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1986 update of HIV seroprevalence, seroconversion, AIDS incidence, and
immunologic correlates of HIV infection in patients with hemophilia A and B
MV Ragni, A Winkelstein, L Kingsley, JA Spero and JH Lewis
A cohort of 181 patients with hemophilia A (149) and hemophilia B (32)
cared for at the Hemophilia Center of Western Pennsylvania was followed to
determine human immunodeficiency virus (HIV) seroprevalence, seroconversion
rate, and clinical and immunologic correlates of HIV infection. By December
1986, 82 (45%) were HIV seropositive, and of these, ten (12%) had developed
AIDS, 28 (34%) had symptomatic HIV infection (CDC class III, IV), of whom
14 (17%) had AIDS-related complex (ARC), and 44 (54%) had asymptomatic HIV
infection (CDC class II). The HIV seropositive group included 82% of those
treated with factor VIII concentrate (97% severe, 5% moderate), 48% of
those treated with factor IX concentrate (92% severe, 8% moderate), 10% of
those treated with cryoprecipitate (67% severe, 33% moderate), and none of
those treated with fresh frozen plasma. Based on 77 serially sampled HIV
seropositive hemophiliacs (1977 to 1986), peak seroconversion occurred in
1982, with 14% (11 of 77) occurring since 1984. With increasing time from
seroconversion, both T4 lymphocyte number and function (the latter measured
by growth in soft agar [T colony assay]) progressively declined; T4 number
declined to 135 +/- 26/mm3 (SEM), and colony count declined 1193 +/- 537
(control 3851 +/- 387) by 5 years after seroconversion. In those developing
AIDS, total T4 fell below 100/mm3 (33 +/- 8/mm3) at diagnosis. In this
cohort, the overall AIDS incidence is 5.5% (12% among the HIV seropositive)
and in those seropositive 5 or more years, the AIDS incidence approaches
32%.
Volume 70,
Issue 3,
pp. 786-790,
09/01/1987
Copyright © 1987 by The American Society of Hematology
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