Among Persons with HIV, Mortality Is Decreasing — But Not Enough

Progress in HIV care since antiretroviral therapy was introduced in 1996 has lengthened life expectancy for persons with HIV (PWH), who we commonly hear can have “nearly normal life expectancy” — but how close to normal is this? NA-ACCORD investigators evaluated mortality in persons entering HIV care between 1999 and 2017 compared with matched controls in the U.S. general population. PWH entering care comprised 82,766 individuals (median age, 42; 84% male, 46% non-Hispanic Black, most residing in northeast/mid-Atlantic or southern states).

Stratifying the cohort into three periods (1999–2004, 2005–2010, and 2011–2017) showed that the proportions of PWH entering care before age 35 or after age 55 rose over time. CD4 count at care entry also i…