Soluble IL-2receptor andtumournecrosis factor-a inplasma ofhaemophilia patients infected withHIV

SUMMARY We measured plasma concentrations ofsoluble receptors forIL-2(sIL-2R) andtumournecrosis factor-a (TNF-cx) in149haemophilia patients. Soluble IL-2Rlevels wereelevated in37%of62HIVseronegative patients (mean570+27U/mlversus 361+17U/mlinthecontrol group, P<0-0001), in 78%of68HIV-seropositive patients (928+49U/ml,P<0-0001), andin95%of19AIDS/ARC patients (1578 +199U/ml, P<0-000 1compared withcontrols andwithHIV-seronegative patients; P<0-005compared withHIV-seropositive asymptomatic patients). A negative correlation was observed between sIL-2R, relative andabsolute numbers ofCD4+cells (P<0-000 1), andCD4/CD8 ratios (P<0-0001). There wasalso anegative correlation between sIL-2R inplasma andthecellular expression ofIL-2R(P<0-00 1). Wefoundasignificant association ofsIL-2R andplasma neopterin (P<0-0001). Withprogression ofthedisease fromHIV-seronegative toseropositive without symptoms andtofull manifestation ofAIDS/ARC, sIL-2Rplasma levels increased. Thehighest levels werefound atthetimeofdiagnosis ofAIDS/ARC, butthelevels decreased again during the following 18months. Eight percentofHIV-seronegative patients, 32%ofHIV-seropositive patients, and24%ofpatients withAIDS/ARChadincreased plasma TNF-ca. Weconclude thatsIL-2R and TNF-aplasma levels areelevated inHIV-infected haemophilia patients andthat sIL-2R isamarker fordisease progression fromasymptomatic HIV-seropositive toAIDS/ARC.