Progression to acquired immunodeficiency syndrome in 94 human immunodeficiency virus-positive hemophiliacs with long-term follow-up

Background and Objectives, Human immunodeficiency virus (HIV) infection was transmitted to many hemophilics treated with non-inactivated factor concen trates before 1986, The aim of this study was to know the long-term inciden ce of AIDS and risk factors for its development in HIV-infected hemophiliac s. Design and Methods, This study was a retrospective analysis of 94 HIV-infec ted hemophilics. The cumulative incidence of AIDS during a follow-up of 16 years from seroconversion was determined by Kaplan-Meier analysis, and pote ntial risk factors were also studied by multivariate analysis. Results. The 16-year estimated incidence of AIDS was 38% (95% Cl 27%-52%). The AIDS incidence was significantly higher in patients with hemophilia B ( p <0.0001), older age at seroconversion (p=0.0004), lower CD4 counts at ser oconversion (p=0.004), and lower concentrate consumption during follow-up ( p=0.02), than it was in those patients without these characteristics. Howev er, only hemophilia type and age at seroconversion remained significant in the multivariate analysis, with a relative risk of 0.06 (95% Cl 0.02-0.20) for hemophilia A and 1.04 (95% Cl 1.01-1.06) for every year of increase in age at seroconversion. The severity of hemophilia, history of inhibitors an d concentrate consumption before seroconversion were not significantly asso ciated with AIDS development. Interpretation and Conclusions. A considerable proportion of HIV-infected h emophiliacs remained AIDS-free 16 years after seroconversion, The risk of A IDS was particularly high in patients with hemophilia B and for patients wh o were older at seroconversion. (C) 2001, Ferrata Storti Foundation.