title: Liver failure and mortality in HIV-positive haemophiliacs: FOURTEEN-YEAR EXPERIENCE AND LITERATURE REVIEW.
abstract: Progression to clinical liver failure has been observed in hepatitis C (HCV)-infected, HIV-seropositive haemophiliacs. We studied the records of 176 haemophiliacs who were infected with HIV and/or HCV seen between 1980 and 1993. Thirty-two of 113 (28%) HIV-seropositive patients died during the study period. Ten of these patients died of liver failure, representing 31% of all mortality. An additional four HIV-seropositive patients who died of other causes had end-stage liver disease. Clinical liver failure occurred in 12% of the HIV-infected cohort. None of the HIV-seronegative, HCV-infected patients suffered from liver failure. Among HIV-infected patients, liver failure was associated with advanced age and decreased CD4 counts. Severe, sporadic ALT elevations were associated with liver failure; persistent transaminase elevations were associated with mortality. We conclude that HIV infection enhances progression of HCV infection to clinical liver failure, and that liver failure is a major cause of mortality in HIV-positive haemophiliacs.
authors.affiliation: The Mount Sinai Medical Center, One Gustave Levy Place, New York, NY, USA.
authors.forename: J D
authors.initials: JD
authors.lastname: Schwartz
authors.affiliation: The Mount Sinai Medical Center, One Gustave Levy Place, New York, NY, USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Aledort
authors.affiliation: The Mount Sinai Medical Center, One Gustave Levy Place, New York, NY, USA.
authors.forename: S V
authors.initials: SV
authors.lastname: Seremetis
keywords: AIDS; HIV; cirrhosis; hepatitis; liver failure.