Pathological status and therapy of HIV-infected hemophiliacs in Japan

Abstract

In Japan, 1531 out of 4171 hemophiliacs (36.7%) are human immunodeficiency virus (HIV)-infected, and up to 31 December 1991, 324 (21.2%) of these patients had developed AIDS. The Research Committee estimated the peak of the seroconversion period of hemophiliacs in Japan as January 1983, having presumed that new cases of seroconversion would not arise after heat treated concentrates came into general use in 1985. However, after a long 5 years window period starting in 1985, cases of seroconversion are being reported. The present mean rate of reduction in cluster difference 4 (CD4) counts of HIV infected hemophiliacs has been increasing since 1990. At present (1991), the proportion of HIV infected hemophiliacs below 20 years is believed to be approximately 40%. Concomitantly with the aging of this group, the incidence of AIDS is expected to increase in the future. Although the aforesaid factors are conducive to a rising incidence of AIDS, the rate of increase of AIDS incidence among hemophiliacs in Japan is actually decelerating. This can, hopefully, be attributed to the commencement of widespread use of periodic pentamidine inhalation therapy, or the administration of drugs such as AZT (zidovudine) or ddI (didanosine) to AIDS related complex (ARC) cases, or to asymptomatic carrier (AC) cases with CD4 counts below 350 cells for the prophylactic treatment against developing to AIDS. Oral administration of didanosine at a dosage of 400 mg/day, or didanosine at a dosage of 334 mg to 500 mg/day, has been found effective for the treatment of hemophiliacs with AIDS.(ABSTRACT TRUNCATED AT 250 WORDS)