Eighty-three symptom-free hemophiliacs were studied clinically, serologically and by in vitro tests for cellular immunity in a geographical area in which AIDS has not yet been encountered despite the exclusive use of concentrates manufactured from American sources of plasma. Some patients showed the following abnormalities: lymphopenia (4%), decreased T-helper/T-suppressor (Th/Ts) cell ratios (49%), or both abnormalities (2%). Low Th/Ts were mostly due to absolute or, less frequently, relative increases in Ts cells. The prevalence rates for these abnormalities were the same in patients treated with factor VIII or factor IX concentrates. There was an association between the higher Ts and lower Th cells counts and the low Th/Ts ratios and greater annual consumption of factor VIII and factor IX concentrates. These results support the view that protein load might be an important pathogenetic factor in lymphocyte abnormalities in symptom-free hemophiliacs.
The prevalence of HTLV-III/LAV antibodies was evaluated in 222 Italian asymptomatic hemophiliacs treated exclusively with commercial factor concentrates made with American plasma. An increase of HTLV-III/LAV seropositivity from 1983 to 1985 was evident. This was independent of the type of hemophilia (A or B) but directly correlated to the amount of concentrate administered in the previous year. Immunological data (T4 and T8 lymphocyte subsets) were evaluated in relation to seropositivity to HTLV-III/LAV. The presence of antibodies was found to be significantly associated with a low T4/T8 ratio and to a reduced T4 subpopulation, whereas increased levels of T8 lymphocytes correlated weakly with seropositivity. Data from 47 hemophiliacs tested both in 1984 and 1985 showed that 100% of those negative in 1984 and highly transfused in the previous year seroconverted up to 1985, whereas 33% of those not highly transfused did so.
Anti-LAV and Concentrate Consumfiion in ltalian Hemophiliacs Sir, In Italy, hemophiliacs are treated exclusively with concentrates made from US plasma and should therefore be exposed to the same high risk of US hemophiliacs of developing the acquired immunodeficiency syndrome (AIDS). This situation prompted us to study the prevalence rate of anti-LAV (lymphadenopathyassociated virus) in 98 hemophiliacs coming at the Center for their annual (1984) checkup. During clinical examination, we looked
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