Increased bleeding in HIV-positive haemophiliacs treated with antiretroviral protease inhibitors.

Seventeen HIV-positive patients with congenital haemophilia, one with von Willebrand's disease, and one with acquired haemophilia in remission, were treated with antiretroviral protease inhibitors. Clear increases in the frequency of bleeds or changes in the bleeding pattern were documented in 10 individuals taking HIV protease inhibitors. Blood product requirements were increased in eight individuals with severe haemophilia over the 6 months after starting HIV protease inhibitors. Therapy with the HIV protease inhibitor was discontinued in two patients in whom the increased bleeding was severe. No haemostatic cause for the increased bleeding tendency could be identified. Patients with bleeding disorders should be warned about this potential complication of HIV protease inhibitor therapy, and should be closely monitored.