Study ‘not representative’

Results of a European study suggesting that mortality rates in HIV patients are now similar to those of the general population should be perceived with caution, according to HIV treatments specialist Bill Whittaker.
A study conducted by the Concerted Action on Seroconversion to AIDS and Death in Europe (CASCADE) group, published earlier this month, stated that the excess mortality rate in HIV patients compared to the general population had dropped by 94 percent since the introduction of highly active antiretroviral therapy.
Researchers also found that the mortality rate for people with HIV in the first five years after seroconversion was almost on par with the general population.
The study was based on data from 16,534 patients with an exact knowledge of their seroconversion date, which Whittaker said means the findings are not directly translatable to the majority of the HIV population.
There is no doubt that better treatments have dramatically reduced the risks of HIV-related death and disease over the past decade. This is very good news, but the results of this study have to be interpreted cautiously because it’s limited to looking only at people with recent and clearly established HIV infection, Whittaker said.
HIV seroconverters aren’t representative of the wider HIV-positive population because they are diagnosed and monitored from an early stage and their outcomes are likely to be more optimistic compared to the experience of the wider HIV-positive population, who are often diagnosed later.
In the real world, even before getting treatment, your chances of getting sick or showing symptoms in the first five years after infection are very low. However, there has always been a small percentage of people who are rapid progressors. The reason the rates are similar is that through treatment and monitoring we’ve been able to pick up on those people and intervene.
The take-home message from this study, though, is that regular health checks give people with HIV and those at risk of HIV infection the best chance of living well and getting the maximum benefit from the better HIV treatments that we have now.