Important note: Information in this article was accurate in July 2000. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; Monday, July 31, 2000
Prepared by AIDS Weekly editors from staff and other reports
NewsRx -- HIV infected men with hemophilia respond well to highly active antiretroviral therapy (HAART), indicate data from a two-decade-long study in England.
"Many hemophilic individuals infected with HIV died before receiving antiretroviral therapy (ART)," wrote C.A. Sabin and colleagues, Royal Free & University College Medical School, England. "Most who remain alive are chronically infected with hepatitis C virus (HCV), which has implications for their prognosis and choice of ART. The clinical status of a cohort of HIV positive hemophilic men is reported together with their response to HAART."
They collected their data from a longitudinal cohort study that was set in a comprehensive care hemophilia center. The cohort included 111 hemophilic men who seroconverted to HIV in the time period between 1979 and 1985.
The researchers followed the cohort from 1979. They reported that by 19.5 years later, by April 30, 1999, 57 of the 111 men had developed AIDS and 65 had died (Kaplan-Meier rates of 57.0% and 65.1%, respectively).
"AIDS rates have declined since 1997 but death rates have remained high, largely owing to deaths from non-HIV related causes," added Sabin et al. "Thirty-five patients remain alive and under follow-up at the clinic."
They observed that of the 35 remaining patients, the 28 given ART had lower CD4 cell counts than the seven patients who had not received ART. In all other aspects, however, the two groups of living patients were similar.
A total of 21 patients started HAART while under care at the center. Within 10-12 months of starting HAART, the patients' viral loads dropped by 2.06 log10 copies/ml. In addition, their CD4 cell counts increased by 60x106 cells/l. Eighteen patients had initial viral loads of >400 copies/ml. In 10 of these, a viral load below this level was attained following initiation of HAART; four had changed therapy at the time.
"While the decision to initiate HAART in hemophilic men should be made carefully because of the possible adverse events, our results suggest that a good response rate was achieved in this group of men," concluded Sabin et al. ("Two decades of HIV infection in a cohort of hemophilic individuals: Clinical outcomes and response to highly active antiretroviral therapy," AIDS 2000 May 26;14(8):1001-7.
The contact person for this report is C.A. Sabin, Royal Free & University College Medical School, Department of Primary Care & Population Sciences, Royal Free Campus, Rowland Hill St., London NW3 2PF, England.
A search of the www.NewsRx.com online database using the terms "HIV" and "hemophilia" generated 238 articles.
Key points reported in this study are:
This article was prepared by AIDS Weekly editors from staff and other reports.
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