Progression to AIDS in French haemophiliacs: association with HLA-B35.
OBJECTIVE
To evaluate whether HLA-B35 influences progression to AIDS in HIV-seropositive subjects with haemophilia.


METHODS
Retrospective (before 1985) and prospective (after 1985) follow-up of a group of French haemophiliacs.


METHODS
We studied 144 seropositive patients with moderate or severe haemophilia A or B or von Willebrand's disease. Enzyme-linked immunosorbent assay was used to screen patient sera for total HIV antigen and core p24 antigen antibodies. All patients were typed for HLA A, B and C antigens in the same laboratory. Time of seroconversion was estimated to be the mid-point between the last seronegative test and the first seropositive test. AIDS-free survival curves were constructed using the Kaplan-Meier estimate and differences in survival analysed using the Mantel-Cox test. The Cox proportional hazards model was used to adjust for confounding variables.


RESULTS
Median follow-up after seroconversion was 8.7 years (range, 3.5-10.7 years). By the end of the study, six HLA-B35-positive patients and 12 HLA-B35-negative patients had progressed to AIDS. Individuals with HLA-B35 showed a significantly faster rate of progression to AIDS over the follow-up period than HLA-B35-negative individuals (hazard ratio, 2.72; P = 0.037). After adjusting for type and severity of haemophilia, CD4 cell count at first seropositive test, age at seroconversion, and zidovudine treatment before AIDS, the hazard ratio was 2.74 (P = 0.045).


CONCLUSIONS
HLA-B35 is a risk factor for more rapid progression to AIDS in subjects with haemophilia.
Sahmoud
T
T
B3E, INSERM U263, SC4, Université Pierre et Marie Curie, Paris, France.
Laurian
Y
Y
Gazengel
C
C
Sultan
Y
Y
Gautreau
C
C
Costagliola
D
D
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000453:epidemiology / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005602:France / Q000453:epidemiology; D006679:HIV Seropositivity; D015497:HIV-1 / Q000276:immunology; D015797:HLA-B35 Antigen; D006467:Hemophilia A / Q000150:complications* / Q000276:immunology; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013997:Time Factors
D015797:HLA-B35 Antigen