The role of HIV infectivity and composition of factor VIII concentrates on the immunity of haemophiliacs positive for HIV antibodies.
Forty-six subjects (44 HIV antibody-positive) with some degree of immune deficiency (at least TH/TS ratio below 1) were randomly distributed into 4 treatment groups. Each group was assigned to 1 of 4 products to be used exclusively for a 1-year period: 1 concentrate was of intermediate purity and not heat-treated, and 3 were heat-treated in order to inactivate HIV, 2 of them being of higher purity. At 4-6-month intervals, check-ups, including as markers clinical examination, platelet, lymphocyte and T cell subset counts, IgG levels and delayed hypersensitivity test, were carried out. At entry as well as at the end of the study, groups were not statistically distinguishable. No intra- nor inter-group differences were demonstrable for any of the markers. In contrast, using a scoring system for each marker and the results of check-up at entry as reference, significant differences between groups appeared on subsequent check-ups. Patients receiving intermediate-purity factor VIII, whether heat-treated or not, were mostly steady, while groups receiving heat-treated concentrates of a higher purity significantly worsened. This surprising outcome was no related to differences in anti-HIV titers or specificities. From this study, the potential long-term predictive value of this scoring system could not be established.
D000163:Acquired Immunodeficiency Syndrome / Q000503:physiopathology*; D000914:Antibodies, Viral / Q000032:analysis*; D005169:Factor VIII / Q000302:isolation & purification* / Q000627:therapeutic use; D006678:HIV / Q000276:immunology*; D006467:Hemophilia A / Q000188:drug therapy / Q000276:immunology*; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D007109:Immunity; D011446:Prospective Studies
D000914:Antibodies, Viral; D005169:Factor VIII