EPIDEMIOLOGY OF HEMOPHILIA AND OF HIV-INFECTION IN ITALY

To evaluate the incidence and prevalence of hemophilia in Italy and th e impact of HIV infection on the Italian hemophiliac population, data from a computerized national registry of patients from 95% of the hemo philia care centers in Italy were analyzed. A total of 4643 patients w ere included in the registry. The prevalence of hemophilia A was 8.2 p er 100,000 males, with no significant regional differences; for hemoph ilia B the corresponding figure was 1.5 per 100,000. Temporal trends i n hemophilia incidence suggest that the diagnosis of mild and moderate hemophilia has improved. The overall HIV prevalence was 26% and was s ignificantly (p < 0.001) higher in patients with hemophilia B (47.1%) compared to those with hemophilia A (26.8%) or other diseases (16.5%). The highest rate of HIV seropositivity was among patients 20-29 years of age. The annual amount of clotting factor concentrates received wa s significantly (p < 0.001) higher in HIV seropositive patients than i n those who were seronegative. Antibody testing was never performed on 10.1% of severely affected patients. The number of patients in the It alian registry was similar to the number that would have been expected based on prevalence estimates from other countries. In comparison wit h other countries, the prevalence of HIV infection recorded in Italy w as lower in persons with hemophilia A, but higher in those with hemoph ilia B. Our study demonstrates the usefulness of a registry in delinea ting the epidemiology of hemophilia and in studying risk factors for H IV infection. It also underlines the need for continuing surveillance of this population.