MODEL OF THE IMPACT OF HIV-INFECTION ON THE SIZE OF FUTURE HEMOPHILIAAND CARRIER BIRTH COHORTS

The introduction of human immunodeficiency virus (HIV) infection in al most half of the U.S. hemophilia population during the late 1970s and early to mid-1980s has resulted in significant mortality and morbidity . The predict the quantitative impact of HIV infection through HIV-con taminated clotting factor on the size of future hemophilia and hemophi lia carrier populations in the United States, a demographic model was developed for hemophilia and hemophilia carrier birth cohorts for the 200 years between 1980 and 2180. Mortality and fertility rates were es timated from databases of the Hemophilia Malignancy Study (HMS), NHLBI Blood Resources Studies, and Centers for Disease Control (CDC) Minima l Data Set. According to the model, the HIV epidemic will produce smal l reductions in the expected numbers of hemophilic (1.79%) and carrier (2.63%) births in the next 2 centuries. More substantial reductions i n the numbers of hemophilic and carrier births required extreme assump tions regarding the fertility of hemophilic men, the extent of HIV inf ection among hemophilic men, and the proportion of hemophilic births t hat arise from spontaneous mutation.