HIV Antibody Status and Immunological Abnormalities in Polish Haemophiliacs

Summary

Sera of 520 multitransfused haemophiliacs were examined for antibody to HIV; 447 patients had haemophilia A and 73 had haemophilia B. In 382 patients with haemophilia A and in 62 with haemophilia B solely Polish-made blood products were used for replacement therapy. The remaining haemophiliacs had also received imported clotting factor concentrates prior to the investigation. Only 8 patients (haemophilia A - 7, haemophilia B - 1) developed anti-HIV and all of them had been exposed to commercial concentrates. The analysis of T-cell subsets demonstrated an inverted T4/T8 ratio (less than 1.0) in 7 (30%) of the 23 haemophiliacs treated solely with domestic cryoprecipitate and in 3 (37%) of the 8 seropositive recipients of commercial concentrates. The most frequent alteration in both subgroups was a reduced ratio with either normal absolute numbers or an increase in T8 cells. Increased serum IgG levels were found in 82% of the users of cryoprecipitate and in 75% of the seropositive patients. Serum beta-2-microglobulin level was elevated in 69 and 62% of each subgroup, respectively. The observed immunological abnormalities, at least in the cryoprecipitate treated subgroup, may be causally related to factors other than HIV infection.

Keywords

Haemophilia - Replacement therapy - AIDS - HIV antibody - Immunological abnormalities

• References

• 1 Jason JM, Evatt BL, Chorba TL, Ramsey RB. Acquired immunodeficiency syndrome (AIDS) in hemophiliacs. Scand J Haematol 1984; 33 suppl (40) 349-356
• 2 Centers for Disease Control. Update: acquired immunodeficiency syndrome (AIDS) in persons with hemophilia. Mortality Morbidity Weekly Report 1984; 33: 589-591
• 3 Ramsey RB, Palmer EL, McDougal JS, Kalyanaraman VS, Jackson DW, Chorba TL, Holman RC, Evatt BL. Antibody to lymphadenopathy-associated virus in haemophiliacs with and without AIDS. Lancet 1984; 2: 397-398
• 4 Gürtler LG, Wernicke D, Eberle J, Zoulek G, Deinhardt F, Schramm W. Increase in prevalence of anti-HTLV-III in haemophiliacs. Lancet 1984; 2: 1275-1276
• 5 Moffat EH, Bloom AL, Mortimer PP. HTLV-III antibody status and immunological abnormalities in haemophilic patients. Lancet 1985; 1: 935
• 6 Kitchen L, Leal M, Wichmann I, Lissen E, Ollero M, Allan JS, McLane MF, Essex M. Antibodies to human T-cell leukemia virus type III in hemophiliacs from Spain. Blood 1985; 66: 1473-1475
• 7 Lederman MM, Ratnoff OD, Scillian JJ, Jones PK, Schacter B. Impaired cellmediated immunity in patients with classic hemophilia. N Engl J Med 1983; 308: 79-83
• 8 Menitove JE, Aster RH, Casper JT, Lauer SJ, Gottschall JL, Williams JE, Gill JC, Wheeler DV, Piaskowski V, Kirchner P, Montgomery RR. Tlymphocyte subpopulations in patients with classic hemophilia treated with cryoprecipitate and lyophilized concentrates. N Engl J Med 1983; 308: 83-86
• 9 Ragni MV, Lewis JH, Spero JA, Bontempo FA, Rabin BS. Decreased helper/ suppressor cell ratios after treatment with factor VIII and IX concentrates and fresh frozen plasma. Am J Med 1984; 76: 206-210
• 10 Gerstoft J, Bentsen K, Scheibel E, Dalsgard-Nielsen J, Gormsen J, Dickmeiss E. Alterations in T-lymphocyte subsets among Danish haemophiliacs: relation to source of factor VIII preparations and high dose factor VIII treatment. Scand J Haematol 1984; 32: 544-551
• 11 Gjerset GF, Martin PJ, Counts RB, Fast LD, Hansen JA. Immunologic status of hemophilia patients treated with cryoprecipitate and lyophilized concentrate. Blood 1984; 64: 715-720
• 12 Biberfeld G, Blombiick M, Egberg N, Lenkei R, Nilsson IM, Porwit-Ksiazek A. Alteration of T lymphocyte subpopulations in Swedish hemophiliacs. Scand J Haematol 1984; 33 suppl (40) 379-382
• 13 Tsoukas C, Gervais F, Fuks A, Guttmann RD, Strawczynski H, Shuster J, Gold P. Immunological dysfunction and persistent lymphadenopathy in patients with classic hemophilia. Scand J Haematol 1984; 33 suppl (40) 383-390
• 14 Daly HM, Palmer R, Scott GL, Lee G. AIDS surveillance in haemophilia. Br J Haematol 1985; 59: 383-390
• 15 Rodeghiero F, Castaman GC, Chisesi T, De Rossi A, Dalla Gassa O, Del Mistro A, Dini E, Castronovo S, Pornaro F, Chieco-Bianchi L. One year follow-up study of T-cell subsets and incidence of seropositivity for HTLV-1 and HTLV-III antibodies in patients treated »on demand« or sporadically with clotting concentrates. Thromb Haemostas 1985; 54: 665-668
• 16 Rasi V PO, Koistinen J LK, Lohman CM, Silvennoinen OJ. Normal T-cell subsets ratios in patients with severe haemophilia A treated with cryoprecipitate. Lancet 1984; 1: 461
• 17 Lopaciuk S, Naleczynska A, Daszynski J, Klenowska Z. A new preparation of antihaemophilic globulin (factor VIII) obtained by cryoprecipitation and with the use of dextrane. Acta Haematol Pol 1971; 2: 103-108
• 18 Mannucci PM, Gringeri A, Ammassari M. Antibodies to AIDS and heated factor VIII. Lancet 1985; 1: 1505-1506
• 19 Reinherz EL, O’Brien C, Rosenthal P, Schlossman SF. The cellular basis for viral-induced immunodeficiency: analysis by monoclonal antibodies. J Immunol 1980; 125: 1269-1274
• 20 Carney WP, Iacoviello V, Hirsch MS. Functional properties of T lymphocytes and their subsets in cytomegalovirus mononucleosis. J Immunol 1983; 130: 390-393