Safety and effectiveness of raltegravir in patients with haemophilia and anti-HIV multidrug resistance

Highly active antiretroviral therapy (HAART) of HIV+ patients with haemophilia poses specific questions on safety and effectiveness because of long-lasting HIV infection, multidrug resistance, concomitant chronic liver disease and bleeding risk. Raltegravir belongs to a new class of drugs that inhibits HIV integrase and is known to have a good effectiveness and safety profile. The aim of this study was to evaluate safety and effectiveness of HAART with raltegravir in patients with haemophilia. HIV+ patients with haemophilia treated with raltegravir for 656\u2003months were included in this retrospective study. Safety criteria were: occurrence of any adverse event, unexpected blood test abnormalities and increased consumption of coagulation factors. Effectiveness criteria were: no disease progression, viral load <40 HIV-RNA copies\u2003mL(-1) and increased or stable CD3+ CD4+ cell count above 200\u2003cells\u2003cmm(-1) . Seven patients with HCV co-infection underwent treatment with raltegravir for a median of 20\u2003months (min-max: 7-30). Before starting treatment with raltegravir, three patients had CD3+ CD4+ cell counts <200\u2003cells\u2003cmm(-1) . The median viral load was 7547\u2003copies\u2003mL(-1) (min-max: <40-37\u2003807). During treatment, no new sign of disease progression was observed. All patients showed suppression of viral replication (