title: Immune status of human immunodeficiency virus seropositive and seronegative hemophiliacs infused for 3.5 years with recombinant factor VIII. The Kogenate Study Group.
abstract: Recent studies suggest that treatment of hemophiliacs with highly purified factor VIII concentrates may preserve immune function. To test this hypothesis, we prospectively studied 51 hemophilic patients (21 human immunodeficiency virus [HIV] seropositive and 30 seronegative) who were on home therapy exclusively with recombinant factor VIII (Kogenate, Miles Laboratory, Berkeley, CA) for 3.5 years. Patients, all of whom had been previously treated with plasma-derived factor VIII concentrates, were monitored every 6 months with T-lymphocyte subsets and beta 2-microglobulin levels. Mean rate of change in absolute CD4 cell counts, calculated from regression slopes for individual patients, showed a small but statistically significant decrease over the 3.5-year study period for HIV seropositive hemophiliacs. No decrease in CD4 cell counts was seen in HIV seronegative hemophiliacs when the data for children under age 6 years were excluded from the analysis. beta 2-microglobulin levels and CD8 cell counts remained unchanged. These data show stability of immunologic parameters in HIV seronegative hemophiliacs, and a small decrease in CD4 cell counts in HIV seropositive hemophiliacs treated with recombinant factor VIII.
authors.affiliation: Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Maggiore Hospital, Italy.
authors.forename: P M
authors.initials: PM
authors.lastname: Mannucci
authors.forename: D B
authors.initials: DB
authors.lastname: Brettler
authors.forename: L M
authors.initials: LM
authors.lastname: Aledort
authors.forename: J M
authors.initials: JM
authors.lastname: Lusher
authors.forename: C F
authors.initials: CF
authors.lastname: Abildgaard
authors.forename: R S
authors.initials: RS
authors.lastname: Schwartz
authors.forename: D
authors.initials: D
authors.lastname: Hurst
mesh_terms: D015496:CD4-Positive T-Lymphocytes; D016827:CD8 Antigens / Q000032:analysis; D005169:Factor VIII / Q000627:therapeutic use*; D018023:HIV Seronegativity / Q000276:immunology*; D006679:HIV Seropositivity / Q000276:immunology*; D006467:Hemophilia A / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007958:Leukocyte Count; D011994:Recombinant Proteins / Q000627:therapeutic use; D001613:beta 2-Microglobulin / Q000032:analysis
chemical_list: D016827:CD8 Antigens; D011994:Recombinant Proteins; D001613:beta 2-Microglobulin; D005169:Factor VIII