited by 407 · see citing works
Decline in deaths from AIDS due to new antiretrovirals
Hogg, R. S., O’Shaughnessy, M. V., Gataric, N., et al. (1997) · The Lancet · doi:10.1016/s0140-6736(05)62505-6 · Cited by 377 · see citing works
Lewden, C. (2004) · International Journal of Epidemiology · doi:10.1093/ije/dyh307 · Cited by 373 · see citing works
Comparison of Sequential Three-Drug Regimens as Initial Therapy for HIV-1 Infection
Robbins, G. K., Gruttola, V. D., Shafer, R. W., Smeaton, L. M., Snyder, S. W., Pettinelli, C. B., Dubé, M. P., Fischl, M. A., Pollard, R. B., Delapenha, R., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa030264 · Cited by 351 · see citing works
Lima, V. D., Hogg, R. S., Harrigan, P. R., et al. (2007) · AIDS · doi:10.1097/qad.0b013e32802ef30c · Cited by 280 · see citing works
Combination Antiretroviral Therapy and Recent Declines in AIDS Incidence and Mortality
Vittinghoff, E., Scheer, S., OʼMalley, P. M., Colfax, G. N., Holmberg, S. D., & Buchbinder, S. P. (1999) · The Journal of Infectious Diseases · doi:10.1086/314623 · Cited by 275 · see citing works
Chêne, G., Sterne, J. A. C., May, M., Costagliola, D. G., Ledergerber, B., Phillips, A. N., Dabis, F., Lundgren, J. D., Monforte, A. D., de Wolf, F., et al. (2003) · The Lancet · doi:10.1016/s0140-6736(03)14229-8 · Cited by 247 · see citing works
MAY, M. T. (2006) · The Lancet · doi:10.1016/s0140-6736(06)69152-6 · Cited by 226 · see citing works
Fang, C., Chang, Y.-C., Hsu, H. M., Twu, S.-J., Chen, K. T., Lin, C. C., Huang, L. Y. L., Chen, M. Y., Hwang, J., Wang, J., et al. (2006) · QJM · doi:10.1093/qjmed/hcl141 · Cited by 164 · see citing works
Valdez, H., Chowdhry, T. K., Asaad, R. J., et al. (2001) · Clinical Infectious Diseases · doi:10.1086/320164 · Cited by 140 · see citing works
Braithwaite, R. S., Kozal, M. J., Chang, C., Roberts, M. S., Fultz, S. L., Goetz, M. B., Gibert, C. L., Rodriguez‐Barradas, M. C., Mole, L. A., & Justice, A. C. (2007) · AIDS · doi:10.1097/qad.0b013e3281532b31 · Cited by 119 · see citing works
Bonnet, F., Morlat, P., Chêne, G., et al. (2002) · HIV Medicine · doi:10.1046/j.1468-1293.2002.00117.x · Cited by 119 · see citing works
Declining HIV/AIDS Mortality in New York City
Chiasson, M. A., Berenson, L., Li, W., Schwartz, S. P., Singh, T., Forlenza, S. W., Mojica, B. A., & Hamburg, M. A. (1999) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-199905010-00008 · Cited by 96 · see citing works
May, M., Royston, P., Egger, M., Justice, A., & Sterne, J. A. C. (2004) · Statistics in Medicine · doi:10.1002/sim.1825 · Cited by 81 · see citing works
Long-Term HIV/AIDS Survival Estimation in the Highly Active Antiretroviral Therapy Era
King, J. T., Justice, A. C., Roberts, M. S., et al. (2003) · Medical Decision Making · doi:10.1177/0272989x02239652 · Cited by 72 · see citing works
Lloyd‐Smith, E., Brodkin, E., Wood, E., et al. (2006) · AIDS · doi:10.1097/01.aids.0000206508.32030.92 · Cited by 70 · see citing works
Wong, K. H., Chan, K. C.-W., & Lee, S. S. (2004) · Clinical Infectious Diseases · doi:10.1086/423183 · Cited by 51 · see citing works
Antiretroviral Therapy Cohort Collaboration (2007) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e31815b7dba · Cited by 50 · see citing works
Staehelin, C., Egloff, N., Rickenbach, M., et al. (2004) · AIDS Patient Care and STDs · doi:10.1089/apc.2004.18.665 · Cited by 33 · see citing works
Efficacy and Durability of Nevirapine in Antiretroviral Drug Naïve Patients
Lange, J. M. A. (2003) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/00126334-200309011-00007 · Cited by 27 · see citing works
Years of potential life lost due to HIV infection in the United States
Selik, R. M., & Chu, S. Y. (1997) · AIDS · doi:10.1097/00002030-199713000-00013 · Cited by 19 · see citing works
There and back again: the impact of adult HIV prevalence on national life expectancies
McGuire, A., Barer, J. M., Montaner, J., et al. (2005) · HIV Medicine · doi:10.1111/j.1468-1293.2005.00266.x · Cited by 7 · see citing works
[Causes of death in HIV-infected French drug users, 1995-2000].
Lewden, C., Bonnet, F., Bevilacqua, S., et al. (2002) · PubMed · Cited by 7 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- [1]Chiang CL The life table and its construction Introduction to stochastic processes in biostatistics New York John Wiley and Sons 1968 189 214
Cited by
Sorted by citations
Guaraldi, G., Orlando, G., Zona, S., Menozzi, M., Carli, F., Garlassi, E., Berti, A., Rossi, E., Roverato, A., & Palella, F. (2011) · Clinical Infectious Diseases · doi:10.1093/cid/cir627 · Cited by 1,331 · see citing works
Montaner, J. S., Lima, V. D., Barrios, R., Yip, B., Wood, E., Kerr, T., Shannon, K., Harrigan, P. R., Hogg, R. S., Daly, P., et al. (2010) · The Lancet · doi:10.1016/s0140-6736(10)60936-1 · Cited by 780 · see citing works
HIV infection, antiretroviral treatment, ageing, and non-AIDS related morbidity.
Deeks, S. G., & Phillips, A. N. (2009) · BMJ · doi:10.1136/bmj.a3172 · Cited by 704 · see citing works
High, K. P., Brennan-Ing, M., Clifford, D. B., Cohen, M. H., Currier, J., Deeks, S. G., Deren, S., Effros, R. B., Gebo, K., Goronzy, J. J., et al. (2012) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0b013e31825a3668 · Cited by 522 · see citing works
Marcus, J. L., Chao, C. R., Leyden, W. A., Xu, L., Quesenberry, C. P., Klein, D. B., Towner, W. J., Horberg, M. A., & Silverberg, M. J. (2016) · JAIDS Journal of Acquired Immune Deficiency Syndromes · doi:10.1097/qai.0000000000001014 · Cited by 439 · see citing works
May, M., Gompels, M., Delpech, V., Porter, K., Post, F., Johnson, M., Dunn, D., Palfreeman, A., Gilson, R., Gazzard, B., et al. (2011) · BMJ · doi:10.1136/bmj.d6016 · Cited by 363 · see citing works
HIV and aging: time for a new paradigm.
Justice, A. C. (2010) · Current HIV/AIDS Reports · doi:10.1007/s11904-010-0041-9 · Cited by 309 · see citing works
Buford, T. W., Anton, S. D., Judge, A. R., Marzetti, E., Wohlgemuth, S. E., Carter, C. S., Leeuwenburgh, C., Pahor, M., & Manini, T. M. (2010) · Ageing Research Reviews · doi:10.1016/j.arr.2010.04.004 · Cited by 295 · see citing works
Ageing and inflammation in patients with HIV infection
Nasi, M., De Biasi, S., Gibellini, L., Bianchini, E., Pecorini, S., Bacca, V, Guaraldi, G., Mussini, C., Pinti, M., & Cossarizza, A. (2016) · Clinical and Experimental Immunology · doi:10.1111/cei.12814 · Cited by 277 · see citing works
Helleberg, M., May, M. T., Ingle, S. M., Dabis, F., Reiss, P., Fätkenheuer, G., Costagliola, D., d’Arminio, A., Cavassini, M., Smith, C., et al. (2015) · AIDS · doi:10.1097/qad.0000000000000540 · Cited by 268 · see citing works
Increased Risk of Fragility Fractures among HIV Infected Compared to Uninfected Male Veterans
Womack, J. A., Goulet, J. L., Gibert, C., Brandt, C., Chang, C. C., Gulanski, B., Fraenkel, L., Mattocks, K., Rimland, D., Rodriguez-Barradas, M. C., et al. (2011) · PLoS ONE · doi:10.1371/journal.pone.0017217 · Cited by 261 · see citing works
Freeman, R., Gwadz, M. V., Silverman, E., Kutnick, A., Leonard, N. R., Ritchie, A. S., Reed, J., & Martinez, B. Y. (2017) · International Journal for Equity in Health · doi:10.1186/s12939-017-0549-3 · Cited by 184 · see citing works
de Bruin, M. (2010) · Archives of Internal Medicine · doi:10.1001/archinternmed.2009.536 · Cited by 181 · see citing works
HIV reservoirs: pathogenesis and obstacles to viral eradication and cure
Chun, T.-W., & Fauci, A. S. (2012) · AIDS · doi:10.1097/qad.0b013e328353f3f1 · Cited by 175 · see citing works
T-cell aging in rheumatoid arthritis
Weyand, C. M., Yang, Z., & Goronzy, J. J. (2014) · Current Opinion in Rheumatology · doi:10.1097/bor.0000000000000011 · Cited by 164 · see citing works
. Towards a combined prognostic index for survival in HIV infection: the role of non-HIV biomarkers.
Justice, A., McGinnis, K., Skanderson, M., Chang, C., Gibert, C., Goetz, M., Rimland, D., Rodriguez‐Barradas, M., Oursler, K., Brown, S., et al. (2010) · HIV Medicine · doi:10.1111/j.1468-1293.2009.00757.x · Cited by 159 · see citing works
Cohen, R. A., Seider, T. R., & Navia, B. (2015) · Alzheimer's Research & Therapy · doi:10.1186/s13195-015-0123-4 · Cited by 149 · see citing works
Samad, F., Harris, M., Puskas, C. M., Ye, M., Chia, J., Chacko, S., Bondy, G. P., Lima, V. D., Montaner, J. S., & Guillemi, S. A. (2017) · BMJ Open Diabetes Research & Care · doi:10.1136/bmjdrc-2017-000457 · Cited by 53 · see citing works
Velichkovska, M., Surnar, B., Nair, M., Dhar, S., & Toborek, M. (2019) · Molecular Pharmaceutics · doi:10.1021/acs.molpharmaceut.8b01014 · Cited by 49 · see citing works
Resistance to HIV integrase strand transfer inhibitors: in vitro findings and clinical consequences
Grobler, J. A., & Hazuda, D. J. (2014) · Current Opinion in Virology · doi:10.1016/j.coviro.2014.07.006 · Cited by 30 · see citing works
Probiotic effects on immunity and microbiome in HIV-1 discordant patients
Blázquez-Bondia, C., Parera, M., Català-Moll, F., Casadellà, M., Elizalde-Torrent, A., Aguiló, M., Espadaler-Mazo, J., Santos, J. R., Paredes, R., & Noguera-Julian, M. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.1066036 · Cited by 30 · see citing works
Past, Present, and Future Drug Delivery Systems for Antiretrovirals
Kirtane, A. R., Langer, R., & Traverso, G. (2016) · Journal of Pharmaceutical Sciences · doi:10.1016/j.xphs.2016.09.015 · Cited by 28 · see citing works
HIV infection and its psychiatric manifestations:A clinical overview
Knights, M. J., Chatziagorakis, A., & Kumar Buggineni, S. (2017) · BJPsych Advances · doi:10.1192/apt.bp.116.016311 · Cited by 18 · see citing works
. Aging, HIV, and wellness: augmenting the components of successful aging.
Vance, D. E., Bayless, H., Kempf, M.-C., Keltner, N. L., & Fazeli, P. L. (2011) · Aging Health · doi:10.2217/ahe.11.28 · Cited by 9 · see citing works
- Authors
- ‡
- Affiliations
- BC Centre for Excellence in HIV/AIDS (CA)
- Corresponding author
- ‡
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2008-07
- Volume
- 372
- Issue
- 9635
- Pages
- 293-299
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- PMC
- PMC3130543
- OpenAlex
- W1573558157
- Cited by
- 1,661
- References
- 42
- Citations by year
- 2026: 30 · 2025: 35 · 2024: 48 · 2023: 72 · 2022: 55 · 2021: 72 · 2020: 83 · 2019: 79 · 2018: 96 · 2017: 99 · 2016: 117 · 2015: 109 · 2014: 144 · 2013: 137 · 2012: 140
- FWCI
- 73.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Funders
- National Science Foundation
- GlaxoSmithKline
- Styrelsen för Internationellt Utvecklingssamarbete
- Michael Smith Health Research BC
- European Commission
- Agence Nationale de la Recherche
- Institut National de la Santé et de la Recherche Médicale
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
- Stichting HIV Monitoring
- Canadian Institutes of Health Research
- Medical Research Council
- National Institute on Alcohol Abuse and Alcoholism (U10AA013566)
- Topics
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
- Health Sciences › Medicine › Emergency Medicine › HIV-related health complications and treatments
- Health Sciences › Medicine › Infectious Diseases › HIV/AIDS drug development and treatment
- Keywords
- HIV, highly active antiretroviral therapy, life expectancy, mortality, years of life lost, CD4 count, intravenous drug use, sex differences, HIV transmission routes, abridged life tables, HIV survival, high-income countries
- MeSH terms
- Adolescent, Adult, Female, Humans, Life Expectancy, Male, Middle Aged, Sex Factors, Cohort Studies, Multicenter Studies as Topic, HIV Infections, Life Tables, Developed Countries, Antiretroviral Therapy, Highly Active
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
