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Progression of HIV infection in the post‐HAART era among a cohort of HIV+ Greek haemophilia patients
Author(s) -
Katsarou O.,
Touloumi G.,
Antoniou A.,
Kouramba A.,
Hatzakis A.,
Karafoulidou A.
Publication year - 2005
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/j.1365-2516.2005.01109.x
Subject(s) - medicine , cohort , haemophilia , seroconversion , human immunodeficiency virus (hiv) , pediatrics , cohort study , haemophilia a , immunology
Summary. Aim: The study aims to describe the course of HIV‐1 infection in the pre‐ and post‐HAART period in a cohort of HIV+ haemophilia patients followed up for up to 21 years. Methods: The cohort includes 158 haemophilic men with known seroconversion dates followed up prospectively for a median time of 12 and 5.7 years in the pre‐ (1980–96) and post‐HAART period (1997–2003), respectively. Results: The risk of developing AIDS was lowered by 56% in the post‐ as compared to the pre‐HAART period. Of the 158 patients 69 developed AIDS in the pre‐HAART period while of the 59 subjects still alive and AIDS free on 1/1/1997 six developed AIDS. The rate of PCP (12.0 cases per 1000 person‐years) and NHL (5.4 cases per 1000 person‐years), the most common causes of AIDS diagnosis in the pre‐HAART era, were remarkably reduced in the post‐HAART era (both rates: 2.8 cases per 1000 person‐years). On the contrary, the corresponding risk for non‐AIDS deaths was fourfold increased in the post‐HAART period. Of the 38 non‐AIDS related deaths in both periods, 13 occurred post‐HAART. The predominant cause of non‐AIDS mortality in both periods was end‐stage liver disease (ESLD) (7 pre‐ and 4 post‐HAART). The rate of non‐AIDS related cancers was also increased during the post‐HAART period. Conclusion: In this haemophilia cohort the risk of AIDS has substantially reduced in the post‐HAART period, but the rate of non‐AIDS mortality tended to increase. Among haemophilia subjects, due to the high rates of HCV/HIV coinfection, ESLD, the predominant cause of non‐AIDS mortality, will become an increasingly important clinical problem.