Mortality from all causes has decreased 70 per cent in adults living with HIV

Significant advances in the management of HIV have reduced mortality from all causes by more than 70 per cent in adults living with HIV, say researchers in a study released today by the Institute for Clinical Evaluative Sciences (ICES) and St. Michael’s Hospital.

The findings, published in Open Medicine, found that while the number of adults living with HIV increased 98.6 per cent between 1996 and 2009, this increase is due to the large reduction in mortality rates from all causes, as the number of new HIV diagnoses has been relatively stable in the same time frame.

“The introduction of combination antiretroviral therapy (cART) means people with HIV are living longer, reflecting the transformation of HIV into a chronic disease characterized by an aging group of patients. People with HIV are also increasingly burdened by other illnesses, such as diabetes and high blood pressure, adding to the complexity of their care,” says Dr. Tony Antoniou, lead author and researcher in the Department of Family and Community Medicine at St. Michael’s Hospital and adjunct scientist at the Institute for Clinical Evaluative Sciences.

The population-based study set out to determine the prevalence of HIV and rates of new HIV diagnoses among adults aged 18 years and older in Ontario between 1996 and 2009, as well as mortality rates from all causes among people with HIV over the same period. The researchers found:

• The number of adults living with HIV increased by 98.6 per cent;
• Women accounted for a larger proportion of people with HIV, increasing from 12.8 per cent to 19.7 per cent of total cases;
• Individuals 50 years and older accounted for a higher proportion of people with HIV, increasing from 10.4 per cent to 29.9 per cent of total cases;
• And, mortality rates among people with HIV decreased by 71.9 per cent.

“We also estimate that a substantial portion of people who have tested positive in Ontario are either undiagnosed or do not remain in care once diagnosed. These individuals may unknowingly contribute to the annual incidence of new infections and are not benefitting from HIV-specific care,” says Dr. Antoniou.

The study “Trends in HIV prevalence, new diagnoses and mortality of persons with HIV who have entered care in Ontario, 1996 to 2009: a population-based study,” was published today in Open Medicine.

Authors: Tony Antoniou, Brandon Zagorski, Ahmed M Bayoumi, Mona R Loutfy, Carol Strike, Janet Raboud and Richard H Glazier.

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of healthcare issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting healthcare needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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St Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future healthcare professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

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