• Nicolai Lohse, Ann-Brit Eg Hansen, Gitte Pedersen, Gitte Kronborg, Jan Gerstoft, Henrik Toft Sørensen, Michael Vaeth, and Niels Obel.
• Department of Infectious Diseases, Odense University Hospital and University of Southern Denmark, Odense, Denmark. nl@dce.au.dk
• Ann. Intern. Med. 2007 Jan 16; 146 (2): 87-95.

BackgroundThe expected survival of HIV-infected patients is of major public health interest.ObjectiveTo estimate survival time and age-specific mortality rates of an HIV-infected population compared with that of the general population.DesignPopulation-based cohort study.SettingAll HIV-infected persons receiving care in Denmark from 1995 to 2005.PatientsEach member of the nationwide Danish HIV Cohort Study was matched with as many as 99 persons from the general population according to sex, date of birth, and municipality of residence.MeasurementsThe authors computed Kaplan-Meier life tables with age as the time scale to estimate survival from age 25 years. Patients with HIV infection and corresponding persons from the general population were observed from the date of the patient's HIV diagnosis until death, emigration, or 1 May 2005.Results3990 HIV-infected patients and 379,872 persons from the general population were included in the study, yielding 22,744 (median, 5.8 y/person) and 2,689,287 (median, 8.4 years/person) person-years of observation. Three percent of participants were lost to follow-up. From age 25 years, the median survival was 19.9 years (95% CI, 18.5 to 21.3) among patients with HIV infection and 51.1 years (CI, 50.9 to 51.5) among the general population. For HIV-infected patients, survival increased to 32.5 years (CI, 29.4 to 34.7) during the 2000 to 2005 period. In the subgroup that excluded persons with known hepatitis C coinfection (16%), median survival was 38.9 years (CI, 35.4 to 40.1) during this same period. The relative mortality rates for patients with HIV infection compared with those for the general population decreased with increasing age, whereas the excess mortality rate increased with increasing age.LimitationsThe observed mortality rates are assumed to apply beyond the current maximum observation time of 10 years.ConclusionsThe estimated median survival is more than 35 years for a young person diagnosed with HIV infection in the late highly active antiretroviral therapy era. However, an ongoing effort is still needed to further reduce mortality rates for these persons compared with the general population.

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