The AIDS epidemic in the city of Copenhagen, Denmark: Potential years of life lost and impact on life expectancy

Abstract

Aims: This study seeks to describe the impact of AIDS on the city of Copenhagen by estimating potential years of life lost (PYLL) before the age of 65 years and to estimate the impact of AIDS deaths on life expectancy for males and females. Methods: All AIDS cases reported to the national AIDS surveillance register for residents in the city of Copenhagen in the period 1983—98 were included. For comparative purposes data were obtained on six other causes of death: accidents, suicide, lung cancer, ischaemic heart disease, testicular cancer, and breast cancer. Results: Overall, deaths from AIDS accounted for 8% of all PYLL in men and showed an increasing tendency from 1983 to 1991, when it became the leading cause of PYLL. AIDS had most impact in men in the age group 25—44 years and accounted for 29% of all PYLL in this group at the peak in 1993, decreasing significantly after the introduction of anti-retroviral treatments to 5% of PYLL in 1998. Other leading causes of PYLL, accidents and suicide, also showed a decreasing tendency over the years, but of a much smaller magnitude than AIDS. The impact of AIDS in women was more modest. In the entire study period suicide, accidents, and breast cancer were the leading causes of PYLL in women. It was shown that AIDS deaths at the top of the epidemic in 1991—95 were responsible for a loss of 0.76 years in life expectancy for men and 0.08 years for women. Conclusions: AIDS has had a considerable impact on potential years of life lost. A significant decline in AIDS deaths has been seen since 1995 with an effect on life expectancy for men in the city of Copenhagen.