Differences in healthy longevity by HIV status and viral load among older South African adults: an observational cohort modelling study.

Adult Female HIV Infections / drug therapy HIV Testing Humans Longevity Longitudinal Studies Male Middle Aged South Africa / epidemiology Viral Load

Journal

The lancet. HIV
ISSN: 2352-3018
Titre abrégé: Lancet HIV
Pays: Netherlands
ID NLM: 101645355

Informations de publication

Date de publication:
10 2022
Historique:
received: 17 01 2022
revised: 03 07 2022
accepted: 06 07 2022
pubmed: 1 10 2022
medline: 5 10 2022
entrez: 30 9 2022
Statut: ppublish

Résumé

The population of people living with HIV in South Africa is rapidly ageing due to increased survivorship attributable to antiretroviral therapy (ART). We sought to understand how the combined effects of HIV and ART have led to differences in healthy longevity by HIV status and viral suppression in this context. In this observational cohort modelling study we use longitudinal data from the 2015 baseline interview (from Nov 13, 2014, to Nov 30, 2015) and the 2018 longitudinal follow-up interview (from Oct 12, 2018, to Nov 7, 2019) of the population-based study Health and Ageing in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) to estimate life expectancy and disability-free life expectancy (DFLE) of adults aged 40 years and older in rural South Africa. Respondents who consented to HIV testing, responded to survey questions on disability, and who were either interviewed in both surveys or who died between survey waves were included in the analysis. We estimate life expectancy and DFLE by HIV status and viral suppression (defined as <200 copies per mL) using Markov-based microsimulation. Among the 4322 eligible participants from the HAALSI study, we find a clear gradient in remaining life expectancy and DFLE based on HIV serostatus and viral suppression. At age 45 years, the life expectancy of a woman without HIV was 33·2 years (95% CI 32·0-35·0), compared with 31·6 years (29·2-34·1) a woman with virally suppressed HIV, and 26·4 years (23·1-29·1) for a woman with unsuppressed HIV; life expectancy for a 45 year old man without HIV was 27·2 years (25·8-29·1), compared with 24·1 years (20·9-27·2) for a man with virally suppressed HIV, and 17·4 years (15·0-20·3) for a man with unsuppressed HIV. Men and women with viral suppression could expect to live nearly as many years of DFLE as HIV-uninfected individuals at ages 45 years and 65 years. These results highlight the tremendous benefits of ART for population health in high-HIV-prevalence contexts and reinforce the need for continued work in making ART treatment accessible to ageing populations. National Institutes of Health.

Sections du résumé

BACKGROUND
The population of people living with HIV in South Africa is rapidly ageing due to increased survivorship attributable to antiretroviral therapy (ART). We sought to understand how the combined effects of HIV and ART have led to differences in healthy longevity by HIV status and viral suppression in this context.
METHODS
In this observational cohort modelling study we use longitudinal data from the 2015 baseline interview (from Nov 13, 2014, to Nov 30, 2015) and the 2018 longitudinal follow-up interview (from Oct 12, 2018, to Nov 7, 2019) of the population-based study Health and Ageing in Africa: a Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) to estimate life expectancy and disability-free life expectancy (DFLE) of adults aged 40 years and older in rural South Africa. Respondents who consented to HIV testing, responded to survey questions on disability, and who were either interviewed in both surveys or who died between survey waves were included in the analysis. We estimate life expectancy and DFLE by HIV status and viral suppression (defined as <200 copies per mL) using Markov-based microsimulation.
FINDINGS
Among the 4322 eligible participants from the HAALSI study, we find a clear gradient in remaining life expectancy and DFLE based on HIV serostatus and viral suppression. At age 45 years, the life expectancy of a woman without HIV was 33·2 years (95% CI 32·0-35·0), compared with 31·6 years (29·2-34·1) a woman with virally suppressed HIV, and 26·4 years (23·1-29·1) for a woman with unsuppressed HIV; life expectancy for a 45 year old man without HIV was 27·2 years (25·8-29·1), compared with 24·1 years (20·9-27·2) for a man with virally suppressed HIV, and 17·4 years (15·0-20·3) for a man with unsuppressed HIV. Men and women with viral suppression could expect to live nearly as many years of DFLE as HIV-uninfected individuals at ages 45 years and 65 years.
INTERPRETATION
These results highlight the tremendous benefits of ART for population health in high-HIV-prevalence contexts and reinforce the need for continued work in making ART treatment accessible to ageing populations.
FUNDING
National Institutes of Health.

Identifiants

DOI: 10.1016/S2352-3018(22)00198-9 PMID: 36179754 PMC: PMC9553125
pubmed: 36179754
pii: S2352-3018(22)00198-9
doi: 10.1016/S2352-3018(22)00198-9
pmc: PMC9553125
mid: NIHMS1840820
pii:
doi:

Types de publication

Case Reports Journal Article Observational Study Research Support, Non-U.S. Gov't Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

e709-e716

Subventions

Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : NIA NIH HHS
ID : P01 AG041710
Pays : United States
Organisme : Medical Research Council
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 058893/Z/99/A
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 069683/Z/02/Z
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 085477/Z/08/Z
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 085477/B/08/Z
Pays : United Kingdom

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2022 The Author(s). Published by Elsevier Ltd. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of interests We declare no competing interests.

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Auteurs

Collin F Payne (CF)

School of Demography, Research School of Social Sciences, The Australian National University, Canberra, ACT, Australia; Center for Population and Development Studies, Harvard T H Chan School of Public Health, Cambridge, MA, USA. Electronic address: collin.payne@anu.edu.au.

Brian Houle (B)

School of Demography, Research School of Social Sciences, The Australian National University, Canberra, ACT, Australia; MRC/Wits Rural Public Health and Heath Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.

Chido Chinogurei (C)

Centre for Infectious Diseases and Epidemiology Research, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa.

Carlos Riumallo Herl (CR)

School of Economics, Erasmus University, Rotterdam, Netherlands.

Chodziwadziwa Whiteson Kabudula (CW)

MRC/Wits Rural Public Health and Heath Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.

Lindsay C Kobayashi (LC)

Center for Social Epidemiology and Population Health, Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA.

Joshua A Salomon (JA)

Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, CA, USA.

Jennifer Manne-Goehler (J)

Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA; Center for Population and Development Studies, Harvard T H Chan School of Public Health, Cambridge, MA, USA.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Differences in healthy longevity by HIV status...
questionsmedicales.fr › Maladies du système immunitaire › Déficits immunitaires › Infections à VIH › Differences in healthy longevity by HIV status...
questionsmedicales.fr › Techniques d'investigation › Techniques de laboratoire clinique › Techniques microbiologiques › Dépistage du VIH › Differences in healthy longevity by HIV status...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Differences in healthy longevity by HIV status...
questionsmedicales.fr › Phénomènes physiologiques › Longévité › Differences in healthy longevity by HIV status...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études longitudinales › Differences in healthy longevity by HIV status...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Differences in healthy longevity by HIV status...
questionsmedicales.fr › Régions géographiques › Afrique › Afrique subsaharienne › Afrique australe › République d'Afrique du Sud › Differences in healthy longevity by HIV status...
questionsmedicales.fr › Phénomènes microbiologiques › Phénomènes physiologiques viraux › Charge virale › Differences in healthy longevity by HIV status...