Controlled prospective study of factor IX concentrate therapy and immunodeficiency.
In 1983, six patients who were exclusively treated with factor IX (FIX) concentrate (greater than 40,000 units/yr) were prospectively matched for age and dosage to six patients treated exclusively with factor VIII (FVIII) concentrate and to six normal male controls. At baseline evaluation between October 1983 and May 1984, both groups had significantly decreased absolute T helper cell counts (mean of 452/microliters and 505/microliters for FIX- and FVIII-treated groups, respectively) compared to normal (1,157/microliters). By August 1988, three of the six FIX-treated group have developed AIDS and two are seropositive for antibody to the human immunodeficiency virus (HIV). Four of the six FVIII-treated group have HIV seropositivity or disease. The other three patients (1/6 for FIX and 2/6 for FVIII) declined HIV antibody testing. Our results support other studies showing a dose-related risk of HIV exposure for FIX concentrate-treated patients and do not support the view that FIX concentrate was intrinsically safer than FVIII concentrate.
Hultin
M B
MB
Department of Medicine, State University of New York at Stony Brook.
Dattwyler
R J
RJ
Lipton
R A
RA
D000163:Acquired Immunodeficiency Syndrome / Q000209:etiology*; D002452:Cell Count; D005164:Factor IX / Q000009:adverse effects* / Q000627:therapeutic use; D005169:Factor VIII / Q000627:therapeutic use; D006467:Hemophilia A / Q000097:blood / Q000188:drug therapy; D006801:Humans; D008297:Male; D011446:Prospective Studies; D006377:T-Lymphocytes, Helper-Inducer / Q000473:pathology; D050378:T-Lymphocytes, Regulatory / Q000473:pathology
D005169:Factor VIII; D005164:Factor IX