Two articles published by American researchers in the January issue of the Journal of Acquired Immune Deficiency Syndromes (JAIDS) showed that HIV-infected adults and children are living longer than they did in the mid-1990s.

One study monitored mortality rates and causes of death in HIV-infected children from 1993 to 2006, a period of time when highly active antiretroviral treatment (HAART) was introduced.

The other study estimated life expectancy and average years of life lost in adults following HIV diagnosis.

Researchers found that pediatric death rates significantly decreased between 1994 and 2000, from 7.2 to 0.8 per 100 person years. Rates remained steady through 2006.

Average adult life expectancy after HIV diagnosis in 2005 was 22.5 years compared with 10.5 years in 1996.

Average years of life lost in adults also improved, from 32.9 years in 1996 to 21.1 years in 2005.

In children, the causes of death were mainly end-stage AIDS and pneumonia. Deaths due to opportunistic infections declined from 37 percent to 24 percent.

Previous studies have found HAART to be associated with improved survival among HIV-infected patients. In a study published in December, Swiss researchers found decreased suicide rates in patients after the introduction of HAART (see related AIDS Beacon news).

Both JAIDS articles report negative trends as well. The pediatric study shows that mortality rates in children with HIV/AIDS are still 30 times higher than in children in the general U.S. population.

In adults, life expectancy for females improved less than in males (women gained 11 years, while men gained 12.1 years). Additionally, minorities live shorter lives than Caucasians. Life expectancy for African-American males was the shortest, followed by Hispanic males and then Caucasian males.

These findings emphasize the importance of addressing quality-of-life issues specifically in female and minority patients.

The study tracking death rates among HIV-positive children followed 3,553 subjects participating in the Pediatric AIDS Clinical Trials Group (PACTG) 219/219C from 1993 to 2006 for a median of 5.3 years. The majority of children were under three years of age upon entering PACTG.

The researchers observing the mortality rate among HIV-positive adults relied on national HIV surveillance data since 1996 from 25 states.

For more information, please see the original studies in JAIDS on pediatric mortality rates (abstract) and adult mortality rates (abstract).