Two new international research studies suggest that increased risk of early death in people living with HIV (PLHIV) is not due to effects of antiretroviral therapy or HIV-related accelerated ageing, as has been debated in recent years, but is related to additional factors. The research indicates that, in the absence of other risk factors, PLHIV on antiretroviral treatments have the same mortality risk as individuals in the general population.

Danish research, published December 2011 in PLoS One, suggests that increased risk of early mortality among PLHIV is caused by risk factors such as co-infection, drug and alcohol misuse and other co-morbidities; the investigators found 'no substantially increased mortality' among HIV patients without these risk factors. However, among patients with either co-morbidities/co-infections or problems with drug and alcohol use the risk of an early death was between 4 to 20 times greater than patients without any other risk factor.

The study investigators stress that: 'Future management of the HIV-infected population should focus on early diagnosis, timely and effective HAART, and treatment of co-morbidity and alcohol/drug abuse.'

Another recent international study, EuroSIDA, has provided strong evidence that taking antiretroviral medications long-term does not increase the risk of non-AIDS related death among PLHIV. The study looked at the outcomes of approximately 12,000 patients who received potent combination antiretroviral therapy after 1996. The study demonstrated 'the prolonged benefit of cART [combination antiretroviral therapy], with a 5% reduction in the overall risk of death per additional year on treatment, which was mostly attributed to a decrease in the risk of AIDS-related deaths.'

However, the study also found that longer duration of HIV therapy was accompanied by an increase in mortality attributed to non-AIDS-related cancers, suggesting this 'may reflect ageing of the HIV population…or improvement in cancer screening.'

The EuroSIDA study authors also concluded that: 'It is clear that death due to accumulating treatment toxicities is a very uncommon event.'

This article is based on reports published by www.aidsmap.com. For further details, see the PLoS article and EuroSIDA article