Idiopathic CD4+ T-lymphocytopenia in HIV seronegative men with hemophilia and sex partners of HIV seropositive men. Multicenter Hemophilia Cohort Study.
Persons with hemophilia or other HIV-1 risk factors may be more likely to have idiopathic CD4+ T-lymphocytopenia (ICL). We determined the frequency of ICL in prospectively followed cohorts of HIV-1 seronegative hemophilic men and seronegative female sex partners of HIV-1 infected hemophilic men, and examined factors potentially associated with ICL. Seven of 304 (2.3%) seronegative hemophilic men and one of 160 (0.6%) female partners met the ICL definition, but the condition resolved for two of the men and for the sole female partner. All five men with persistent ICL had lymphocytopenia (< 1,200 total lymphocytes/microliters) and < 300 total CD4+ lymphocytes/microliters; only one had a low CD4+ percentage. On the most recent measurement, 14.5% of the 304 seronegative hemophilic men had lymphocytopenia. Compared with matched hemophilic controls, men with persistent ICL more often had a history of liver disease (3/5 cases, 0/21 controls, P = 0.007) or splenomegaly (3/5 cases, 4/21 controls; P = 0.04), but not severe hemophilia, greater clotting factor concentrate exposure, high alanine aminotransferase levels, hepatitis B virus antigenemia, or detectable hepatitis C virus RNA in plasma. All five cases and 20/21 controls had antibodies to hepatitis C virus present in their serum. In this cohort of hemophilic men, ICL was related to lymphocytopenia associated with liver disease rather than selective loss of CD4+ lymphocytes.
O'Brien
T R
TR
Viral Epidemiology Branch, National Cancer Institute, Rockville, MD 20852, USA.
Diamondstone
L
L
Fried
M W
MW
Aledort
L M
LM
Eichinger
S
S
Eyster
M E
ME
Hilgartner
M W
MW
White
G
G
Di Bisceglie
A M
AM
Goedert
J J
JJ
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications; D000328:Adult; D015496:CD4-Positive T-Lymphocytes; D016022:Case-Control Studies; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006467:Hemophilia A / Q000150:complications*; D016174:Hepacivirus / Q000276:immunology; D006508:Hepatitis Antibodies / Q000097:blood; D006801:Humans; D008107:Liver Diseases / Q000150:complications; D008231:Lymphopenia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012747:Sexual Partners; D013163:Splenomegaly
D006508:Hepatitis Antibodies