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Hemophiliacs With HIV Antibody Are Actively Infected
J. Brooks Jackson, MD;
Kim J. Sannerud, MT;
Jocelyn S. Hopsicker, RN;
Shirley Y. Kwok;
J. Roger Edson, MD;
Henry H. Balfour, Jr, MD
JAMA. 1988;260(15):2236-2239.
Abstract
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Cultures of peripheral blood mononuclear cells for human immunodeficiency virus type 1 (HIV-1) and assays for the p24 antigen were performed for a group of 75 unselected hemophiliacs to determine whether patients positive for HIV-1 antibody are actively infected rather than immunized by viral proteins in non— heat-treated factor VIII or IX concentrates. Fifty-six (75%) of the 75 hemophiliacs were antibody positive and 55 (98%) of the 56 with antibodies also had positive cultures. The one culture-negative individual had detectable HIV-1 proviral DNA sequences in three separate samples of peripheral blood mononuclear cell DNA, as detected by a polymerase chain reaction assay. Detection of serum p24 antigen and the time to development of a positive culture were significantly more frequent and shorter, respectively, in symptomatic vs asymptomatic patients. None of the 19 hemophiliacs negative for HIV-1 antibody had positive cultures, detectable p24 serum antigen, or symptoms of HIV-1 infection. Moreover, latent HIV-1 infection was not detected in 16 female sexual partners of hemophiliacs positive for HIV-1 antibody using Western blot testing, assays for p24 antigen, HIV-1 cultures, and polymerase chain reaction assays, despite repeated unprotected sexual exposure. We conclude that antibody-positive hemophiliacs have been actively infected by HIV-1 and that a long period of latent HIV-1 infection prior to overt seroconversion is unlikely.
(JAMA 1988;260:2236-2239)
Author Affiliations
From the Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (Drs Jackson, Edson, and Balfour and Mss Sannerud and Hopsicker); American Red Cross—St Paul Region (Dr Jackson); and the Department of Infectious Diseases, Cetus Corp, Emeryville, Calif (Ms Kwok).
Footnotes
Read in part before the Annual Meeting of the American Association of Blood Banks, Orlando, Fla, Nov 12, 1987.
Reprint requests to Box 437 UMHC, University of Minnesota, Harvard St at East River Rd, Minneapolis, MN 55455 (Dr Balfour).
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