Faculty Collaboration Database

Human immunodeficiency virus-1 disease progression in hemophiliacs. Am J Hematol 1990 Jul;34(3):204-9

Date

07/01/1990

Pubmed ID

2163586

DOI

10.1002/ajh.2830340310

Scopus ID

2-s2.0-0025309277 (requires institutional sign-in at Scopus site)   39 Citations

Abstract

A retrospective study of 153 hemophiliacs infected with human immunodeficiency virus-1 (HIV-1) was performed to determine the clinical and immunological consequences of HIV-1 infection and the markers and cofactors associated with these changes. Nearly 80% of HIV-1-infected hemophiliacs have developed a significant reduction in their CD-4+ counts (less than 400 CD-4+ cells/mm3) with 40% having less than 200 CD-4+ cells/mm3 by the end of 1987. The rate of CD-4+ cell count decline was slightly greater in patients who have already developed the acquired immunodeficiency syndrome (AIDS) compared to those who have not (50 vs. 31 cells/mm3/6 months). Thrombocytopenia and older age were associated with a more rapid CD-4+ count deterioration, but the quantity of clotting factor utilized did not affect immunologic progression. In patients with less than 200 CD-4+ cells/mm3, the incidence of AIDS was significantly higher in adults (greater than 21 years old) compared to children/adolescents. Cytomegalovirus (CMV) seroprevalence increased with age but did not correlate with the amount of concentrated clotting factor used. Although there was no relationship between CMV status and progression to AIDS, CMV-seropositive patients were older and had a lower CD-4+ count. Thus the majority of HIV-1-infected hemophiliacs are developing progressive immune dysfunction measured by CD-4+ count decline. This drop in CD-4+ count significantly correlates with a risk for the development of AIDS in adults but not in children (less than 21 years old).

Author List

Becherer PR, Smiley ML, Matthews TJ, Weinhold KJ, McMillan CW, White GC 2nd

Author

Gilbert C. White MD Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Acquired Immunodeficiency Syndrome
Adolescent
Adult
Aging
Antigens, CD
Antigens, Differentiation, T-Lymphocyte
CD4 Antigens
CD8 Antigens
Child
Cytomegalovirus Infections
HIV Seropositivity
HIV-1
Hemophilia A
Humans
Leukocyte Count
Lymphocytes
Regression Analysis
Risk Factors