Life expectancy of XXXX -positive individuals on combination antiretroviral therapy in Canada.

@entity1 @entity404 @entity645 @entity2246
BACKGROUND: We sought to evaluate life expectancy and mortality of @entity645 -positive individuals initiating combination antiretroviral therapy (ART) across Canada, and to consider the potential error introduced by @entity1 loss to follow-up (LTFU). METHODS: Our study used data from the Canadian Observational Cohort (CANOC) collaboration, including @entity645 -positive individuals aged >= 18  years who initiated ART on or after January 1, 2000. The CANOC collaboration collates data from eight sites in British Columbia, Ontario, and Quebec. We computed abridged life-tables and remaining life expectancies at age 20 and compared outcomes by calendar period and @entity1 characteristics at treatment initiation. To correct for potential underreporting of mortality due to @entity1 LTFU, we conservatively estimated 30  % mortality among @entity1 lost to follow-up. RESULTS: 9997 individuals contributed 49,589 @entity1 -years and 830 deaths for a crude mortality rate of 16.7 [ @entity2246 ( @entity2246 ) 0.6] per 1000 @entity1 -years. When assigning death to 30  % of @entity1 lost to follow-up, we estimated 1170 deaths and a mortality rate of 23.6 [ @entity2246 0.7] per 1000 @entity1 -years. The crude overall life expectancy at age 20 was 45.2 [ @entity2246 0.7] and 37.5 [ @entity2246 0.6] years after adjusting for LTFU. In the LTFU-adjusted analysis, lower life expectancy at age 20 was observed for @entity1 compared to @entity1 (32.4 [ @entity2246 1.1] vs. 39.2 [ @entity2246 0.7] years), for @entity1 with injection drug use (IDU) history compared to those without IDU history (23.9 [ @entity2246 1.0] vs. 52.3 [ @entity2246 0.8] years), for @entity1 reporting Aboriginal ancestry compared to those with no Aboriginal ancestry (17.7 [ @entity2246 1.5] vs. 51.2 [ @entity2246 1.0] years), and for @entity1 with @entity404 count <350 cells/ L compared to @entity404 count >= 350 cells/ L at treatment initiation (36.3 [ @entity2246 0.7] vs. 43.5 [ @entity2246 1.3] years). Life expectancy at age 20 in the calendar period 2000-2003 was lower than in periods 2004-2007 and 2008-2012 in the LTFU-adjusted analyses (30.8 [ @entity2246 0.9] vs. 38.6 [ @entity2246 1.0] and 54.2 [ @entity2246 1.4]). CONCLUSIONS: Life expectancy and mortality for @entity645 -positive individuals receiving ART differ by calendar period and @entity1 characteristics at treatment initiation. Failure to consider LTFU may result in underestimation of mortality rates and overestimation of life expectancy.
