       Document 0246
 DOCN  M95B0246
 TI    Prognostic factors for all-cause mortality among hemophiliacs infected
       with human immunodeficiency virus.
 DT    9511
 AU    Diamondsstone LS; Blakley SA; Rice JC; Clark RA; Goedert JJ; Viral
       Epidemiology Branch, National Cancer Institute, Rockville,; MD 20852,
       USA.
 SO    Am J Epidemiol. 1995 Aug 1;142(3):304-13. Unique Identifier : AIDSLINE
       MED/95358149
 AB    To identify the prognostic significance of hemophilia- and virus-related
       factors, the authors undertook a survival analysis among 644 human
       immunodeficiency virus (HIV)-infected subjects enrolled in the
       Multicenter Hemophilia Cohort Study between 1985 and 1993. Acquired
       immunodeficiency syndrome (AIDS) was the leading cause of death,
       followed by hemorrhage and hepatic disease. Adverse prognostic factors
       included older age and CD4-positive lymphocyte values below 14 percent
       either at entry (age-adjusted mortality rate ratio (RR) = 6.4, 95%
       confidence interval (CI) 3.4-12.1) or after entry (time-dependent RR =
       4.2, 95% CI 2.6-6.7); indeterminate antibody responses to hepatitis C
       virus (RR = 3.0, 95% CI 1.8-5.0); and inhibitory antibodies to factor
       VIII concentrates (RR = 1.8, 95% CI 1.1-3.1). Indeterminate hepatitis C
       virus status was associated with mortality from hepatic disease but not
       with AIDS mortality. Factors that were not prognostic included duration
       of HIV infection, hepatitis B virus infection, and other hemophilia
       variables. These findings suggest that fatal liver disease among
       coinfected subjects with an indeterminate hepatitis C virus status is
       probably related to an insufficient humoral response secondary to HIV
       immune dysfunction and that the risk of death among HIV-infected
       subjects is best evaluated with age and duration of low CD4 percentage.
 DE    Acquired Immunodeficiency Syndrome/COMPLICATIONS/*MORTALITY  Adolescence
       Adult  Aged  Aging/BLOOD  Cause of Death  Cohort Studies  CD4 Lymphocyte
       Count  Follow-Up Studies  Hemophilia/COMPLICATIONS/*MORTALITY/VIROLOGY
       Hepatitis B/COMPLICATIONS  Hepatitis C/COMPLICATIONS  Human
       HIV-1/ISOLATION & PURIF  Male  Middle Age  Prognosis  Survival Analysis
       JOURNAL ARTICLE  MULTICENTER STUDY

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

