Durban, South Africa – People living with HIV in South Africa who start antiretroviral therapy before their immune systems are severely compromised have life expectancies close to that of the general population, researchers have found.
Published this week in the journal PLOS Medicine, the research shows that the life expectancy is around 80 percent of that of the general population, provided those with HIV initiate treatment before their CD4 count (a measure of the strength of the immune system at the time of starting treatment) drops below 200.
The findings could affect the cost of life insurance (reducing it) and epidemiological modelling estimates, which typically assume that life expectancy after starting antiretroviral therapy is around 10 years.
The UCT researchers also found that life expectancy was significantly influenced by baseline CD4 counts. Life expectancy in patients with baseline CD4 counts of 200 cells per microlitre or more was between 70 percent and 86 percent of those HIV-negative adults of the same age and sex, while patients starting treatment with CD4 counts of less than 50 had life expectancies that were between 48 percent and 61 percent of those of HIV-negative adults. The study showed that risk of death was the highest during the first year after starting antiretroviral therapy, because of the delay between the start of treatment and the recovery of the immune system.