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Liver failure and mortality in HIV-positive haemophiliacs: FOURTEEN-YEAR EXPERIENCE AND LITERATURE REVIEW

J D Schwartz1, L M Aledort1, S V Seremetis1

  • 1The Mount Sinai Medical Center, One Gustave Levy Place, New York, NY, USA.

Haemophilia : the Official Journal of the World Federation of Hemophilia
|May 24, 2016
PubMed

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.

Keywords:
AIDSHIVcirrhosishepatitisliver failure.

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