Estimated median survival in the HIV group rose from 11.8 years in 1996-1999 to 17.8 years in 2000-2005 and to 22.5 years in 2006-2014. Median survival in general population controls was 30.2 years across all three periods. Mortality rate ratio comparing HIV-positive people with controls was highest among 50- to 55-year-olds (3.8) and declined in each older age group. But in the oldest age group, 75- to 80-year-olds, people with HIV still had a significantly higher death rate than population controls (mortality rate ratio 1.6, 95% confidence interval [CI] 1.0 to 2.6). Mortality did not differ substantially between HIV-positive people diagnosed before or after age 50.
The “well-treated” subset included 517 people with HIV and 3192 age- and gender-matched general-population controls. Estimated median survival from age 50 was 25.6 years in the HIV group (to age 75.6) versus 34.2 years in controls (to age 84.2). Those numbers meant people with HIV but without AIDS or comorbidities had a 70% higher death rate than general-population controls without comorbidities (mortality rate ratio 1.7, 95% CI 1.2 to 2.3).
The researchers concluded that “survival after age 50 has improved markedly in the HIV-population within the [combination ART] era, but is still substantially lower than in the background population,” even in “well-treated” HIV-positive people without AIDS or comorbidities.
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