Life Expectancy With HIV on the Increase in Latin America and Caribbean

By David Douglas

April 30, 2021

NEW YORK (Reuters Health) - Growing availability of antiretroviral therapy (ART) has led to a rise in life expectancy among people living with HIV in Latin America and the Caribbean, according to a new study.

Dr. Jessica L. Castilho told Reuters Health by email that although these results are a consequence of increased access to ART in the current "Treat All" era as designated by the World Health Organization, "more work is needed to address persistent disparities, focus on early HIV diagnosis and immediate access to HIV treatment." Such measures "remain paramount to expanding the impact of these findings to all populations."

Dr. Castilho of Vanderbilt University Medical Center, in Nashville, Tennessee, and colleagues analyzed data on more than 30,000 people living with HIV who had started treatment between 2003 and 2017. Most (57%) were from Haiti.

Mortality rates decreased among all age groups over calendar eras. In Haiti, from 2003 to 2008, overall life expectancy for people with HIV at the age of 20 years was 13.9 years but by 2013 to 2017 had risen to 61.2 years. Corresponding increases elsewhere were from 31.0 years to 69.5 years.

During the study period there were 1,470 deaths among people in Haiti and 1,167 deaths at other sites. However, the survival gains, particularly during the most recent period after the adoption of the "Treat All" approach, brought life expectancy among people living with HIV on ART to within 10 years of that of the general population. This amounted to 69.9 years in Haiti and 78.0 years elsewhere.

Co-author Dr. Claudia P. Cortes of the University of Chile School of Medicine, in Santiago, said in a statement, "More data on HIV in Latin America and the Caribbean is needed and there are several countries in Latin America for which there is practically no information on HIV. Latin America and the Caribbean is a large, heterogeneous, and diverse region, and HIV impacts a number of different populations. It is also, however, a region with the least resources available for HIV clinical studies and research."

Nevertheless, Dr. Castilho stated, "The significant gains in life expectancy that we've observed are very encouraging, and mirror reports from higher-income countries on the impact of the WHO's 'Treat All' approach to ART. Ongoing efforts should see the gap between the life expectancies of people living with HIV and the general population in low- and middle-income countries narrow yet further."

SOURCE: https://bit.ly/3tZHF8Z The Lancet HIV, online April 20, 2021.

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