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M94A0139.TXT
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1994-10-01
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Document 0139
DOCN M94A0139
TI Effect of low- and intermediate-purity clotting factor therapy on
progression of human immunodeficiency virus infection in congenital
clotting disorders. Transfusion Safety Study Group.
DT 9412
AU Gjerset GF; Pike MC; Mosley JW; Hassett J; Fletcher MA; Donegan E;
Parker JW; Counts RB; Zhou Y; Kasper CK; et al; Puget Sound Blood
Center, Seattle, WA.
SO Blood. 1994 Sep 1;84(5):1666-71. Unique Identifier : AIDSLINE
MED/94348094
AB Low- and intermediate-purity clotting-factor therapies are believed to
accelerate human immunodeficiency virus (HIV) progression in
hemophiliacs through adverse immune effects of the other plasma proteins
in the preparations. To investigate this postulate, we evaluated data
from six clinical centers that observed persons with congenital factor
deficiencies at 6-month intervals. The present analysis is based on
HIV-infected subjects who received intermediate purity factor VIII or
factor IX concentrates, or cryoprecipitate. For long-term outcome, we
classified 374 subjects by the type and amount of treatment during our
first year of observation, and determined the subsequent rate of
progression to a CD4 count less than 200 cells/microL. A second analysis
of this group used a repeated-measures, random-effect model that allowed
for individual differences in CD4 decline. Finally, we compared
short-term rates of change in CD4 count in each treatment interval of
525 subjects with the type and amount of factor therapy received in the
same interval. There was no overall or dose-related deleterious effect
of any form of treatment on CD4 trend. The CD4 decrease was less when
cryoprecipitate was administered alone or combined with concentrate, but
not significantly so. Our results counter the assertion that low- and
intermediate-purity products accelerate the rate of CD4 decrease in
HIV-1-infected hemophiliacs.
DE Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY/*ETIOLOGY/ IMMUNOLOGY
Antigens, CD4/*BLOOD Blood Coagulation
Disorders/*COMPLICATIONS/*THERAPY Christmas Disease/*THERAPY Factor
IX/STANDARDS/*THERAPEUTIC USE Factor VIII/STANDARDS/*THERAPEUTIC USE
Follow-Up Studies Hemophilia/*THERAPY Human *HIV Seropositivity
HIV-1 Support, U.S. Gov't, P.H.S. Survival Analysis Time Factors T4
Lymphocytes/*IMMUNOLOGY JOURNAL ARTICLE MULTICENTER STUDY
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).