Natural history of human immunodeficiency virus infections in hemophiliacs: effects of T-cell subsets, platelet counts, and age.

Serial T-cell subsets and platelet counts were determined in a cohort of 84 hemophiliacs in whom time of seroconversion for human immunodeficiency virus (HIV) antibody could be ascertained. An abrupt decrease in the number of T-helper (T4) cells was seen in 9 patients 12 to 24 months before the acquired immunodeficiency syndrome (AIDS) was diagnosed (p = 0.0007 compared with those who did not develop AIDS). Thrombocytopenia also was associated with an increased risk for AIDS (p = 0.02), as was older age at the time of seroconversion (p = 0.03). Ten patients developed AIDS at 24 to 95 months after seroconversion, for a cumulative incidence (+/- SE) of 18.0% +/- 7.1% at 6 years. Hemophiliacs who had T4 cell counts of less than 200 cells/microL had a 50% +/- 16% cumulative incidence of AIDS within 2 years, indicating that decreasing or very low T4 cell counts have predictive value for the development of AIDS. Furthermore, the data suggest that thrombocytopenia and older age may be markers for a cofactor that increases the risk for AIDS in hemophiliacs.

[1]  J. Goedert,et al.  Effect of T4 count and cofactors on the incidence of AIDS in homosexual men infected with human immunodeficiency virus. , 1987, JAMA.

[2]  D. Jeffries,et al.  THREE-YEAR PROSPECTIVE STUDY OF HTLV-III/LAV INFECTION IN HOMOSEXUAL MEN , 1986, The Lancet.

[3]  J Coffin,et al.  Human immunodeficiency viruses. , 1986, Science.

[4]  J. Goedert,et al.  Long-term seropositivity for human T-lymphotropic virus type III in homosexual men without the acquired immunodeficiency syndrome: development of immunologic and clinical abnormalities. A longitudinal study. , 1986, Annals of internal medicine.

[5]  Susan E. Wilson,et al.  Three-year incidence of AIDS in five cohorts of HTLV-III-infected risk group members. , 1986, Science.

[6]  R. Cheynier,et al.  Long-term cultures of HTLV-III--infected T cells: a model of cytopathology of T-cell depletion in AIDS. , 1986, Science.

[7]  J K Nicholson,et al.  Binding of HTLV-III/LAV to T4+ T cells by a complex of the 110K viral protein and the T4 molecule. , 1986, Science.

[8]  John M. Coffin,et al.  Human immunodeficiency viruses [letter] , 1986 .

[9]  M. Hilgartner,et al.  Long-term follow-up of hemophiliacs with lymphocytopenia or thrombocytopenia. , 1985, Blood.

[10]  R. Prescott,et al.  HUMAN T-LYMPHOTROPIC VIRUS TYPE III (HTLV-III) INFECTION IN SERONEGATIVE HAEMOPHILIACS AFTER TRANSFUSION OF FACTOR VIII , 1985, The Lancet.

[11]  L. Bianchi,et al.  A study of liver biopsies and liver disease among hemophiliacs. , 1985, Blood.

[12]  C. Hay,et al.  PROGRESSIVE LIVER DISEASE IN HAEMOPHILIA: AN UNDERSTATED PROBLEM? , 1985, The Lancet.

[13]  D. Lawrence,et al.  Acquired immunodeficiency syndrome among patients attending hemophilia treatment centers and mortality experience of hemophiliacs in the United States. , 1985, American journal of epidemiology.

[14]  J. Goedert,et al.  Development and early natural history of HTLV-III antibodies in persons with hemophilia. , 1985, JAMA.

[15]  B. Evatt,et al.  Coincidental appearance of LAV/HTLV-III antibodies in hemophiliacs and the onset of the AIDS epidemic. , 1985, The New England journal of medicine.

[16]  J. Goedert,et al.  Antibodies reactive with human T cell leukemia viruses in the serum of hemophiliacs receiving factor VIII concentrate. , 1985, Blood.

[17]  G. Füst,et al.  Immunological alterations in anti-HTLV-III negative haemophiliacs and homosexual men in Hungary. , 1985, Immunology letters.

[18]  P. Levine,et al.  Aetiology of AIDS—antibodies to human T-cell leukaemia virus (type III) in haemophiliacs , 1984, Nature.

[19]  J. Goedert,et al.  DETERMINANTS OF RETROVIRUS (HTLV-III) ANTIBODY AND IMMUNODEFICIENCY CONDITIONS IN HOMOSEXUAL MEN , 1984, The Lancet.

[20]  C. Griscelli,et al.  Selective tropism of lymphadenopathy associated virus (LAV) for helper-inducer T lymphocytes. , 1984, Science.

[21]  B. Safai,et al.  SEROEPIDEMIOLOGICAL STUDIES OF HUMAN T-LYMPHOTROPIC RETROVIRUS TYPE III IN ACQUIRED IMMUNODEFICIENCY SYNDROME , 1984, The Lancet.

[22]  B. Haynes,et al.  Frequent detection and isolation of cytopathic retroviruses (HTLV-III) from patients with AIDS and at risk for AIDS. , 1984, Science.

[23]  R. Gallo,et al.  Detection, isolation, and continuous production of cytopathic retroviruses (HTLV-III) from patients with AIDS and pre-AIDS. , 1984, Science.

[24]  J Schüpbach,et al.  Antibodies reactive with human T-lymphotropic retroviruses (HTLV-III) in the serum of patients with AIDS. , 1984, Science.

[25]  J Schüpbach,et al.  Serological analysis of a subgroup of human T-lymphotropic retroviruses (HTLV-III) associated with AIDS. , 1984, Science.

[26]  R. Detels,et al.  Quantitative changes in T helper or T suppressor/cytotoxic lymphocyte subsets that distinguish acquired immune deficiency syndrome from other immune subset disorders. , 1984, The American journal of medicine.

[27]  M. Greaves,et al.  The CD4 (T4) antigen is an essential component of the receptor for the AIDS retrovirus , 1984, Nature.

[28]  J. Goedert,et al.  Acid-labile alpha interferon. A possible preclinical marker for the acquired immunodeficiency syndrome in hemophilia. , 1983, The New England journal of medicine.

[29]  J. Chermann,et al.  Isolation of a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). , 1983, Science.

[30]  M H Gail,et al.  Evaluating serial cancer marker studies in patients at risk of recurrent disease. , 1981, Biometrics.

[31]  David R. Cox,et al.  Regression models and life tables (with discussion , 1972 .

[32]  E. Kaplan,et al.  Nonparametric Estimation from Incomplete Observations , 1958 .