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. Eig ht patients fulfilled revised CDC criteria for AIDS, 6 subjects reache d stage III of CDC, and 5 remained asymptomatic (CDC stage II). All pa tients who developed AIDS died. In 5 patients, the terminal cause of d eath was a severe haemorrhage (hematemesis, melena or haemoptysis) aft er gastrointestinal or lung opportunistic infections. Two other patien ts died as a consequence of disseminated infections but without signif icant bleeding. Only one subject died due to neoplastic disease. In th e first stages of CDC (II and III), no increase in bleeding symptoms w ere seen in cCD HIV infected patients. The risk of haemorrhages is, ho wever, increased in AIDS patients. Adequate replacement therapy should be started early whenever severe opportunistic infections appear.