Жизнь с ВИЧ

Продолжительность жизни с ВИЧ резко возрастает

Male doctor discussing reports with patient at desk in medical o

20-летний ВИЧ-положительный, который сегодня начинает принимать антиретровирусную (АРВ) терапию может согласно новым расчетам прожить, в среднем, до 69 лет.

20-летний ВИЧ-инфицированный человек, который сегодня начинает принимать антиретровирусную (АРВ) терапию может согласно новым расчетам, опубликованным в журнале The Lancet, прожить, в среднем, до 69 лет. Авторы исследования говорят, что, таким образом, продолжительность жизни увеличилась на 37%, по сравнению с прогнозами для тех 20-летних, которые начинали АРВ-терапию в первые годы появления комбинированного лечения.

ВИЧ-положительные люди часто задают своим поставщикам медицинских услуг вопрос о том, как долго они проживут с вирусом, особенно с таким количеством эффективных вариантов АРВ-терапии. К настоящему моменту ответу на этот вопрос посвящено очень мало исследований.

Чтобы определить продолжительность жизни ВИЧ-положительных пациентов, международный реестр исследователей объединил свои силы и просмотрел медицинские карты более чем 43 000 людей, живущих с вирусом в США, Канаде и ряде европейских стран. Участники исследования были разделены на три группы: 18 587 человек, которые начали АРВ-терапию в период между 1996 и 1999 годом, 13 914 человек, которые начали лечение в период между 2000 и 2002 годом, и 10 854 человека, которые начали лечение в период между 2003 и 2005 годом.

Согласно прогнозам исследователей, 20-летний человек, который начал АРВ-терапию в период между 1996 и 1999 годом, то есть в первые годы появления комбинированной АРВ-терапии, мог прожить еще 36 лет, то есть до 56. Однако этот показатель значительно увеличился со временем. 20-летний, который начал лечение в период между 2003 и 2005 годом, по расчетам, может прожить еще 49 лет, то есть до 69 лет.

В то же время, средняя продолжительность жизни для 20-летнего ВИЧ-отрицательного, по крайней мере, в промышленно развитых странах, составляет еще 60 лет, то есть смерть наступает, в среднем, в возрасте 80 лет.

ВИЧ-положительные люди, которые не начинали АРВ-терапию, пока уровень CD4 не снизился до 100, согласно расчетам, живут на 10 лет меньше, чем люди, которые начали терапию, когда их уровень CD4 бы выше 200. Авторы также установили, что ВИЧ-положительные люди, которые употребляли инъекционные наркотики, согласно расчетам, живут на 10 лет меньше, чем те, кто никогда не использовали инъекционные наркотики.

В письме в журнал The Lancet Дэвид Купер, доктор медицинских наук из Университета Нового Южного Уэльса в Сиднее, комментируя исследование, говорит о том, что, если начинать АРВ-терапию еще раньше, когда число лимфоцитов CD4, например, выше 500, то это вряд ли приведет к увеличению продолжительности жизни. Доктор Купер надеется, что ответ дадут международные клинические испытания «Стратегия планирования антиретровирусной терапии (Strategic Timing of Anti-Retroviral Treatment — START), в рамках которых изучается процесс раннего начала АРТ.

Продолжительность жизни с ВИЧ резко возрастает

Результаты крупного европейского исследования, о которых было доложено в феврале 2010 года на 17-ой Конференции по ретровирусам и оппортунистическим инфекциям (CROI), также говорят о том, у людей, живущих с ВИЧ, у которых уровень лимфоцитов CD4 выше 500 клеток в течение по крайней мере трех лет, средняя продолжительность жизни «близка к нормальной».

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