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Query: UMLS:C0001175 (AIDS)
 120,706 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical, immunological, and serological status of 28 patients with hemophilia A and of 13 patients with hemophilia B was investigated. Thirty-four patients were treated regularly by clotting factor concentrates and 7 patients had been substituted only 1 to 4 times. Almost all patients with severe hemophilia suffered from hepatopathy. No patient had clinical evidence of the acquired immunodeficiency syndrome (AIDS). Asymptomatic hemophiliacs showed a decreased number of T-helper (OKT 4) cells and an increased number of T-suppressor (OKT 8) cells, which resulted in an inversed OKT 4/OKT 8 cell ratio. Natural killer cell activity of all patients was decreased compared to controls. After culture there was no significant difference of NK cell activity between hemophiliacs and controls. This phenomena was interpreted as a possible maturation defect of NK-cells in vivo. No relationship between immunological alterations and hepatopathy, hepatitis markers, CMV antibodies, amount and source of required factor concentrates, and the kind of hemophilia was observed. IgG immunoglobulins were higher and the OKT 4/OKT 8 ratio lower in the eight patients with lymphadenopathy than in patients without lymphadenopathy. The prevalence of antibodies to human T-lymphotropic virus (HTLVIII) was measured in 35 hemophiliacs and in 25 polytransfused patients, most of whom were suffering from acute leukemia. In 8 of 35 hemophiliacs antibodies to HTLVIII virus were detected by an enzyme linked immunosorbent assay (ELISA) and confirmatory tests. All seropositive patients were treated by blood products from the United States. Eight hemophiliacs treated by factor concentrates from German donors only were seronegative. In comparison 2 of 25 examined non-hemophilia patients receiving multiple blood products from local donors were seropositive for HTLVIII. The results show that hemophilia patients treated by imported clotting factor concentrates have a high risk of HTLVIII positivity. Hemophiliacs substituted by blood products obtained by local donor pools have only a small risk of infection. Because non-hemophiliac polytransfused patients had HTLVIII antibodies, there must be asymptomatic virus carriers in the local donor pool. The HTLVIII antibody screening of all donors and the heat treating of factor concentrates will give better therapeutic safety.
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PMID:HTLV III antibodies and immunological alterations in hemophilia patients. 300 59

Children with hemophilia A are at risk for the acquired immunodeficiency syndrome (AIDS). Clinically asymptomatic hemophiliacs demonstrate many immune abnormalities that might represent exposure to the AIDS agent through blood products or be a natural reaction to their therapy. In this study, we examined lymphocyte subset distribution in children with hemophilia A who had been exposed to HTLV-III as determined by antibody seroconversion. Seroconversion to HTLV-III was confirmed using Western blot analysis. The lymphocyte subsets studied included T4+ and T8+ cells. The distribution of lymphocyte subsets in children with hemophilia A was independent of seroconversion to HTLV-III. Children with hemophilia A treated with commercial factor VIII concentrate had normal numbers of circulating T4+ lymphocytes and significantly increased numbers of circulating T8+ lymphocytes compared with their nontransfused age-matched counterparts. An increased number of T8+ lymphocytes was not observed, however, in children treated exclusively with cryoprecipitate. These results suggest that HTLV-III alone cannot account for changes in lymphocyte subsets in hemophiliacs. Higher antigenic protein loads in factor VIII concentrate or additional factors might account for the increased absolute numbers of T8+ lymphocytes and represent a natural response to therapy.
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PMID:HTLV-III status and abnormalities in T lymphocyte distribution in children with hemophilia A. 300 71

Serum samples from 850 individuals from Venezuela were tested for the presence of antibodies to HTLV-III/LAV virus, the probable etiological agent of acquired immune deficiency syndrome (AIDS). At the time of the study, none of the individuals tested had symptoms indicative of AIDS or related disorders. Viral antibodies were assayed by indirect immunofluorescence (IF) assay, using a chronically infected, HTLV-III/LAV producer cell line CEM/LAV-NIT established in our laboratory. Twenty individuals (2.5%), 8 of them (40%) female, were seropositive by IF and by confirmatory Western blotting and radioimmunoprecipitation assays. The seropositivity rate ranged from 2.4% (11 of 465) in the general healthy population, 4% (2 of 50) among patients with Chagas' disease, and up to 29.2% (7 of 24) among patients with acute malaria infection. The titers of HTLV-III/LAV antibodies ranged from 1:40 to 1:640. In addition, 2 of 36 patients with hemophilia A (5.5%) also had antibodies to HTLV-III/LAV. Two of 7 patients with acute malaria had specific antibodies both to HTLV-III/LAV and HTLV-I, as determined by IF and Western blotting. None of over 169 randomly chosen, healthy blood donors from seven major Venezuelan cities, as well as none of 99 patients with leukemia/lymphoma, had antibodies to HTLV-III/LAV. The presence of specific antibodies among various Venezuelan populations indicates that HTLV-III/LAV, or a closely related cross-reactive virus, is indigenous in Latin American subjects as was previously indicated for tropical populations of central Africa. Isolation and characterization of this virus will help to understand the origin and etiology of AIDS.
AIDS Res 1986
PMID:Antibodies to acquired immune deficiency syndrome (AIDS)-associated virus (HTLV-III/LAV) in Venezuelan populations. 301 23

The first fatal case of AIDS in an hemophiliac observed in Italy is reported. The propositus is a 53-year-old hemophilia A patient who died on the 8th December, 1984. AIDS was documented clinically and in the laboratory by serum antibodies to HTLV-III detected by ELISA and Western blot assays. A progressive intellectual worsening of the patient due to diffuse cerebral atrophy was followed by CT scan, EEG and by evaluation of proper neurological signs and symptoms.
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PMID:First case in Italy of fatal AIDS in a hemophiliac. 301 94

A seroepidemiological survey has been carried out in the Veneto region to determine the prevalence of HTLV-III and HTLV-I antibodies in subjects at risk for development of AIDS and related conditions. Serum samples were tested by ELISA and, for confirmation, by radioimmunoassay (Western blot), using disrupted virus as antigen. The results show that 22 out of 112 hemophiliacs had antibodies against HTLV-III; however disaggregation of data resulted in 22.6 and 77.8% positivity for patients with severe forms of hemophilia A and B, respectively. Two patients with hemophilia A and two with hemophilia B were positive for antibodies to HTLV-I. The prevalence of HTLV-III antibodies in the homosexual and intravenous drug abuser groups was 52 and 33% respectively. No positive cases for antibodies to HTLV-I were found in homosexuals, while 4.3% seropositivity to HTLV-I was observed in drug abusers. Among patients suffering from various pathologic conditions not strictly AIDS related, only 1 with generalized non-Hodgkin lymphoma was positive for HTLV-I antibodies. In a further group of patients with clinical diagnosis of LAS and AIDS, antibodies to HTLV-III were found in 90 and 100% respectively, while seropositivity for HTLV-I was observed only in 6.4% of LAS patients. The implications of these findings are discussed, particularly in view of the potential oncogenic effect possessed by HTLV-I.
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PMID:HTLV-III and HTLV-I infection in populations at risk in the Veneto region of Italy. 301 30

One hundred fifty-eight hemophilia A, B, and von Willebrand disease (VWD) patients treated with clotting factor concentrates from a single manufacturer were tested for antibody to the human T-lymphotropic virus type III (HTLV-III). Antibody was detected in 63% and 40% of those with severe hemophilia A and B, respectively, 12% and 0% of those with mild hemophilia A and B, and two patients with recessive VWD. Forty-two antibody-positive and 20 antibody-negative patients were studied for clinical and laboratory features of infection. Eleven seropositive patients had clinical signs of infection including Pneumocystis carinii pneumonia, lymphadenopathy, splenomegaly or diarrhea; however, only one patient had developed acquired immune deficiency syndrome (AIDS), and only two had significant impairment of their performance status. Thirty-one patients remained totally asymptomatic. Eight patients had a history suggestive of acute HTLV-III infection. Thrombocytopenia was observed in 18% of seropositive patients, lymphopenia in 60%, depressed T-helper cells in 43%, reduced T-helper:T-suppressor ratios (TH:TS) in 33%, and elevated platelet-bound immunoglobulin in 53%. The antibody-negative group had normal T-helper cell levels (except one patient) and TH:TS ratios, and normal platelet immunoglobulin levels. Both groups demonstrated a significant elevation of immunoglobulin levels and a high prevalence of antinuclear factor and antismooth muscle antibodies. The mean level of IgG was significantly higher in the antibody-positive group. This study confirms the correlation between HTLV-III infection and reduced T-helper cells in hemophiliacs but demonstrates a low incidence of clinical symptomatology. There was evidence of polyclonal B-cell hyperactivity in the antibody-negative group as well as the seropositive group.
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PMID:Spectrum of HTLV-III infection in a hemophilic cohort treated with blood products from a single manufacturer. 302 Sep 77

The retrovirus LAV/HTLV III, highly likely to be responsible for the acquired immunodeficiency syndrome (AIDS) in some recipients of blood products, can be inactivated by chemical and/or heat treatment, so the use of virus-inactivated factor VIII and factor IX preparations for treating hemophilia A and B has become important. We examined hemophilic children and found that those children treated since 1979 with virus-inactivated preparations did not develop antibodies against LAV/HTLV III. In contrast, 77% of patients treated with conventional factor VIII or factor IX preparations had antibodies against this virus.
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PMID:Correlation of antibodies to LAV/HTLV III in hemophiliacs with the use of virus-inactivated clotting factors. 309 47

During the 5-year period from 1981 to 1985, we have observed 8 cases of acquired immunodeficiency syndrome (AIDS) among our 85 patients with hemophilia A. Thus, the prevalence of AIDS with hemophilia A is 9.4% in our patient population. By utilizing stored serum or plasma samples dating back to 1978, antibody against HTLV-III was detected in all 8 cases with AIDS. Based on the time interval from the appearance of antibody to HTLV-III to the diagnosis of AIDS in these patients, the incubation period ranged from 27 months to 60 months, with a median of 36 months. Before the diagnosis of full-blown AIDS, all patients exhibited a variety of prodromal manifestations of non-specific nature, including weight loss, oral candidiasis, unexplained non-productive chronic cough, generalized lymphadenopathy, and thrombocytopenia lasting several months to several years. Serial T-lymphocyte subset studies were available in some patients during the HTLV-III seropositive period and showed progressive lymphopenia, depletion of T4 cells with an average absolute count of 94 +/- 128 per mm3 (mean +/- 1 S.D.), and a markedly reversed T4/T8 ratio of 0.26 +/- 0.19 (mean +/- 1 S.D.). These findings suggest that the incubation period of AIDS is considerably long and that prospective study of serial immunologic markers and HTLV-III markers may be warranted in hemophilic patients at risk.
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PMID:Natural history of acquired immunodeficiency syndrome in hemophilic patients. 310 90

Peripheral blood lymphocyte subsets and the incidence of LAV/HTLV-III antibodies were studied in 63 patients with hemophilia A who had been transfused with a low dose regimen of commercial (U.S.A.) factor VIII concentrates. Five patients with hemophilia B were also included in this study. In hemophilia A patients a significant reduction in the percentage and absolute numbers of T4+ cells and of the T4/T8 ratio and a significant increase in the percentage of T8+ and Leu-7+ cells were observed. These abnormalities were independent of the presence of anti-LAV/HTLV-III. In hemophilia B patients a significant increase of T8+ cells and a decrease of T4/T8 ratio was noted while the percentage of Leu-7+ cells was normal. A significant negative correlation of F VIII units transfused and T4/T8 ratio was seen only in LAV/HTLV (-) patients, suggesting that F VIII per se could cause immunodysregulation. Seropositive patients were found to have consumed a larger amount of F VIII units than seronegative patients during the period 1980-1984 (p less than 0.005).
AIDS Res 1986
PMID:Abnormalities of lymphocyte subsets and anti-LAV/HTLV-III status in Greek hemophiliacs. 310 12

To date, 16 cases of AIDS have been officially reported in Japan: 8 of them were hemophiliacs and the others were male homosexuals. We had two hemophiliacs with AIDS, and describe these cases in this paper. One was a 48-year-old man with hemophilia B and the other was a 62-year-old man with hemophilia A. Both had ARC symptoms before developing overt and fatal opportunistic infections, candidiasis and a combination of atypical mycobacteriosis and aspergillosis. Impairment of cellular immunity such as lowered T4/T8 ratio, depressed lymphocyte response to mitogen and NK activity, and negative PPD skin reaction was evident in both patients. Anti-LAV/HTLV-III antibodies were detected in their sera, and the retrovirus was demonstrated in the lymph nodes and other organs on the postmortem electron microscopic examination. The assay for anti-LAV/HTLV-III on 70 other hemophiliacs in our clinic revealed seropositivity up to 50%. The seropositive group showed a significantly lower T4/T8 ratio on an average than the seronegative group. The prevalence of seropositivity for antibodies to other viruses including HBV, EBV, CMV, PV, and HTLV-I was markedly higher in the hemophiliacs. In LAV/HTLV-III seropositive hemophiliacs, however, no distinct correlation was found between T4/T8 ratio and the presence of antibodies to other viruses. There is a retrospective study to show that LAV/HTLV-III seropositive hemophiliacs appeared as early as 1980 in Japan. For prevention of LAV/HTLV-infection in hemophiliacs via blood products, heat-treated factor concentrates have recently become available. In a trial of the heat-treated products on 15 "virgin" hemophiliacs, no seroconversion has occurred thus far.
AIDS Res 1986 Dec
PMID:Clinical, immunological, and virological aspects in Japanese hemophiliacs and AIDS patients. 310 37


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