Impact of HAART and injection drug use on life expectancy of two HIV-positive cohorts in British Columbia

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Abstract
Background: The introduction of HAART has led to consistent improvements in survival among HIV-infected individuals. However, there is evidence that not all populations have benefited equally from HAART and that mortality rates are higher in HIV-infected injection drug users than in non-users. Objective: To model life expectancies for HIV-positive individuals subdivided according to history of injection drug use and treatment with HAART. Design: Population-based study of HIV-positive persons in British Columbia's HIV/AIDS treatment program. Methods: The primary outcome measures in this study were life expectancy at exact age 20 and potential years of life lost. Results: The highest life expectancy (38.9 years) and lowest potential years of life lost were measured for individuals taking HAART and without a history of injection drug use. The lowest life expectancy (19.1 years) and highest potential years of life lost were measured in HIV-positive injection drug users who were not taking HAART. Conclusions: There are substantial disparities in life expectancy for persons living with HIV in British Columbia. Members of the injection drug community, particularly those who are not taking HAART, experience elevated mortality in comparison with those without a history of drug use.