Life expectancy among HIV-positive patients in Rwanda: a retrospective observational cohort study

Nsanzimana, Sabin; Remera, Eric; Kanters, Steve; Chan, Keith; Forrest, Jamie I; Ford, Nathan; Condo, Jeanine; Binagwaho, Agnès; Mills, Edward J.

doi:10.1016/s2214-109x(14)70364-x

Cited by 104 publications

(108 citation statements)

References 23 publications

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“…Of 30 potentially eligible studies, 20 were excluded because they did not present relevant data on life expectancy on ART, were based on the same study population as another study or only presented life expectancy estimates in selected groups of patients (Figure 1). Among 10 studies included, three were from Canada [10–12], two from European countries [13,14], three from African countries [15–17] and two were multi-country studies [8,18] (Table 1). …”

Section: Identifying and Calculating Estimates Of Life Expectancymentioning

confidence: 99%

Trends in life expectancy of HIV-positive adults on antiretroviral therapy across the globe

Wandeler

Johnson

Egger

2016

Current Opinion in HIV and AIDS

320

240

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Purpose of review Improved virological and immunological outcomes and reduced toxicity of antiretroviral combination therapy (ART) raise the hope that life expectancy of HIV-positive persons on ART will approach that of the general population. We systematically review the literature and summarize published estimates of life expectancy of HIV-positive populations on ART. We compare their life expectancy with the life expectancy of the general or, in sub-Saharan Africa, HIV-negative populations, by time period and gender. Recent findings Ten relevant studies were published from 2006 to 2015. Three studies were from Canada, two from European countries, three from sub-Saharan Africa and two were multi-country studies. Life expectancy increased over time in all studies and regions. Expressed as the percentage of life expectancy in the HIV-negative or general population, estimated life expectancy at age 20 years in HIV-positive people on ART ranged from 60.3% (95% CI 58.0–62.6) in Rwanda (2008–2011) to 89.1% (95% CI 84.7–93.6) in Canada (2008–2012). The percentage of the life expectancy in the HIV-negative or general population achieved was higher in HIV-positive women than in HIV-positive men in all countries, except for Canada where the opposite was the case. Summary Life expectancy in HIV-positive people on ART has improved worldwide in recent years, but important gaps remain compared to the general and HIV-negative population, and between regions and genders.

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Section: Identifying and Calculating Estimates Of Life Expectancymentioning

confidence: 99%

Trends in life expectancy of HIV-positive adults on antiretroviral therapy across the globe

Wandeler

Johnson

Egger

2016

Current Opinion in HIV and AIDS

320

240

View full text Add to dashboard Cite

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“…These findings were also confirmed by other recent reports. [115][116][117][118][119] In conclusion, while starting HAART in older HIV-infected patients is undoubtedly recommended, the poorer immunological response seen in this population represent a matter of concern and should be intensively investigated to increase life expectancy of elderly patients.…”

Section: Clinical Outcomementioning

confidence: 99%

Immunosenescence and hurdles in the clinical management of older HIV-patients

2017

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People living with HIV (PLWH) who are treated with effective highly active antiretroviral therapy (HAART) have a similar life expectancy to the general population. Moreover, an increasing proportion of new HIV diagnoses are made in people older than 50 y. The number of older HIVinfected patients is thus constantly growing and it is expected that by 2030 around 70% of PLWH will be more than 50 y old. On the other hand, HIV infection itself is responsible for accelerated immunosenescence, a progressive decline of immune system function in both the adaptive and the innate arm, which impairs the ability of an individual to respond to infections and to give rise to long-term immunity; furthermore, older patients tend to have a worse immunological response to HAART.In this review we focus on the pathogenesis of HIV-induced immunosenescence and on the clinical management of older HIV-infected patients.

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“…285 Although the longitudinal cohort approach may appear to be complex, it has been successfully implemented in a number of diverse settings, including directly observed treatment, short-course-based TB control, noncommunicable chronic diseases, and also HIV in some settings, including in British Columbia, Canada, Malawi, Rwanda, and Switzerland. 279,[286][287][288] Attrition at different stages along the HIV care continuum is heterogeneous. It comprises individuals who dropout of HIV treatment for the first time, experience multiple treatment discontinuations, as well as those lost to HIV care entirely (ie, discontinued regular physician follow-up and diagnostic testing).…”

Section: Metrics For and Monitoring Of The Hiv Care Continuummentioning

confidence: 99%

IAPAC Guidelines for Optimizing the HIV Care Continuum for Adults and Adolescents

Bekker¹,

Montaner²,

Ramos³

et al. 2015

J Int Assoc Provid AIDS Care

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Life expectancy among HIV-positive patients in Rwanda: a retrospective observational cohort study

Abstract: Bill & Melinda Gates Foundation.

Cited by 104 publications

References 23 publications

Trends in life expectancy of HIV-positive adults on antiretroviral therapy across the globe

Trends in life expectancy of HIV-positive adults on antiretroviral therapy across the globe

Immunosenescence and hurdles in the clinical management of older HIV-patients

IAPAC Guidelines for Optimizing the HIV Care Continuum for Adults and Adolescents

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