Australian hemophiliac recipients of voluntary donor blood products longitudinally evaluated for AIDS. A clinical and laboratory study, 1983-1986.
One hundred and sixty-one Australian patients with hereditary bleeding disorders comprising hemophilia A (120), hemophilia B (18), von Willebrand's disease (16), and seven symptomatic female hemophilia A or B carriers were screened for clinical and serological evidence of exposure to HTLV-III/LAV/ARV/HIV infection. During the previous five years (1979-1984) they had been treated almost exclusively with blood products derived from Australian voluntary donors. The prevalence of HTLV-III antibodies in 1985 was 45%, with the highest frequency being in those with severe hemophilia A (78%) and the lowest in patients with hemophilia B (6%). Antibody positivity correlated with a reduced absolute T helper (T4) cell numbers and/or an inverted T4:T8 ratio. Lymphadenopathy was detected in 23 subjects but only 13 had an abnormal T cell ratio. Comparison of seropositivity and T4:T8 ratios in 32 patients studied in 1983 and again in 1985 suggested that T4 cell deficiency reflected HTLV-III exposure rather than being a predisposing factor for infection with the virus. Individual patients showed considerable fluctuation in T cell subsets over a 12 month period of follow-up, but as a population there was a slight trend with time towards diminishing T4:T8 ratio only in the antibody positive hemophilia A patients of mild to moderate severity. Three (2%) of the 161 patients screened to date have developed confirmed AIDS with fatal outcome.(ABSTRACT TRUNCATED AT 250 WORDS)
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology / Q000635:transmission*; D000914:Antibodies, Viral / Q000032:analysis; D001315:Australia; D001779:Blood Coagulation Factors / Q000627:therapeutic use; D001782:Blood Donors; D001803:Blood Transfusion; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000276:immunology; D015483:HIV Antibodies; D006679:HIV Seropositivity / Q000276:immunology; D006467:Hemophilia A / Q000276:immunology / Q000628:therapy*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D012307:Risk Factors; D006377:T-Lymphocytes, Helper-Inducer / Q000276:immunology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology
D000914:Antibodies, Viral; D001779:Blood Coagulation Factors; D015483:HIV Antibodies