Abstract :

The AIDS pandemic on average took a life every minute in 2021 despite effective HIV treatment and tools to prevent, detect, and treat opportunistic infections. The objective of this study was to estimate the average life expectancy and life years lost (LYL) in people diagnosed with HIV or AIDS in Puerto Rico from 2000-2020. The epidemiological design was a retrospective cohort study of 24,143 people diagnosed with HIV or AIDS and received services under the Eligible Metropolitan Area (EMA) of San Juan, Puerto Rico. The population with a diagnosis of HIV or AIDS was described using socioeconomic characteristics with frequencies and proportions by category. We estimated the LYL by matching the expected residual lifetime for someone diagnosed with the disease with the life expectancy of the general population at that specific age as the null model. Average years of life lost (LYL) is a measure that reflects expected earlier death as a result of a condition. The number of LYL is dependent on the year of onset of the condition. In general, the earlier the onset of HIV or AIDS results in a larger impact of LYL. For individuals diagnosed at the age of 30 with AIDS the LYL is approximately 35.5 years, whereas for an individual where the onset is at age 70 years, being diagnosed with HIV or AIDS results in approximately 2.7 years lost. In our study, we found a greater number of LYL in patients diagnosed with AIDS in this population compared to those diagnosed with HIV. This study confirms the dramatic impact of HIV and AIDS on the lifespan of individuals and how the age of onset of the conditions impacts LYL.

---

Keywords :

HIV/AIDS, Life Expectancy, Life Years Lost, Puerto Rico.

---

References :

1. World Health Organization. The Global Health Observatory. Updated July 20, 2022. https://www.who.int/data/gho. Accessed March 25, 2023.
2. Sauce, D., Pourcher, V., Ferry, T., Boddaert, J., Slama, L., Allavena, C. Immune activation and chronic inflammation: Is there an additional effect of HIV in a geriatric population? Medicine (Baltimore). 2021 Apr 30;100(17).
3. Andersen PK. Life years lost among patients with a given disease. Stat Med. 2017; 36:3573–3582. https://doi.org/10.1002/sim.7357 PMID: 28585255.
4. Andersen PK, Canudas-Romo V, Keiding N. Cause-specific measures of life years lost. Demogr Res. 2013; 29: 1127–1152. https://doi.org/10.4054/DemRes.2013.29.41.
5. Plana-Ripoll, O., Canudas-Romo, V., Weye, N., Laursen, T. M., McGrath, J. J., & Andersen, P. K. lillies: An R package for the estimation of excess Life Years Lost among patients with a given disease or condition. PloS one. 2020; 15(3), e0228073. https://doi.org/10.1371/journal.pone.0228073.
6. Lebanova, H., Stoev, S., Naseva, E., Getova, V., Wang, W., Sabale, U., & Petrova, E.. Economic Burden of Cervical Cancer in Bulgaria. International Journal of Environmental Research and Public Health. 2023; 20(3), 2746.
7. Dreier, J. W., Laursen, T. M., Tomson, T., Plana-Ripoll, O., & Christensen, J. Cause-specific mortality and life years lost in people with epilepsy: a Danish cohort study. Brain. 2023; 146(1), 124-134.
8. Ruffieux, Y., Wettstein, A., Maartens, G., Folb, N., Mesa Vieira, C., Didden, C., Haas, A. D. Life-years lost associated with mental illness: a cohort study of beneficiaries of a South African medical insurance scheme. medRxiv. 2023-01.
9. Chudasama YV, Khunti K, Gillies CL, Dhalwani NN, Davies MJ, Yates T, Zaccardi F. Estimates of years of life lost depended on the method used: tutorial and comparative investigation. J Clin Epidemiol. 2022 Oct; 150:42-50. doi: 10.1016/j.jclinepi.2022.06.012. Epub 2022 Jun 24. PMID: 35760239.
10. Salama, A. K., Rosa, N.d, Scheri, R. P., Herndon, J. E., Tyler, D. S., Marcello, J., Pruitt, S. K., & Abernethy, A. P. The effect of metastatic site and decade of diagnosis on the individual burden of metastatic melanoma: contemporary estimates of average years of life lost. Cancer investigation, 2012; 30(9), 637–641. https://doi.org/10.3109/07357907.2012.726387.
11. Yaghoobi, H., Ahmadinia, H., Shabani, Z., Vazirinejad, R., Safari, R., Shahizadeh, R., Zolfizadeh, F., & Rezaeian, M. Life expectancy and years of life lost in HIV patients under the care of BandarAbbas Behavioral Disorders Counseling Center. Nepal journal of epidemiology, 2017; 7(4), 702–712. https://doi.org/10.3126/nje.v7i4.20627.
12. Siddiqi, A., Hall, H. I., Hu, X. & Song, R. Population-Based Estimates of Life Expectancy After HIV Diagnosis: United States 2008-2011. JAIDS Journal of Acquired Immune Deficiency Syndromes, 2016; 72 (2), 230-236. Doi: 10.1097/QAI.0000000000000960.
13. Lynch, K. E., Livingston, N. A., Gatsby, E., Shipherd, J. C., DuVall, S. L., & Williams, E. C. Alcohol-attributable deaths and years of potential life lost due to alcohol among veterans: Overall and between persons with minoritized and non-minoritized sexual orientations. Drug and alcohol dependence, 2022; 237, 109534. https://doi.org/10.1016/j.drugalcdep.2022.109534.
14. Boeck, M. A., Wei, W., Robles, A. J., Nwabuo, A. I., Plevin, R. E., Juillard, C. J., Bibbins-Domingo, K., Hubbard, A., & Dicker, R. A. The Structural Violence Trap: Disparities in Homicide, Chronic Disease Death, and Social Factors Across San Francisco Neighborhoods. Journal of the American College of Surgeons. 2022; 234(1), 32–46. https://doi.org/10.1016/j.jamcollsurg.2021.09.008.
15. Harrison, K. M., Song, R. & Zhang, X. Life Expectancy After HIV Diagnosis Based on National HIV Surveillance Data From 25 States, United States. JAIDS Journal of Acquired Immune Deficiency Syndromes. 2010; 53 (1), 124-130. Doi: 10.1097/QAI.0b013e3181b563e7.
16. Joint United Nations Programme on HIV/AIDS. Global HIV & AIDS Statistics — 2022 Fact Sheet. 2022. https://www.unaids.org/en/resources/fact-sheet. Accessed March 25, 2023.
17. Marcus, J. Increased Overall Life Expectancy but Not Comorbidity-Free Years for People with HIV, Conference on Retroviruses and Opportunistic Infections (CROI). March 8-11, 2020. Boston. Abstract 151. croiconference.org/sessions/increased-overall-life-expectancy-not-comorbidity-free-years-people-hiv.
18. Marcus JL, Leyden WA, Alexeeff SE, Anderson AN, Hechter RC, Hu H, Lam JO, Towner WJ, Yuan Q, Horberg MA, Silverberg MJ. Comparison of Overall and Comorbidity-Free Life Expectancy Between Insured Adults with and Without HIV Infection, 2000-2016. JAMA Netw Open. 2020 Jun 1;3(6): e207954. doi: 10.1001/jamanetworkopen. 2020; 7954. PMID: 32539152; PMCID: PMC7296391.
19. Pesquera, F. M. J. Tablas de vida abreviadas para Puerto Rico. 1999-2002 a 2008-2010. Estado Libre Asociado de Puerto Rico, Departamento de Salud, Secretaría Auxiliar de Planificación y desarrollo. 2013. salud.gov.pr. Accessed March 20, 2023.
20. Erlangsen, A., Andersen, P. K., Toender, A., Laursen, T. M., Nordentoft, M., & Canudas-Romo, V. Cause-specific life-years lost in people with mental disorders: a nationwide, register-based cohort study. The lancet. Psychiatry. 2017; 4(12), 937–945. https://doi.org/10.1016/S2215-0366(17)30429-7.
21. Plana-Ripoll, O. lillies: Estimation of Life Years Lost. R package version 0.2.9. 2021. https://CRAN.R-project.org/package=lillies.
22. Wickham H, Averick M, Bryan J, Chang W, McGowan LD, François R, Grolemund G, Hayes A, Henry L, Hester J, Kuhn M, Pedersen TL, Miller E, Bache SM, Müller K, Ooms J, Robinson D, Seidel DP, Spinu V, Takahashi K, Vaughan D, Wilke C, Woo K, Yutani H. “Welcome to the tidyverse.” Journal of Open-Source Software. 2019; *4*(43), 1686. doi:10.21105/joss.01686 https://doi.org/10.21105/joss.01686.