Influence of HIV-infection on the Karnofsky score and general social functioning in patients with hemophilia.

Quality of live, defined by different models, has become a major focus of research in chronic disorders. Patients with hemophilia have been found to suffer seriously from the impact of HIV infection. To compare the impact of HIV infection on HIV-positive and HIV-negative patients, we evaluated a group of 60 patients, 30 being positive and 30 negative, suffering from hemophilia, using the Karnofsky index of functioning besides more general social and clinical data. Most patients (n = 53) suffered from hemophilia A. The mean Karnofsky score decreased from 65.22 to 63.43 in the HIV-infected group between 1988 and 1991, but increased from 77.7 to 82.2 in the HIV-negative group; differences were not significant, though differences were significant between the HIV-infected and HIV-negative groups. The Karnofsky score remained constant or increased in 26 (86.6%) of the HIV-negative patients, in contrast to 50% in the infected group. Seven patients, all from the infected group, had died in 1991. The initial Karnofsky score was not a prognosticator of survival. The group as a whole was socially well integrated. Consequently, the Karnofsky score can be a useful instrument in evaluating the global quality of live in HIV-infected patients, though a careful evaluation of results is necessary and a low initial score does not predict survival.