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Decrease of CD4 cell number and function in HIV-seropositive hemophiliacs in a longitudinal study.


Ann Allergy. 1989 Sep;63(3):189-94. Unique Identifier : AIDSLINE

The Regional Hemophilia Center in St. Louis initiated a prospective study beginning in 1982 to measure sequentially T-cell subpopulations and in vitro lymphoproliferative responses in hemophilia A patients. In a cohort of 106 hemophiliacs, the prevalence of HIV-seropositivity increased from 46.7% in 1982 to 74.5% by 1987. There was a persistent gradual decline over time of T helper/inducer (CD4) cells in HIV-seropositive hemophiliacs (P less than .01). This was reflected by an increasing percentage of hemophiliacs with abnormally low CD4 cells (less than 2 standard deviations below the mean of normal individuals) from 6.7% in 1983 to 52.4% in 1987. Function of CD4 cells, as estimated by in vitro lymphoproliferative responses to phytohemagglutinin (PHA) and tetanus toxoid stimulations also demonstrated a decline over the same years. Lymphoproliferative responses to PHA by HIV-seropositive hemophiliacs' mononuclear cells (MNC) declined from a 90.2% normal response in 1983 to a 71.7% normal response in 1987 (P less than .05). Decreased responses to stimulation with the soluble antigen tetanus toxoid were also seen from 1983 compared with 1987 (P less than .05). This was due to an increased percentage of HIV-seropositive hemophiliacs' MNC, which were unresponsive to stimulation to tetanus toxoid (stimulation index less than 3.0) from 20.8% in 1983 to 41.0% in 1987. These findings indicate that HIV-infection was associated over time with a decline of CD4 number and function in a substantial portion of hemophiliacs.

Adolescence Adult *Antigens, Differentiation, T-Lymphocyte Blood Transfusion/ADVERSE EFFECTS Child Factor VIII/THERAPEUTIC USE Hemophilia/COMPLICATIONS/*IMMUNOLOGY Human HIV Antibodies/ANALYSIS HIV Seropositivity/DIAGNOSIS/ETIOLOGY/*IMMUNOLOGY Leukocyte Count Longitudinal Studies Lymphocyte Transformation Phenotype Support, Non-U.S. Gov't T-Lymphocytes, Helper-Inducer/*IMMUNOLOGY JOURNAL ARTICLE


Information in this article was accurate in December 30, 1989. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.