Factors associated with progression to AIDS and mortality in a cohort of HIV-infected patients with hemophilia followed up since seroconversion.
Progression to AIDS and death were evaluated in 112 patients, 84 with hemophilia A and 28 with hemophilia B. Seroconversion period and age at seroconversion were similar in both groups. 36/112 patients died: 21/84 with hemophilia A (25%) and 15/28 (54%) with hemophilia B. Mean survival time was 11.7 years. The 10-year cumulative survival was 75.8%. It was lower in hemophilia B (56.2%) compared to hemophilia A patients (82.4%; p = 0.002). 37 patients (33%) developed full-blown AIDS: 26 with hemophilia A (31%) and 11 with hemophilia B (39%). Mean AIDS-free survival time was 11.4 years. The 10-year cumulative AIDS-free survival was 71.2%. It was 74.8% in hemophilia A and 60.3% in hemophilia B patients. CD4 counts lower than 200/cmm occurred in 62 patients (56%): 45 with hemophilia A (54%) and 17 with hemophilia B (63%). The mean time to CD4 counts lower than 200 was 9.4 years. Mean survival time in older seroconverters (35 year old or more) was shorter than in younger (9.5 vs. 11.7 years, p < 0.05). Mean CD4 cell counts at seroconversion were similar in hemophilia A and B patients and in different age classes at seroconversion. CD4 cell counts at seroconversion affected the survival: 90% seroconverters with CD4 cell counts of 800/cmm or more were alive at 10 years vs. 60% of seroconverters with CD4 cell counts lower than 800 (p < 0.05).
Santagostino
E
E
A. Bianchi Bonomi Hemophilia and Thrombosis Center, Institute of Internal Medicine, IRCCS Maggiore Hospital, University of Milan, Italy.
Gringeri
A
A
Cultraro
D
D
Tradati
F
F
Siracusano
L
L
Marinoni
A
A
Mannucci
P M
PM
D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D018791:CD4 Lymphocyte Count; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006679:HIV Seropositivity; D015528:HIV Seroprevalence; D015497:HIV-1 / Q000276:immunology; D006467:Hemophilia A / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D002836:Hemophilia B / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D013997:Time Factors