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dc.contributor.authorTrickey, Adam
dc.contributor.authorSabin, Caroline A
dc.contributor.authorBurkholder, Greer
dc.contributor.authorCrane, Heidi
dc.contributor.authord'Arminio Monforte, Antonella
dc.contributor.authorEgger, Matthias
dc.contributor.authorGill, M John
dc.contributor.authorGrabar, Sophie
dc.contributor.authorGuest, Jodie L
dc.contributor.authorJarrin-Vera, Inmaculada 
dc.contributor.authorLampe, Fiona C
dc.contributor.authorObel, Niels
dc.contributor.authorReyes, Juliana M
dc.contributor.authorStephan, Christoph
dc.contributor.authorSterling, Timothy R
dc.contributor.authorTeira, Ramon
dc.contributor.authorTouloumi, Giota
dc.contributor.authorWasmuth, Jan-Christian
dc.contributor.authorWit, Ferdinand
dc.contributor.authorWittkop, Linda
dc.contributor.authorZangerle, Robert
dc.contributor.authorSilverberg, Michael J
dc.contributor.authorJustice, Amy
dc.contributor.authorSterne, Jonathan A C
dc.identifier.citationLancet HIV. 2023 May;10(5):e295-e307.es_ES
dc.description.abstractBackground: The life expectancy of people with HIV taking antiretroviral therapy (ART) has increased substantially over the past 25 years. Most previous studies of life expectancy were based on data from the first few years after starting ART, when mortality is highest. However, many people with HIV have been successfully treated with ART for many years, and up-to-date prognosis data are needed. We aimed to estimate life expectancy in adults with HIV on ART for at least 1 year in Europe and North America from 2015 onwards. Methods: We used data for people with HIV taking ART from the Antiretroviral Therapy Cohort Collaboration and the UK Collaborative HIV Cohort Study. Included participants started ART between 1996 and 2014 and had been on ART for at least 1 year by 2015, or started ART between 2015 and 2019 and survived for at least 1 year; all participants were aged at least 16 years at ART initiation. We used Poisson models to estimate the associations between mortality and demographic and clinical characteristics, including CD4 cell count at the start of follow-up. We also estimated the remaining years of life left for people with HIV aged 40 years who were taking ART, and stratified these estimates by variables associated with mortality. These estimates were compared with estimates for years of life remaining in a corresponding multi-country general population. Findings: Among 206 891 people with HIV included, 5780 deaths were recorded since 2015. We estimated that women with HIV at age 40 years had 35·8 years (95% CI 35·2-36·4) of life left if they started ART before 2015, and 39·0 years (38·5-39·5) left if they started ART after 2015. For men with HIV, the corresponding estimates were 34·5 years (33·8-35·2) and 37·0 (36·5-37·6). Women with CD4 counts of fewer than 49 cells per μL at the start of follow-up had an estimated 19·4 years (18·2-20·5) of life left at age 40 years if they started ART before 2015 and 24·9 years (23·9-25·9) left if they started ART after 2015. The corresponding estimates for men were 18·2 years (17·1-19·4) and 23·7 years (22·7-24·8). Women with CD4 counts of at least 500 cells per μL at the start of follow-up had an estimated 40·2 years (39·7-40·6) of life left at age 40 years if they started ART before 2015 and 42·0 years (41·7-42·3) left if they started ART after 2015. The corresponding estimates for men were 38·0 years (37·5-38·5) and 39·2 years (38·7-39·7). Interpretation: For people with HIV on ART and with high CD4 cell counts who survived to 2015 or started ART after 2015, life expectancy was only a few years lower than that in the general population, irrespective of when ART was started. However, for people with low CD4 counts at the start of follow-up, life-expectancy estimates were substantially lower, emphasising the continuing importance of early diagnosis and sustained treatment of HIV.es_ES
dc.description.sponsorshipThe Antiretroviral Therapy Cohort Collaboration is funded by the US National Institute on Alcohol Abuse and Alcoholism (grant U01-AA026209). UK CHIC is funded by the UK Medical Research Council (grants G0000199, G0600337, G0900274, and M004236/1). JACS is funded by the National Institute for Health and Care Research Bristol Biomedical Research Centre and by Health Data Research UK. AT is funded by the Wellcome Trust under a Sir Henry Wellcome Postdoctoral Fellowship (222770/Z/21/Z). Funding for the individual Antiretroviral Therapy Cohort Collaboration cohorts was provided by Alberta Health, Gilead, the French National Agency for Research on AIDS, the French Ministry of Health, the Austrian Agency for Health and Food Safety, Stichting HIV Monitoring, the Dutch Ministry of Health, Welfare, and Sport (through the Centre for Infectious Disease Control of the National Institute for Public Health and the Environment), the Translational Platform-HIV by the German Centre for Infection Research (NCT02149004), the Instituto de Salud Carlos III through the Red Temática de Investigación Cooperativa en Sida (RD06/006, RD12/0017/0018, and RD16/0002/0006, as part of the Plan Nacional I+D+i and co-financed by ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional), ViiV, Preben og Anna Simonsens Fond, Institut National de la Santé et de la Recherche Médicale, Bristol Myers Squibb, Janssen, Merck Sharp & Dohme, the US National Institute on Alcohol Abuse and Alcoholism (U01-AA026230), the Spanish Ministry of Health, the Swiss National Science Foundation (33CS30_134277), Centers for AIDS Research Network of Integrated Clinical Systems (1R24 AI067039-1 and P30-AI-027757), the US Department of Veterans Affairs, the US National Institute on Alcohol Abuse and Alcoholism (U01-AA026224, U01-AA026209, and U24-AA020794), the US Veterans Health Administration Office of Research and Development, and the US National Institute of Allergy and Infectious Diseases (P30 AI110527). We thank the study funders and all patients and clinical teams in the participating cohort studies.es_ES
dc.publisherElsevier es_ES
dc.subject.meshHIV Infections es_ES
dc.subject.meshMale es_ES
dc.subject.meshHumans es_ES
dc.subject.meshAdult es_ES
dc.subject.meshFemale es_ES
dc.subject.meshCohort Studies es_ES
dc.subject.meshEurope es_ES
dc.subject.meshLife Expectancy es_ES
dc.subject.meshNorth America es_ES
dc.subject.meshCD4 Lymphocyte Count es_ES
dc.subject.meshAntiretroviral Therapy, Highly Activees_ES
dc.titleLife expectancy after 2015 of adults with HIV on long-term antiretroviral therapy in Europe and North America: a collaborative analysis of cohort studieses_ES
dc.typeresearch articlees_ES
dc.rights.licenseAtribución 4.0 Internacional*
dc.contributor.funderNIH - National Institute on Alcohol Abuse and Alcoholism (NIAAA) (Estados Unidos) es_ES
dc.contributor.funderMedical Research Council (Reino Unido) es_ES
dc.contributor.funderNIHR - Bristol Biomedical Research Centre (Reino Unido) es_ES
dc.contributor.funderHealth Data Research UKes_ES
dc.contributor.funderWellcome Trust es_ES
dc.contributor.funderAlberta Health (Canadá)es_ES
dc.contributor.funderGilead Sciences (Spain) es_ES
dc.contributor.funderAgence Nationale de la Recherche (Francia) es_ES
dc.contributor.funderMinistère de la Santé (Francia) es_ES
dc.contributor.funderAustrian Agency for Health and Food Safety es_ES
dc.contributor.funderStichting HIV Monitoring es_ES
dc.contributor.funderMinistry of Health Welfare and Sport (Países Bajos) es_ES
dc.contributor.funderGerman Center for Infection Research (Alemania) es_ES
dc.contributor.funderInstituto de Salud Carlos III es_ES
dc.contributor.funderRed de Investigación Cooperativa en Investigación en Sida (España) es_ES
dc.contributor.funderPlan Nacional de I+D+i (España) es_ES
dc.contributor.funderUnión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF) es_ES
dc.contributor.funderInstitut National de la Santé et de la Recherche Médicale (Francia) es_ES
dc.contributor.funderBristol-Myers Squibb es_ES
dc.contributor.funderJanssen Cilag es_ES
dc.contributor.funderMerck, Sharp & Dohme es_ES
dc.contributor.funderMinisterio de Sanidad (España) es_ES
dc.contributor.funderSwiss National Science Foundation es_ES
dc.contributor.funderUnited States Department of Veterans Affairs es_ES
dc.identifier.journalThe lancet. HIVes_ES
dc.repisalud.centroISCIII::Centro Nacional de Epidemiologíaes_ES
dc.rights.accessRightsopen accesses_ES
dc.relation.projectFECYTinfo:eu-repo/grantAgreement/MINECO//RD12%2F0017%2F0018/ES/SIDA/ es_ES

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