Mortality before and after HIV infection in the complete UK population of haemophiliacs

Abstract

During 1977-91, 6,278 males diagnosed with haemophilia were living in the UK. During 1979-86, 1,227 were infected with the human immunodeficiency virus (HIV-1) as a result of transfusion therapy (median estimated seroconversion date, October 1982). Among 2,448 with severe haemophilia, the annual death rate was stable at 8 per 1,000 during 1977-84; during 1985-92 death rates remained at 8 per 1,000 among HIV-seronegative patients but rose steeply in seropositive patients, reaching 81 per 1,000 in 1991-92. Among 3,830 with mild or moderate haemophilia, the pattern was similar, with an initial death rate of 4 per 1,000 in 1977-84, rising to 85 per 1,000 in 1991-92 in seropositive patients. During 1985-92, there were 403 deaths in HIV seropositive patients, whereas 60 would have been predicted from rates in seronegatives, suggesting that 85% of the deaths in seropositive patients were due to HIV infection. Most of the excess deaths were certified as due to AIDS or to conditions recognized as being associated with AIDS.

Prevalence and risk factors for heart disease among males with hemophilia

“…Several European studies [1][2][3] and one U.S. study [4] of cause-specific mortality have found lower rates of death from ischemic heart disease in persons with hemophilia compared to the general population. These findings have been interpreted as providing evidence that the hypocoagulable state offers protection from the thrombotic event that precipitates infarction.…”

Mortality rates and causes of death among all HIV-positive individuals with hemophilia in Canada over 21 years of follow-up

“…The rates and causes of death in HIV-infected individuals with hemophilia have been previously documented from other national registries, [1][2][3][4][5][6][7] and data from Canada have been reported up to 1995. 8,9 The death rate increased steadily during the late 1980s before the introduction of antiretroviral therapy, reached a peak from 1991 to 1993, and then appeared to decrease thereafter.…”

The natural history of chronic hepatitis C in a cohort of HIV-negative Italian patients with hereditary bleeding disorders

“…[21][22][23][24][25] Furthermore, most of the few studies published so far refer to hemophiliacs coinfected with HIV, [26][27][28][29][30] which is a well-known risk factor for a more rapid progression of liver disease and could be a confounding factor in evaluating the natural history of HCV infection.…”