Azidothymidine (AZT) in the Treatment of Symptomatic HIV-1-Infected Hemophiliacs

Eichinger, Sabine; Pabinger, Ingrid; Hartl, H; Stain, Christoph; Mayerhofer, S; Schweiger, Ch.; Kier, P; Schwarzinger, I.; Kyrle, Paul A.; Lechner, Klaus

doi:10.1055/s-0038-1647263

Cited by 7 publications

(2 citation statements)

References 15 publications

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“…beginning of the HIV epidemic, the survival analyses presented here do not reflect the results of more recent pharmacologic breakthroughs in improving survival. For example, in a recently published study of zidovudine (Retrovir, formerly azidothymidine [AZT]) in the treatment of symptomatic HIV-infected hemophiliacs, the progression of disease to AIDS appeared to be hindered by continuous AZT treatment, and no significant changes were observed in the consumption of clotting factor concentrates and number of bleeding episodes before and after AZT treatment [24]. Further studies are needed to examine the recent impact of AZT and other treatments on the survival experience of persons with hemophilia.…”

Section: Discussionmentioning

confidence: 99%

Survival of hemophilic males with acquired immunodeficiency syndrome with and without risk factors for AIDS other than hemophilia

et al. 1992

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Between January 1, 1981, and June 30, 1990, 1,514 hemophilia-associated acquired immunodeficiency syndrome (AIDS) cases in males were diagnosed in the United States. In 1,394, hemophilia was reported as the sole risk factor. For an additional 120, other risk factors were reported: of 101 of these, 40 had homosexual/bisexual activity, 53 had a history of intravenous drug use, and 8 had both of these risk factors. We examined the demographic data and the survival data of two principal groups: males for whom hemophilia was the sole reported risk factor for human immunodeficiency virus (HIV) exposure, and hemophilic males for whom homosexual/bisexual activity, intravenous drug use, or both of these additional risk factors were reported. The survival curves showed marginal differences between the hemophilia-only and the multiple risk groups; the median survival times were 13.1 and 14.6 months, with the cumulative probability of survival at 1 year as 52.7% and 54.0%, respectively. Kaposi's sarcoma was among AIDS indicator diseases more commonly found in the multiple risk factor group. Pneumocystis carinii pneumonia was the sole reported diagnosis indicative of AIDS for 34.4% of those in the hemophilia-only group, compared with 20.8% of those with multiple risk factors. The principal demographic difference between the two groups was the age distribution; those in the multiple risk factor group were primarily between 20 and 44 years of age. Restricting the analysis to those between 20 and 44 years resulted in a slightly longer survival time in the hemophilia-only group and no appreciable difference between the disease distributions and survival curves of the two groups.

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Section: Discussionmentioning

confidence: 99%

Survival of hemophilic males with acquired immunodeficiency syndrome with and without risk factors for AIDS other than hemophilia

et al. 1992

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“…Attempts at modeling when increases in hemophilia-associated AIDS-related deaths will peak [29,59] may or may not be much affected by advances in treatment of HIV-infected persons. Continuous treatment with zidovudine [Retrovir, formerly azidothymidine (AZT)] appears to hinder the progression of disease to AIDS for HIV-1 -infected persons with hemophilia [61][62][63]. Early treatment with zidovudine [64,65] and prophylaxis against Pneurnocystis carinii pneumonia [62] appear to prolong survival in addition to prolonging the time until AIDS develops.…”

Section: Discussionmentioning

confidence: 99%

Changes in longevity and causes of death among persons with hemophilia A

et al. 1994

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To examine recent changes in longevity and the causes of death among persons with hemophilia A, we evaluated death certificate data for persons who died in the United States from 1968 through 1989 and had hemophilia A or congenital Factor VIII disorder (ICD code 286.0) listed on the death certificate as one of the multiple causes of death. Multiple-cause-of-death mortality data for the United States from 1968 to 1989 were examined to compare death rates by year, focusing on death rates and causes of death for 1979-1981, 1983-1985, and 1987-1989. Gender, age group, race, geographic region, and median age at death of persons with hemophilia A and human immunodeficiency virus (HIV)-related disease listed as a cause of death were compared with those with hemophilia A without HIV-related disease. From 1968 through 1989, 2,792 hemophilia A deaths were reported. The death rate increased from 0.5 to 1.3 per 1,000,000 persons. From 1979-1981 through 1987-1989, mortality increased in all age groups above 9 years of age and age at death shifted markedly to lower ages. Median age at death decreased from 57 years in 1979-1981 to 40 years in 1987-1989. The percentage of deaths due to hemorrhage or diseases of the circulatory system decreased markedly as the result of the increase in deaths associated with HIV infection or infections other than HIV infection. Spread of HIV-1 infection in persons with hemophilia A has disrupted the reduction in mortality seen with factor replacement therapy, implementation of home care, and use of comprehensive hemophilia treatment centers. It is hoped that advances in the care of HIV-infected persons will improve survival in the hemophilia community.

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Prospective study of antigenemia, plasma viremia and lymphocytic viremia in HIV-infected hemophiliacs

Garcia

Navarro

Pinto

et al. 1995

Eur. J. Clin. Microbiol. Infect. Dis.

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A total of 186 blood samples from 24 HIV-1 seropositive hemophiliac patients, monitored every four months for 29 months, were investigated for the presence of viral antigen in plasma. In addition, peripheral blood mononuclear cells (PBMC) were cultured for HIV-1, using normal PBMC as a target for replication. Antigenemia was detected in 51% of the patients and from PBMC in 87.5% of the patients. The incidence of HIV isolation in asymptomatic patients (42.8%) was similar to that found in symptomatic patients (51.4%). Patients with opportunistic infections had a higher incidence of lymphocytic viremia (p < 0.05). Plasma viremia was closely associated (p < 0.05) with low CD4+ counts and infection progression. The persistence of antigenemia was also a marker of a poor clinical course. In treated patients, plasma viremia was the marker that better correlated with the clinical course, and it did not appear during the first nine months of therapy. Zidovudine doses of > 500 mg/day significantly lowered the appearance of antigenemia and lymphocytic viremia (p < 0.05).

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Azidothymidine (AZT) in the Treatment of Symptomatic HIV-1-Infected Hemophiliacs

Cited by 7 publications

References 15 publications

Survival of hemophilic males with acquired immunodeficiency syndrome with and without risk factors for AIDS other than hemophilia

Survival of hemophilic males with acquired immunodeficiency syndrome with and without risk factors for AIDS other than hemophilia

Changes in longevity and causes of death among persons with hemophilia A

Prospective study of antigenemia, plasma viremia and lymphocytic viremia in HIV-infected hemophiliacs

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