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An immunologic and virologic work-up was undertaken in 425 symptom-free
multitransfused patients with hemophilias or hemoglobinopathies living in
France. Patients were entered into five groups according to the type of
blood product they received: local factor VIII, a mixture of local and
imported factor VIII, imported factor IX, local factor IX, washed red blood
cells. The overall prevalence of IgG antibodies to the
lymphadenopathy-associated virus (LAV) was 45%. The highest rate was
observed in hemophiliacs who received factor VIII concentrates prepared
from plasma collected mainly on the American continent; intermediary values
were found for hemophilic patients treated with local factor VIII or factor
IX concentrates; and the lowest values were found for those who were
treated with washed red blood cells. Lymphadenopathy, decreased skin
hypersensitivity reactions, relative lymphopenia, and altered ratio of T
lymphocyte subsets occurred at significantly higher rates in patients
positive for LAV antibody, although such abnormalities were also
encountered in LAV serologically negative patients. A correlation between
treatment intensity and immunologic disturbances was found in patients
infused with factor VIII preparations, irrespective of their positive or
negative LAV antibody status. This study has shown the prominent role of
LAV in the occurrence of immunologic disturbances in multitransfused
patients. However, allogenic or altered proteins present in factor VIII but
not in factor IX concentrates seem to play a role of immunocompromising
agents. The interplay between LAV and additional factors possibly leading
to acquired immunodeficiency syndrome remains to be analyzed.
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| Copyright © 1985 by American Society of Hematology Online ISSN: 1528-0020 | |||||||||
