Comparison of immunodeficiency and AIDS defining conditions in HIV negative and HIV postive men with haemophilia A

Sabin, Caroline; Pasi, K. J.; Phillips, Andrew; Lilley, P.; Bofill, Margarita; Lee, C. A.

doi:10.1136/bmj.312.7025.207

Cited by 9 publications

(9 citation statements)

References 12 publications

(15 reference statements)

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“…Sabin et al, comparing HIV negative and HIV positive men with haemophilia A, recently rejected this hypothesis,16 but the debate continues 17. None of our subjects had received factor VIII or zidovudine; nor was there any evidence of misuse of injected drugs in the population.…”

Section: Reseultmentioning

confidence: 76%

Mortality associated with HIV-1 infection over five years in a rural Ugandan population: cohort study

Nunn

Mulder

Kamali

et al. 1997

BMJ

112

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Objective: To assess the impact of HIV-1 infection on mortality over five years in a rural Ugandan population. Design: Longitudinal cohort study followed up annually by a house to house census and medical survey. Setting: Rural population in south west Uganda. Subjects: About 10 000 people from 15 villages who were enrolled in 1989-90 or later. Main outcome measures: Number of deaths from all causes, death rates, mortality fraction attributable to HIV-1 infection. Results: Of 9777 people resident in the study area in 1989-90, 8833 (90%) had an unambiguous result on testing for HIV-1 antibody; throughout the period of follow up adult seroprevalence was about 8%. During 35 083 person years of follow up, 459 deaths occurred, 273 in seronegative subjects and 186 in seropositive subjects, corresponding to standardised death rates of 8.1 and 129.3 per 1000 person years. Standardised death rates for adults were 10.4 (95% confidence interval 9.0 to 11.8) and 114.0 (93.2 to 134.8) per 1000 person years respectively. The mortality fraction attributable to HIV-1 infection was 41% for adults and was in excess of 70% for men aged 25-44 and women aged 20-44 years. Median survival from time of enrolment was less than three years in subjects aged 55 years or more who were infected with HIV-1. Life expectancy from birth in the total population resident at any time was estimated to be 42.5 years (41.4 years in men; 43.5 years in women), which compares with 58.3 years (56.5 years in men; 60.5 years in women) in people known to be seronegative. Conclusions: These data confirm that in a rural African population HIV-1 infection is associated with high death rates and a substantial reduction in life expectancy.

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Section: Reseultmentioning

confidence: 76%

Mortality associated with HIV-1 infection over five years in a rural Ugandan population: cohort study

Nunn

Mulder

Kamali

et al. 1997

BMJ

112

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show abstract

“…Because HIV is a rare contaminant of factor VIII, it seems to be just a surrogate marker for high dosages of foreign proteins. Sabin et al confirm this: “Most patients with severe haemophilia—and therefore the highest users of clotting factor concentrate—were seropositive to HIV….”2 Thus their results support the foreign protein hypothesis.…”

Section: Still No Evidence For Infectionmentioning

confidence: 86%

“…This explains why the morbidity of American6 and British7 patients with haemophilia has sharply increased since 1987, when most HIV positive haemophilic patients began zidovudine. *RF 1, 1a* Sabin et al confirm the zidovudine hypothesis, as “all nine HIV positive patients with AIDS received zidovudine” in addition to the “toxic” pentamidine,10 co-trimoxazole, and fluconazole 2…”

Section: Strong Temporal Evidencementioning

confidence: 94%

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Commentary: non-HIV hypotheses must be studied more carefully

Duesberg

1996

BMJ

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“…In 1991 Duesberg challenged researchers to provide either data on “controlled epidemiologic studies comparing matched hemophiliacs, with and without HIV, or epidemiological evidence that the mortality of hemophiliacs is increased by HIV.”1 We and Darby et al have provided that evidence 2 3. Duesberg's commentary4 requires further comment.…”

mentioning

confidence: 99%

Response: Arguments contradict the "foreign protein-zidovudine" hypothesis

Sabin

Phillips

Lee

1996

BMJ

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Comparison of immunodeficiency and AIDS defining conditions in HIV negative and HIV postive men with haemophilia A

Abstract: These data reject the hypothesis that high usage of clotting factor concentrate, rather than HIV infection, is the cause of immunodeficiency and AIDS in men with haemophilia.

Cited by 9 publications

References 12 publications

Mortality associated with HIV-1 infection over five years in a rural Ugandan population: cohort study

Mortality associated with HIV-1 infection over five years in a rural Ugandan population: cohort study

Commentary: non-HIV hypotheses must be studied more carefully

Response: Arguments contradict the "foreign protein-zidovudine" hypothesis

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