Survival analysis of hemophilia-associated AIDS cases in the US.

Abstract

Using national hemophilia-associated AIDS (acquired immunodeficiency syndrome) surveillance data and the life table method of survival analysis, the median length of survival of hemophilic patients in the United States after the diagnosis of AIDS was 11.7 months; the cumulative probability of survival at one year was 49.2 + 2.0 percent; at two years, 28.9 ± 2.3 percent. Patients 13-29 years of age at the time of diagnosis had the longest survival and those 60 years and older had the shortest. Patients diagnosed since 1986 survived longer than those diagnosed before 1986. Length of survival did not differ significantly by race, coagulation disorder,

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

“…When age was restricted to those 2 W 4 years, the hemophilia-only group showed a longer survival time, and no appreciable difference was found between the hemophilia-only group and the multiple risk group. As expected, the longer survival time reflects the effect of age on survival [7,19,20]. The race/ethnicity distribution of the two groups was different for those 20-44 years old, i.e., only blacks were more likely to have additional risk factors than whites.…”

“…Surveillance of AIDS for persons with hemophilia and other coagulation disorders is maintained through standardized AIDS case reporting, which is required in all U.S. states and territories [7]. Cases meeting a surveillance definition for AIDS are reported to CDC by state health departments [S] .…”

Clinical Decisions in the Care of Elderly Persons with AIDS

“…The proportion of AIDS patients who have AIDS diagnosed in the same month in which they die ranges from about 1 in 10 among young adults to over a third (37%) of those aged 80 or above 1 . The period between seroconversion and AIDS‐defining opportunistic illness tends to decrease with increasing age among transfusion recipients, 23 there is more rapid progression to immunodeficiency in older than younger hemophiliacs, 24 and there is shorter survival after AIDS diagnosis in older hemophiliacs 25 . A factor may be that AIDS may be underdiagnosed among clinicians caring for elderly patients, such that it is often not diagnosed until fulminant 5 , 6…”

Psychosocial Risk Factors of HIV Morbidity and Mortality: Findings from the Multicenter AIDS Cohort Study (MACS)

“…The median time from initial HIV infection to AIDS is estimated at approximately 10 years although estimates have varied from 6.6 to 10.2 years Bacchetti & Moss, 1989;Brookmeyer & Goedert, 1989;Brown, Siddiqui, & Chu, 1996;Enger et al, 1996;Hessol et al, 1994;Leserman et al, 1999;Longini, Clark, Gardner, & Brundage, 1991;Lui et al, 1986;Mayne, Vittinghoff, Chesney, Barrett, & Coates, 1996;Medley, Anderson, Cox, & Billard, 1987;Munoz et al, 1989;Pezzotti et al, 1996, Veugelers et al, 1994. The median time from AIDS diagnosis to death is estimated at 10 months with prior estimates ranging from 3 to 51 months Batalla et al, 1989;Brown et al, 1996;Burack et al, 1993;Friedland et al, 1991;Gail, Tan, Pee, & Goedert, 1997;Justice, Feinstein, & Wells, 1989;Karlsen, Reinvang, & Froland, 1995;Luo, Law, Kaldor, McDonald, & Cooper, 1995;Lyketsos et al, 1993;Marasca & McEvoy, 1986;Mayeux et al, 1993;McGrady, Jason, & Evatt, 1987;Osmond, Charlebois, Lang, Shiboski, & Moss, 1994;Rothenberg et al, 1987;Stehr-Green, Holman, & Mahoney, 1989;Whyte, Swanson, & Cooper, 1989;Vella et al, 1995). The advent of antiretroviral medications, effective treatment of opportunistic infections beginning in the late 1980s, and the introduction of protease inhibitors and combination therapies in the 1990s has also increased average clinical latency and longevity by several years (Detels et al, 1998;…”