Abnormalities of lymphocyte subsets are correlated with concentrate consumption in asymptomatic Italian hemophiliacs treated with concentrates made from American plasma

Abstract

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.

One Year Follow-Up Study of T-Cell Subsets and Incidence of Seropositivity for HTLV-I and HTLV-III Antibodies in Patients Treated “On Demand” or Sporadically with Clotting Concentrates

“…We are not able to demonstrate a significant relationship between the average quantity of clotting concentrate consumption and the degree of T 4/T 8 reduction, but such a correlationalthough not evident in studies including small groups of patients (16,20) -has been found by others studying a larger number of haemophiliacs (15,21).…”

“…Our findings confirm previous reports of several authors showing that the T 4/T 8 ratio is often decreased in healthy haemophiliacs and that this abnormality is due to an increased number of T 8 cells rather than a decreased number of T 4 cells (1)(2)(3)(4)(5)15). However, longitudinal studies of this abnormality are not available and, moreover, the lymphocyte subset distribution in patients exposed in the past to clotting concentrates and no longer treated for a long period of time is not known.…”

Anti-LAV and Concentrate Consumption in Italian Hemophiliacs

“…The anti-LAV prevalence rate is proportional to the total dose of concentrate received during the last 4-year period, in agreement with other data (2,3). The observed association of anti-LAV with abnormalities of T-lymphocyte subsets is likely to reflect the association of both the parameters with concentrate consumption (4). Finally, our findings in asymptomatic hemophiliacs support the view that anti-LAV per se cannot be used for diagnostic evidence of AIDS; only by longitudinal studies of asymptomatic anti-LAV positive hemophiliacs can the relevance of such test to AIDS risk be established.…”

Hepatitis C virus quasispecies in the natural course of HCV‐related disease in patients with haemophilia

“…In our cohort four of six patients with progressive liver disease had very high quasispecies homogeneity and we can speculate that the immune damage caused by plasma-derived products, which were in the past overloaded by different foreign proteins, have played a role [26,27]. These findings could reflect a more vigorous and selective immune pressure in these patients, in agreement with the results obtained by Botarelli et al who described an association between the strength of CD4+ T-lymphocyte response to HCV antigens and a more benign course of infection in healthy HCV-seropositive patients.…”

“…These findings could reflect a more vigorous and selective immune pressure in these patients, in agreement with the results obtained by Botarelli et al who described an association between the strength of CD4+ T-lymphocyte response to HCV antigens and a more benign course of infection in healthy HCV-seropositive patients. In our cohort four of six patients with progressive liver disease had very high quasispecies homogeneity and we can speculate that the immune damage caused by plasma-derived products, which were in the past overloaded by different foreign proteins, have played a role [26,27]. However, from this study is clear that in patients with haemophilia a higher percentage of homology quasispecies (in five of 12) is observed, compared with patients with normal immune function [23] nevertheless the multiple infections to which those patients received until 1985 when virucidical methods have been introduced after the epidemic AIDS outbreak.…”