Health-adjusted life expectancy in HIV-positive and HIV-negative men and women in British Columbia, Canada: a population-based observational cohort study

摘要: Summary Background We sought to understand whether people living with HIV (PLHIV) ever on highly active antiretroviral therapy (ART) follow a pattern where morbidity is compressed into the last years of life or lessened as age. aimed estimate health-adjusted expectancy (HALE) among adults and without HIV, examine dependency between causes comorbidities. Methods The Comparative Outcomes Service Utilization Trends (COAST) study retrospective cohort (≥20 years) including all known PLHIV 10% random sample general population British Columbia, longitudinal data spanning from April 1, 1996, Dec 31, 2012. determined prevalence select comorbidities (cardiovascular, respiratory, liver, renal diseases, non-AIDS defining cancers because their high PLHIV) by age sex use case-finding algorithms. Deaths were obtained vital event registry Canada. Comorbid-specific HALE was estimated 20 status sex. For each comorbidity, healthy state defined proportion comorbid-free, adjusted probability occurrence other different sensitivity estimates assessed sequencing for dependent comorbidity adjustments. Findings Our consisted electronic health records 9310 HIV-infected 510 313 uninfected over period These individuals contributed 49 605 deaths 5 576 841 person-years period. At exactly years, about 31 (SD 0·16) men 27 (0·16) women HIV. In HIV-negative population, around 58 0·02) 63 (0·02) women. results seem independent ordering. However, PLHIV, particularly had much shorter overall expectancies than did counterparts in [29·1 0·1) vs 65·4 (0·1)], thus spent less time state. Interpretation Although we noted little differences levels compression status, PLHIV—especially HIV—spent Expanded service delivery interventions address complex care needs ageing are crucial expectancies, improve states. Funding Canadian Institutes Health Research.