Progression of HIV infection in the post‐HAART era among a cohort of HIV+ Greek haemophilia patients

Κατσαρού, Όλγα; Touloumi, Giota; Antoniou, Anna; Kouramba, Anna; Hatzakis, Angelos; Karafoulidou, Anastasia

doi:10.1111/j.1365-2516.2005.01109.x

Cited by 7 publications

(6 citation statements)

References 39 publications

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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 longterm follow-up (AIDS development in 48-69% and death in 62-67% of patients during follow-up periods of 20-23 years) [20][21][22][23]. 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 [12].…”

Section: Discussioncontrasting

confidence: 75%

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: Discussioncontrasting

confidence: 75%

Morbidity and mortality in ageing HIV‐infected haemophilia patients

et al. 2012

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“…4,6 Our cohort, with more than 21 years of follow-up, lends support to the importance of liver disease as an ongoing cause of morbidity and mortality in this cohort of HIV and HCV co-infected individuals with hemophilia. With the introduction of HAART in Canada between 1995 and 1997, 17 overall mortality and deaths due to AIDS has decreased, 18,19 while deaths due to liver disease have increased.…”

Section: Org Frommentioning

confidence: 98%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Arnold

Julian

Walker

2006

Blood

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Many individuals with hemophilia were infected with human immunodeficiency virus (HIV) in the early 1980s through contaminated blood products. Most also were co-infected with hepatitis C virus (HCV). Deaths among the entire cohort of HIV-positive hemophiliacs in Canada up to 2003 are described. Using registry data, we analyzed Kaplan-Meier survival curves, determined the effect of age at HIV seroconversion on mortality, and described cause-specific proportional mortality patterns over time. Of 2427 Canadians with hemophilia, 660 (27.2%) were HIVpositive, of whom 406 (61.5%) died. In contrast, 114 (6.5%) deaths occurred in HIV-negative controls. Median age at HIV seroconversion was 20 (range, < 1-67 years), and median survival was 15.0 years (95% confidence interval, 13.6-16.4 years). Younger age at HIV seroconversion was associated with improved survival; however, this finding was not explained by differences in causes of death across age groups. Following the introduction of highly active antiretroviral therapy, the proportion of deaths due to acquired immune deficiency syndrome has decreased, while the proportion of deaths due to liver disease has increased. There were 1134 HCV-positive individuals, of whom only 444 (39.2%) were also HIV-positive. Liver disease is a growing health concern among many hemophiliacs, not only those who are HIV-positive.

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“…Since its description in 1981 until 1987 when the first ART, zidovudine introduced, being diagnosed with HIV was synonymous to a death sentence, there was no treatment with significant impact to the progression of the disease [54]. Furthermore, during that era, a significant proportion of HIV-infected patients developed AIDS as compared to HAART era [55, 56]. With the commencement of the first monotherapy with zidovudine, resistance started to develop quickly especially in HIV patients with advanced disease and hence a significant proportion of patients continue to deteriorate as a result of treatment failure [57].…”

Section: Adrenal Insufficiency In Pre- and During Haart Eramentioning

confidence: 99%

Adrenal Insufficiency: A Forgotten Diagnosis in HIV/AIDS Patients in Developing Countries

Nassoro

Mkhoi

Sabi

et al. 2019

International Journal of Endocrinology

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Adrenal insufficiency (AI) is one of the most common endocrine disease in patients with HIV/AIDS, leading to high morbidity and mortality in HIV patients who become critically ill. Various etiologies are associated with the condition, including cytomegalovirus (CMV), Mycobacterium tuberculosis, lymphoma, Kaposi’s sarcoma, and drugs such as rifampin, among others. HIV patients with advanced disease develop relative cortisol deficiency largely due to the reduction of cortisol reserve, which predisposes patients to adrenal crisis in periods of stress or critical illness. The prevalence of AI in HIV/AIDS patients during HAART era is higher in developing than developed countries, probably due to limited access to both diagnosis and adequate treatments which increases the risk of opportunistic infections. The clinical features of functional adrenal insufficiency in HIV/AIDS patients can be masked by various infectious, noninfectious, and iatrogenic causes, which reduce clinical recognition of the condition. Development of simple screening algorithms may help clinicians reach the diagnosis when approaching these patients. In many low-income countries, most HIV patients are diagnosed with advanced disease; thus, further research is necessary to elucidate the prevalence of adrenal insufficiency in HIV/AIDS patients and the condition’s impact on mortality in this population.

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Progression of HIV infection in the post‐HAART era among a cohort of HIV+ Greek haemophilia patients

Cited by 7 publications

References 39 publications

Morbidity and mortality in ageing HIV‐infected haemophilia patients

Morbidity and mortality in ageing HIV‐infected haemophilia patients

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

Adrenal Insufficiency: A Forgotten Diagnosis in HIV/AIDS Patients in Developing Countries

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