Cited by 363HIV/AIDS Research and InterventionsHIV-related health complications and treatmentsHIV Research and Treatment

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Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study

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May, M., Gompels, M., Delpech, V., Porter, K., Post, F., Johnson, M., Dunn, D., Palfreeman, A., Gilson, R., Gazzard, B., Hill, T., Walsh, J., Fisher, M., Orkin, C., Ainsworth, J., Bansi, L., Phillips, A., Leen, C., Nelson, M., Anderson, J., Sabin, C.·2011·BMJ

DOI 10.1136/bmj.d6016PMC PMC3191202

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Abstract

OBJECTIVES: To estimate life expectancy for people with HIV undergoing treatment compared with life expectancy in the general population and to assess the impact on life expectancy of late treatment, defined as CD4 count <200 cells/mm(3) at start of antiretroviral therapy. DESIGN: Cohort study. SETTING: Outpatient HIV clinics throughout the United Kingdom. Population Adult patients from the UK Collaborative HIV Cohort (UK CHIC) Study with CD4 count ≤ 350 cells/mm(3) at start of antiretroviral therapy in 1996-2008. MAIN OUTCOME MEASURES: Life expectancy at the exact age of 20 (the average additional years that will be lived by a person after age 20), according to the cross sectional age specific mortality rates during the study period. RESULTS: 1248 of 17,661 eligible patients died during 91,203 person years' follow-up. Life expectancy (standard error) at exact age 20 increased from 30.0 (1.2) to 45.8 (1.7) years from 1996-9 to 2006-8. Life expectancy was 39.5 (0.45) for male patients and 50.2 (0.45) years for female patients compared with 57.8 and 61.6 years for men and women in the general population (1996-2006). Starting antiretroviral therapy later than guidelines suggest resulted in up to 15 years' loss of life: at age 20, life expectancy was 37.9 (1.3), 41.0 (2.2), and 53.4 (1.2) years in those starting antiretroviral therapy with CD4 count <100, 100-199, and 200-350 cells/mm(3), respectively. CONCLUSIONS: Life expectancy in people treated for HIV infection has increased by over 15 years during 1996-2008, but is still about 13 years less than that of the UK population. The higher life expectancy in women is magnified in those with HIV. Earlier diagnosis and subsequent timely treatment with antiretroviral therapy might increase life expectancy.

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Authors: May, M., Gompels, M., Delpech, V., Porter, K., Post, F., Johnson, M., Dunn, D., Palfreeman, A., Gilson, R., Gazzard, B., Hill, T., Walsh, J., Fisher, M., Orkin, C., Ainsworth, J., Bansi, L., Phillips, A., Leen, C., Nelson, M., Anderson, J., & Sabin, C.
Affiliations: University of Bristol (GB)
North Bristol NHS Trust (GB)
University College London (GB)
King's College London (GB)
The Royal Free Hospital (GB)
Medical Research Council (GB)
Leicester Royal Infirmary (GB)
Mortimer Market Centre (GB)
Chelsea and Westminster Hospital (GB)
Imperial College Healthcare NHS Trust (GB)
Brighton and Sussex University Hospitals NHS Trust (GB)
Queen Mary University of London (GB)
North Middlesex Hospital (GB)
Western General Hospital (GB)
Homerton University Hospital (GB)
Corresponding author: May, M.
ORCID: May, M.
Gompels, M.
Delpech, V.
Porter, K.
Post, F.
Johnson, M.
Dunn, D.
Palfreeman, A.
Gilson, R.
Hill, T.
Walsh, J.
Fisher, M.
Orkin, C.
Phillips, A.
Leen, C.
Nelson, M.
Anderson, J.
Sabin, C.
Venue: BMJ
Publisher: BMJ
Published: 2011-10-11
Volume: 343
Issue: oct11 2
Pages: d6016-d6016
ISSN: 0007-1447 (ISSN-L)
0959-8138
1468-5833
DOI: 10.1136/bmj.d6016
PMC: PMC3191202
OpenAlex: W2008613145
Cited by: 363
References: 40
Citations by year: 2026: 9 · 2025: 12 · 2024: 11 · 2023: 21 · 2022: 21 · 2021: 18 · 2020: 21 · 2019: 22 · 2018: 26 · 2017: 16 · 2016: 42 · 2015: 39 · 2014: 31 · 2013: 34 · 2012: 30
FWCI: 22.54
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
Locations: BMJ (publishedVersion, cc-by-nc)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
Research Portal (King's College London) (publishedVersion, other-oa)
Figshare (submittedVersion, cc-by)
ResearchOnline (submittedVersion)
Sussex Research Online (University of Sussex) (submittedVersion)
UCL Discovery (University College London) (submittedVersion)
Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by-nc)
Bristol Research (University of Bristol) (submittedVersion)
ResearchOnline (Glasgow Caledonian University) (submittedVersion, cc-by-nc)
Funders: Medical Research Council
Topics: Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Health Sciences › Medicine › Infectious Diseases › HIV-related health complications and treatments
Life Sciences › Immunology and Microbiology › Virology › HIV Research and Treatment
Keywords: HIV-1, life expectancy, delayed diagnosis, late treatment, antiretroviral therapy, CD4 count, mortality, sex differences
MeSH terms: Adult, Aged, Cooperative Behavior, Drug Therapy, Combination, Female, United Kingdom, Humans, Life Expectancy, Male, Middle Aged, Time Factors, Cohort Studies, HIV-1, HIV Infections, Practice Guidelines as Topic, CD4 Lymphocyte Count, Anti-HIV Agents, Young Adult, Delayed Diagnosis

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Impact of late diagnosis and treatment on life expectancy in people with HIV-1: UK Collaborative HIV Cohort (UK CHIC) Study

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