Years of potential life lost due to HIV infection and associated factors based on national HIV surveillance data in Latvia, 1991-2010

Background: Latvia is still experiencing one of the highest human immunodeficiency virus (HIV) mortality rates in the European Union, and HIV is the 6^th leading cause of death among young adults (15-39 y) in the country. The aim of the study was to determine the years of potential life lost (YPLL) as an indicator of premature mortality and the associated factors among people living with HIV (PLH) in Latvia. Methods: Data from the National Registry of HIV/AIDS Cases was used for the time period 1991-2010. Data on 738 deaths were analysed. The cut-off age for YPLL calculations was 65 y. Univariable analysis was done using Mann-Whitney and Kruskal-Wallis tests. A linear regression model was constructed for determining the independent effects of the particular factors on the number of YPLL. Results: The total number of YPLL due to HIV in Latvia was 21,097 (50.4/100,000 general population; 511.1/1000 PLH). Each PLH who died had lost 28.8 YPLL on average. The numbers of YPLL reflect the population groups most affected by the HIV epidemic (young men, non-ethnic Latvians, living in the capital city, and being infected via drug injection). Our regression model indicated that among deceased PLH, non-Latvian ethnicity and injecting drug use as the mode of HIV transmission were associated with an additional 2.4 (p=0.003) and 5.7 (p<0.001) average YPLL, respectively. Conclusions: A considerable number of years of potential life have been lost in Latvia due to HIV. YPLL is significantly associated with ethnicity and mode of HIV transmission.