San Francisco Chronicle - July 2, 2008
Sabin Russell at srussell@sfchronicle.com.

AIDS drugs have so improved the survival prospects of people with HIV that death rates among the recently diagnosed in industrialized countries have become comparable to those never exposed to the virus, according to a newly published European study.

Medical records show that, before 1996 - when combinations of antiviral drugs became available - the death rates for HIV-infected patients were 41 times that of people of comparable age in 10 European nations and Australia.

Death rates fell dramatically by 1997, to 31 times the norm, and continued dropping until they reach six times the norm by 2006.

That's still a substantial increase in risk of death from HIV, but it takes into account patients who were diagnosed long ago and have been switching from one drug regimen to the next to stay alive. It also includes those who contracted the virus through sharing of needles, and who live with a variety of health risks related to their drug use.

The picture is brighter for those who were infected more recently and have been treated with the latest generation of drugs.

Among a subgroup of HIV-positives - those diagnosed with a sexually transmitted infection since 1999 and treated with the latest AIDS drug cocktails - the analysis found virtually no difference in death rates between them and uninfected people of similar age.

By 2006, excess mortality - deaths attributed to AIDS - had fallen 94 percent compared with pre-1996 levels, said the study authors, led by Kholoud Porter of the Medical Research Council Clinical Trials Unit in London. Their work, which analyzed the records of more than 16,000 patients, was published Tuesday in the Journal of the American Medical Association.

"We found that the gap in mortality rates between HIV-infected individuals in our study and the general population narrowed in every calendar period from 1996 onward," Porter and colleagues wrote.

The researchers tempered their upbeat findings with a warning that the study still found an increased risk of death for HIV-infected people of all ages based on the amount of time they have been living with the virus.

They wrote that excess probability of death becomes "apparent only later in the course of infection." The analysis showed, for example, that the increased risk of death for someone age 15 to 24 at the time of infection was 4.8 percent over a 10-year period.

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