Comparison between HIV-1-infected hemophiliacs and non-hemophiliacs on survival and clinical courses after starting highly active antiretroviral therapy

Abstract

In order to investigate the long-term prognosis and clinical efficacy of highly active antiretroviral therapy (HAART) in HIV-1-infected hemophiliacs, we compared clinical courses of 69 HIV-1-infected hemophiliacs and 29 non-hemophiliacs all of whom were asymptomatic between 1990 and 1993. Changes of CD4 count during 1990 through 2000 in both groups were not significantly different. The time to death due to AIDS in both groups were also not significantly different. The major causes of death not related to AIDS in hemophiliacs were bleeding, liver cirrhosis, and liver cancer. A total of 55 (39 hemophiliacs and 16 non-hemophiliacs) out of 98 patients survived in 1997. Since then, the 28 hemophiliacs and the 12 non-hemophiliacs received HAART. Although the percentage of patients whose viral loads (VL) decreased to below undetectable level (VL<400 copies/ml) by the initial HAART regimens without saquinavir were not significantly different, continuation of the same regimens in the hemophiliacs were significantly longer than non-hemophiliacs (84 weeks vs. 51 weeks, p<0.05). From starting HAART to July 2000, 35.7% of the hemophiliacs were changed regimens three times or more. That is higher prevalence comparing with non-hemophiliacs of 16.7%. This study suggests that there might be the patient group who have to been changed HAART regimens frequently in the hemophiliacs.