Persons entering HIV care have elevated mortali- ty compared with a matched United States popu- lation, but the difference has decreased over time, according to a study published in the Annals of Internal Medicine. Researchers examined the ex- tent to which mortality among persons enter- ing HIV care is elevated over mortality among matched individuals from the general US popu- lation and assessed trends in this difference over time. Data were included for 82,766 adults en- tering HIV clinical care between 1999 and 2017 and a calendar time-, age-, sex-, race/ethnicity-, and county-matched subset of the US popula- tion. The researchers found that 5-year mortality was 10.6% among persons entering HIV care and 2.9% among the matched US population (difference, 7.7%). There was a decrease observed in this difference over time, from 11.1% to 2.7% among those entering care during 1999-2004 and 2011-2017, respectively. “Understanding dif- ferences in mortality between persons entering HIV care and the matched US population is critical to monitor opportunities to improve care,” the study authors wrote. “Although these differences have decreased dramatically in the era of modern treatments, gaps remain. These gaps could reflect the effects of prolonged im- munodeficiency in persons who present late to care or persistent immune activation and sub- sequent end-stage chronic diseases even among those who are successfully treated.”
