The
acquired immunodeficiency syndrome (
AIDS) was first recognized among hemophiliacs in 1982. The authors have conducted investigations to determine the onset and incidence of
AIDS among hemophiliacs and to determine trends in
hemophilia mortality since the introduction of
clotting-factor concentrates in the late 1960s. A survey of United States
hemophilia treatment centers, supported by the Centers for Disease Control and the National
Hemophilia Foundation, defined a population of hemophiliacs which was monitored for
AIDS cases through June 1984. Death reports from the United States Vital Statistics System and from the
hemophilia treatment center survey provided mortality trends for 1968-1979 and for 1978-1982, respectively. The results of these investigations demonstrate the following points. 1) The
AIDS epidemic is a new and important cause of illness and mortality among hemophiliacs, although a very low incidence of
AIDS among hemophiliacs prior to 1982 cannot be ruled out. 2) The
AIDS cases who attended the surveyed
hemophilia treatment centers were distributed throughout the United States and were older than
hemophilia treatment center patients without
AIDS.
AIDS cases also used more lyophilized
clotting-factor concentrate, but only a small number of cases were reported with this information. 3) Improved care for
hemophilia, including the use of
clotting-factor concentrates, dramatically reduced
hemophilia mortality rates during the 1970s. 4) In 1982,
hemorrhage was the major cause of death among hemophiliacs. Deaths from non-
alcoholic liver disease were also increased.
AIDS incidence among
hemophilia treatment center attendees was stable at 0.6 cases per 1,000
hemophilia treatment center attendees per year during 1982 and 1983 but increased sharply to 5.4 cases per 1,000 during the first quarter of 1984.