Bleeding as a cause of death in HIV-seropositive patients with congenital clotting disorders.
The causes of death in a group of HIV-seropositive patients suffering from congenital clotting disorders (cCD) were studied. During the past 6 years, we have followed 19 patients with cCD and HIV infection. Eight patients fulfilled revised CDC criteria for AIDS, 6 subjects reached stage III of CDC, and 5 remained asymptomatic (CDC stage II). All patients who developed AIDS died. In 5 patients, the terminal cause of death was a severe haemorrhage (hematemesis, melena or haemoptysis) after gastrointestinal or lung opportunistic infections. Two other patients died as a consequence of disseminated infections but without significant bleeding. Only one subject died due to neoplastic disease. In the first stages of CDC (II and III), no increase in bleeding symptoms were seen in cCD HIV infected patients. The risk of haemorrhages is, however, increased in AIDS patients. Adequate replacement therapy should be started early whenever severe opportunistic infections appear.
Mares
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Institute of Medical Semeiotics, University of Padua Medical School, Italy.
Sartori
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MT
Stocco
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Girolami
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A
D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000401:mortality; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D001778:Blood Coagulation Disorders / Q000150:complications*; D002423:Cause of Death; D005500:Follow-Up Studies; D006679:HIV Seropositivity / Q000150:complications*; D006396:Hematemesis / Q000209:etiology / Q000401:mortality; D006469:Hemoptysis / Q000209:etiology / Q000401:mortality; D006470:Hemorrhage / Q000209:etiology / Q000401:mortality*; D006801:Humans; D016483:Lymphoma, AIDS-Related / Q000401:mortality; D008297:Male; D008551:Melena / Q000209:etiology / Q000401:mortality; D008875:Middle Aged