Public Health

Life insurance should be an option for successfully treated HIV patients

Last Updated: 2003-09-12 16:06:22 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The rate of excess deaths when HIV-infected, hepatitis C-negative patients are successfully treated with highly active antiretroviral therapy (HAART) is no more than that associated with successfully treated cancer.

Therefore, suggest the authors of a report In The Lancet for September 13, life insurance companies might reconsider their usual practice of not making policies available to patients with HIV.

Dr. Bernard Hirschel and colleagues examined data from nearly 4000 patients in the Swiss HIV Cohort Study for whom hepatitis C serology results were available since January of 1997. They documented 341 deaths, an excess death rate of 23.9 per 1000 patient-years compared with the general Swiss population.

In the subgroup of patients successfully treated with HAART who were negative for hepatitis C, excess death rates were < 5 per 1000 patient-years.

When these patients sustain a CD4 count of greater than 250 cells/�L, "mortality is likely to remain low during the next few years," Dr. Hirschel, of University Hospital Geneva, and colleagues write.

Co-infection with hepatitis C substantially increases excess death rates. And even though successful treatment of hepatitis C also lowers excess mortality, the rates remain higher than among those not co-infected.

Because the excess death rates resemble those of successfully treated cancer patients -- 5 to 20 per 1000 patient years -- life insurance coverage is appropriate when specific conditions are met, the investigators conclude.

Lancet 2003;361:877-878.