Background: HAART has decreased AIDS deaths but mortality in patients with HIV is still perceived to be much higher than the mortality of the general population.  This perception precludes life insurance. This perception precludes the conclusion of life insurance contracts.

Methods: Patients analyzed were all Swiss patients (29.1 percent women) with a Swiss HIV Cohort Study (SHCS) visit after 1/1/1997. Prognostic factors examined were presence/absence of antibody to the hepatitis C virus, and success of treatment, defined as attaining, at least once, a CD4 count of > 250 after 1/1/1997, after more than 6 months after > 6 months on HAART. The analysis of mortality started with the date of the CD4 count indicating success in the successfully treated patients, and with the first cohort visit after 1/1/1997 in all others. Patients were followed until 12/31/2001, or until death, whatever occurred first. Official death registries were checked to determine if any of the patients in low-risk categories with loss of follow-up, had died. The excess death rate (EDR) mortality of SHCS patients, in extra deaths per 1000 per year, was calculated on the basis of the most recentwas divided by the age-and-sex-adjusted  age-and-sex-specific Swiss population mortality. of the Swiss population in order to obtain the mortality ratio.

Results:

Population	N patients (f/u years)	N of deaths	Mortality ratioEDR	95% CI of MREDR
1) 1) All (with hep C serology)	3963 (1290086)	41822	24.49.4	21.9 to 27.1 8.6 to 10.4
2) HepC negative	2318 (7’5983)	1340	14.04.7	11.3 to 17.2 3.9 to 5.5
3) Hep C negative and CD4 > 250 on HAART	1567 (4’498)1564 (4'493)	3531	4.21.9	2.0 to  7.2 1.4 to 2.7
4) HepC negative, CD4 > 250, and VL < 400 on HAART	1281 (3’594)	25	3.4	1.1 to 6.7
55) Same, but CD4 nadir < 250 before HAART	545 (1’564)693 (1’629)	1311	1.63.1	0.0 to 8.6 0.9 to 2.7

 

Conclusion: Succesfully treated HIV positive and hepC negative patients, including those who were immunosuppressed before treatment, have have a short term mortality at least as low as similar successfully treated cancer patients (EDRMR 2-5in the range of 5 to 20) , smokers (MR » 2) or obese people – two a groups who isare able to obtain life insurance.