This article is more than 5 years old. Information may no longer be current.
Exhaustion of HIV therapies expected for some patients
Click Here to Manage Email Alerts
GLASGOW — As treatment options are exhausted in the coming years, a substantial difference in life expectancy between people living with HIV and the general population is expected —particularly for those with HIV acquired at a younger age or for those who are highly treatment-experienced, according to presenter James Jansson, research assistant in the surveillance and evaluation program of public health at the Kirby Institute in Australia.
A model aimed at projecting the future life expectancy of people living with HIV in resource-rich settings estimated that the median time until exhaustion of currently available treatment options is 43.4 years and that 10% will use up all currently available ART options after only 22.6 years.
“If we had an increased life expectancy in people living with HIV, this means that there is a greater amount of time that a person may experience a resistance event with their medication. So, this means we’ll need more medications when we first starting introducing ART,” Jansson said.
Although data have suggested normal life expectancies for people living with HIV receiving ART, the effect of multiclass resistance on long-term survival has not been considered, according to the study abstract. Therefore, Jansson and colleagues pooled data from an observational cohort of 3,434 (94.2% male) people living with HIV in Australia between 1997 and 2010.
The researchers then analyzed the potential time to exhaustion of all treatment options and the anticipated effect on HIV-associated mortality with an individual-based mathematical model. According to the abstract, standardized mortality ratios were used to simulate expected survival before and after treatment exhaustion.
After adjusting for treatment option exhaustion, those who initiate currently available ART regimens at age 20 years are anticipated to live to a median of 64.7 years compared with 82.2 years for an HIV-uninfected male in the general population. This life expectancy gap was even greater for those who acquired HIV at a younger age.
“We have evidence that most people will likely have sufficient ART options to see them through to the rest of their life, but a small portion of people living with HIV will not have sufficient options through the end of their life,” Jansson said. “Younger people who initiated treatment during the 1990s will be more affected by this limitation in ART.”
For more information:
Jansson J. #132. Presented at: HIV11 Congress; Nov. 11-15, 2012; Glasgow.
Disclosure: Jansson reports no relevant financial disclosures.