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Liver failure and mortality in HIV‐positive haemophiliacs: FOURTEEN‐YEAR EXPERIENCE AND LITERATURE REVIEW
Author(s) -
SCHWARTZ J. D.,
ALEDORT L. M.,
SEREMETIS S. V.
Publication year - 1997
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1046/j.1365-2516.1997.00081.x
Subject(s) - medicine , liver disease , human immunodeficiency virus (hiv) , hepatitis c , liver failure , cohort , hepatitis , gastroenterology , mortality rate , surgery , immunology
Progression to clinical liver failure has been observed in hepatitis C (HCV)‐infected, HIV‐seropositive haemophiliacs. We studied the records of 176 haemophiliacs who were infected with HIV and/or HCV seen between 1980 and 1993. Thirty‐two of 113 (28%) HIV‐seropositive patients died during the study period. Ten of these patients died of liver failure, representing 31% of all mortality. An additional four HIV‐seropositive patients who died of other causes had end‐stage liver disease. Clinical liver failure occurred in 12% of the HIV‐infected cohort. None of the HIV‐seronegative, HCV‐infected patients suffered from liver failure. Among HIV‐infected patients, liver failure was associated with advanced age and decreased CD4 counts. Severe, sporadic ALT elevations were associated with liver failure; persistent transaminase elevations were associated with mortality. We conclude that HIV infection enhances progression of HCV infection to clinical liver failure, and that liver failure is a major cause of mortality in HIV‐positive haemophiliacs.