Model of the impact of HIV infection on the size of future hemophilia and carrier birth cohorts.

The introduction of human immunodeficiency virus (HIV) infection in almost half of the U.S. hemophilia population during the late 1970s and early to mid-1980s has resulted in significant mortality and morbidity. The predict the quantitative impact of HIV infection through HIV-contaminated clotting factor on the size of future hemophilia and hemophilia carrier populations in the United States, a demographic model was developed for hemophilia and hemophilia carrier birth cohorts for the 200 years between 1980 and 2180. Mortality and fertility rates were estimated from databases of the Hemophilia Malignancy Study (HMS), NHLBI Blood Resources Studies, and Centers for Disease Control (CDC) Minimal Data Set. According to the model, the HIV epidemic will produce small reductions in the expected numbers of hemophilic (1.79%) and carrier (2.63%) births in the next 2 centuries. More substantial reductions in the numbers of hemophilic and carrier births required extreme assumptions regarding the fertility of hemophilic men, the extent of HIV infection among hemophilic men, and the proportion of hemophilic births that arise from spontaneous mutation.