Twenty five years of HIV infection in haemophilic men in Britain: an observational study

Sabin, Caroline; Phillips, Andrew; Yee, T. T.; Griffioen, A; Lee, Christine A.

doi:10.1136/bmj.38604.468785.de

Cited by 5 publications

(3 citation statements)

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“…The proportions of patients in our study who developed AIDS (45%) and who were deceased (52%) were slightly lower than those reported in other studies in HIV‐infected haemophilia patients with long‐term follow‐up (AIDS development in 48–69% and death in 62–67% of patients during follow‐up periods of 20–23 years) . As expected, the proportion of patients who developed AIDS did not increase since Roosendaal's earlier report on this cohort, while the proportion of deceased patients did .…”

Section: Discussionmentioning

confidence: 99%

Morbidity and mortality in ageing HIV‐infected haemophilia patients

et al. 2012

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Summary Over 25 years of follow‐up is now available for HIV‐infected haemophilia patients. The aim of this study was to retrospectively asses the morbidity and mortality of HIV infection and the effects of HAART in these patients. Data on HIV infection, its treatment and all types of comorbidity were collected from medical records of all 60 HIV‐positive haemophilia patients who were treated at the Van Creveldkliniek since 1980 and compared with data from 152 HIV‐negative patients with severe haemophilia and the general age‐matched male population. AIDS developed in 27 patients (45%), while 31 patients died (52%). Death was solely or partially AIDS‐related in 71%. Development of AIDS and AIDS‐related deaths declined strongly after the introduction of HAART. Only one major ischaemic cardiovascular event occurred in our study population. Of the 27 patients who were still treated at our clinic in 2010, 25 (93%) were on HAART. They had more often hypertension and diabetes, but less often overweight and obesity and lower cholesterol levels than the general population. The occurrence of spontaneous intracranial bleeding was higher in HIV‐positive haemophilia patients on HAART than in HIV‐negative patients with severe haemophilia (16.6 vs. 1.2 per 1000 patient years). Since the introduction of HAART, the impact of HIV infection on morbidity and survival has decreased. The increased prevalences of hypertension and diabetes, however, warrant regular screening. HIV‐positive haemophilia patients on HAART appear to have an increased risk of spontaneous intracranial bleeding.

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Section: Discussionmentioning

confidence: 99%

Morbidity and mortality in ageing HIV‐infected haemophilia patients

et al. 2012

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“…In a Spanish study, 252 (66%) of a total of 383 hemophiliacs had died by December 2001 [20]. In addition, if we look at the present status of a well-studied British hemophilic cohort that began with 111 patients, 74 (67%) had died by 31 December 2004 [21]. Particular note is a comparison with a Canadian study [9].…”

Section: Discussionmentioning

confidence: 99%

Current status of Japanese HIV-infected patients with coagulation disorders: coinfection with both HIV and HCV

et al. 2008

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We herein report on the current status of Japanese HIV-positive patients with coagulation disorders, primarily hemophilia, based on the national survey of 31 May 2006. The total number of registered patients was 1,431 (Hemophilia A 1,086; Hemophilia B 325; von Willebrand disease 8; others 12), and 604 of these patients were deceased by 31 May 2006. The survival rate after the beginning of 1983 was evaluated by the Kaplan-Meier method. The total number of surviving patients was 827, and the survival rate on 31 May 2006 was 55.7 +/- 1.4%. Among the 827 surviving patients, HCV antibody was observed in 740, was negative in 16, and was not reported in 71 patients. Thus, the prevalence of HCV infection was 98% in the surviving patients based on the presence of HCV antibody. Among the 604 deceased patients, liver disease was reported as a cause of death in 149 cases (25%), and infection with HCV was reported as the possible cause of liver disease in 120 cases (20%). After 1997, 63 cases among the subtotal of 148 deaths had critical hepatic disease that originated from HCV infection, which accounted for 43% of the subtotal. The cumulative rate of patients who received interferon therapy was 32%. Interferon therapy should be prescribed more frequently to HIV-positive patients with coagulation disorders in order to realize the survival benefits, although clinicians should be aware of side effects and toxicities.

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“…In the modern cART era, patients with ongoing severe immunosuppression (CD4 + T-cell count ≤200 cells/mm 3 ) are in a minority [5,13,14]; severe immunosuppression might result from the late presentation of HIV or from failure to achieve a satisfactory response to cART due to non-adherence or development of antiretroviral resistance. Morbidity and mortality associated with both AIDS and non-AIDS events is highest in these patients [15,16].…”

Section: Introductionmentioning

confidence: 99%