HUMAN IMMUNODEFICIENCY VIRUS-1 DISEASE PROGRESSION IN HEMOPHILIACS

被引:33
作者
BECHERER, PR
SMILEY, ML
MATTHEWS, TJ
WEINHOLD, KJ
MCMILLAN, CW
WHITE, GC
机构
[1] UNIV N CAROLINA,DEPT MED,DIV HEMATOL,CHAPEL HILL,NC 27599
[2] UNIV N CAROLINA,DEPT PEDIAT,CHAPEL HILL,NC 27599
[3] DUKE UNIV,MED CTR,DEPT SURG,DURHAM,NC 27710
[4] BURROUGHS WELLCOME CO,RES TRIANGLE PK,NC 27709
关键词
acquired immunodeficiency syndrome; AIDS; cytomegalovirus; HIV‐1;
D O I
10.1002/ajh.2830340310
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 (<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 < 200 CD‐4+ cells/mm3, the incidence of AIDS was significantly higher in adults (>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 (<21 years old). Copyright © 1990 Wiley‐Liss, Inc., A Wiley Company
引用
收藏
页码:204 / 209
页数:6
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