MORTALITY BEFORE AND AFTER HIV-INFECTION IN THE COMPLETE UK POPULATION OF HEMOPHILIACS

DURING 1977-91, 6,278 males diagnosed with haemophilia were living in the UK. During 1979-86, 1,227 were infected with the human immunodefic iency virus (HIV-1) as a result of transfusion therapy (median estimat ed seroconversion date, October 1982). Among 2,448 with severe haemoph ilia, the annual death rate was stable at 8 per 1,000 during 1977-84; during 1985-92 death rates remained at 8 per 1,000 among HIV-seronegat ive patients but rose steeply in seropositive patients, reaching 81 pe r 1,000 in 1991-92. Among 3,830 with mild or moderate haemophilia, the pattern was similar, with an initial death rate of 4 per 1,000 in 197 7-84, rising to 85 per 1,000 in 1991-92 in seropositive patients. Duri ng 1985-92, there were 403 deaths in HIV seropositive patients, wherea s 60 would have been predicted from rates in seronegatives, suggesting that 85% of the deaths in seropositive patients were due to HIV infec tion. Most of the excess deaths were certified as due to AIDS or to co nditions recognized as being associated with AIDS.