Prevalence of conditions associated with human immunodeficiency and hepatits virus infections among persons with haemophilia, 2001-2003

James J. Goedert, Jaime Siegel, Kay Miller, Michael M. Lederman, Alexis Thompson, Brittan Browning, Susan Gamerman, Kevin McRedmond, Janice Withycombe, Ralph Gruppo, Gina Stack, Jeanne Lusher, Linda Percy, Diane Nugent, Marianne McDaniel, Catherine Manno, Regina Butler, Amanda Wade, Anne Angiolillo, Naomi L C LubanChristine Guelcher, Michael Tarantino, Suzi Greer, Joan Gill, Jodie Nelson, Gilbert White, Michael Fried, Aime L. Grimsley, Donna DiMichele, Ilene Goldberg, James French, Sandra Hibner, James Steinberg, Steven Faust, Nigel Key, Vicky Hannemann, Craig M. Kessler, Anastasia E. Lee, M. Elaine Eyster, Kathryn Galli, Gillian Jenkins, Zale P. Bernstein, Linda Belling, Amy Shapiro, Marge Halley, Patti Noblet, Lawrence Jardine, Lori Laudenbach, Richard Lipton, Christine Pece, Cindy A. Leissinger, Cecilia Schmidt, Marcus Carr, Melinda Nolte, Marilyn Manco-Johnson, Sheryl Giambartolomei, Sheldon H. Rubin, Dorine Belliveau, Louis Aledort, Johanna McCarthy, Richard Lemons, Shirley Bleak, Eric Kraut, Leslie Witkoff, Charles Sexauer, Felicia Kiplinger, Arthur Thompson, Charles Cooper, Howard Britton, Kathi Cobb, Hans Joachim Reimers, Judy A. Bagato, Jerry S Powell, Muriel Herr, Karen Scott, John Hutter, Mary Lou Damiano, Willis Navarro, Jessie Roth, Joseph Palascak, Kenneth Sherman, Madeline Heffner, Jorge DiPaolo, Michael Lammer, Rathi Iyer, Prasad Matthew, Marcia Schwartz, Barbara Konkle, Nirmala Vijayanathan, Marion Dugdale, Donald Lilley, Keith Hoots, Deborah Brown, Megan Ullman, Anne Neff, Steven Klintworth, Hernan Sabio, Anita Smith, Anastasia Karafoulidou

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Before the mid-1980s, haemophilia often was unknowingly treated with contaminated plasma products, resulting in high rates of human immunodeficiency virus (HIV-1), hepatitis C virus (HCV) and hepatitis B virus (HBV) infections. To estimate the impact of these infections, a new cohort was established. All HCV-seropositive patients, age 13-88 years, at 52 comprehensive haemophilia treatment centres were eligible. Cross-sectional data collected during April 2001 to January 2004 (median June 2002) were analysed. Plasma HIV-1 and HCV RNA were quantified by polymerase chain reaction. Highly active antiretroviral therapy (HAART) was defined as use of at least three recommended medications. Among 2069 participants, 620 (30%) had HIV-1. Of 1955 with known HBV status, 814 (42%) had resolved HBV and 90 (4.6%) were HBV carriers. Although 80% of the HIV-1-positive participants had ≥200 CD4+ cells μL-1, only 59% were on HAART. HIV-1 RNA was undetectable in 23% of those not taking antiretroviral medications. Most (72%) participants had received no anti-HCV therapy. HCV RNA was detected less frequently (59%) among participants treated with standard interferon plus ribavirin (P = 0.0001) and more frequently among HIV-1-positive than HIV-1-negative participants (85% vs. 70%, P < 0.0001). HIV-1-positive participants were more likely to have pancytopenia and subclinical hepatic abnormalities, as well as persistent jaundice, hepatomegaly, splenomegaly and ascites. HAART recipients did not differ from HIV-negative participants in the prevalence of ascites. The clinical abnormalities were more prevalent with older age but were not confounded by HBV status or self-reported alcohol consumption. Eleven participants presented with or previously had hepatocellular carcinoma or non-Hodgkin lymphoma. Although prospective analysis is needed, our data reveal the scale of hepatic and haematological disease that is likely to manifest in the adult haemophilic population during the coming years unless most of them are successfully treated for HIV-1, HCV or both.

Original languageEnglish (US)
Pages (from-to)516-528
Number of pages13
JournalHaemophilia
Volume11
Issue number5
DOIs
StatePublished - Sep 2005

Keywords

  • Acquired immunodeficiency syndrome
  • Alcoholism
  • Cancer
  • Cohort study
  • Haemophilia
  • Hepatitis B
  • Hepatitis C

ASJC Scopus subject areas

  • Hematology
  • Genetics(clinical)

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    Goedert, J. J., Siegel, J., Miller, K., Lederman, M. M., Thompson, A., Browning, B., Gamerman, S., McRedmond, K., Withycombe, J., Gruppo, R., Stack, G., Lusher, J., Percy, L., Nugent, D., McDaniel, M., Manno, C., Butler, R., Wade, A., Angiolillo, A., ... Karafoulidou, A. (2005). Prevalence of conditions associated with human immunodeficiency and hepatits virus infections among persons with haemophilia, 2001-2003. Haemophilia, 11(5), 516-528. https://doi.org/10.1111/j.1365-2516.2005.01138.x