HIV infection and immunity disorders in patients with hemophilia

: The clinical, serological and immunological status of 23 haemophilia patients (21 with haemophilia 9 and 2 with haemophilia B) was investigated. In 12 of 23 haemophiliacs antibodies to HIV were detected. All seropositive patients were treated by imported clotting factor concentrates, and cryoprecipitates obtained by local donors. Six HIV positive haemophiliacs were in asymptomatic stage of HIV infection, and six others were in persistent generalized lymphadenopathy stage. HIV positive haemophiliacs showed a decreased number of CD4 and CD2 lymphocytes, inversed CD4/CD8 lymphocytes ratio, anergy to skin tests, decreased NK (natural killer), cell cytoxic activity, increased IgG and increased immune complexes. HIV negative haemophiliacs showed no different immunologic abnormality than healthy controls. Our results also showed differences in the degree and type of immunological abnormalities depending on different stages of HIV infection. Haemophiliacs in asymptomatic stage of HIV infection showed qualitative abnormalities of T cell immunity, manifested with decreased NK cells cytotoxic activity and anergy to skin tests, while haemophiliacs in persistent generalized lymphadenopathy stage, besides qualitative, showed quantitative abnormalities of T cell immunity, manifested with decreased lymphocyte subpopulations (CD2, CD3, CD4). Immunological disorders observed in our haemophilia patients were in direct correlation with the presence of anti HIV antibodies in peripheral blood, and we suppose that they may be attributed to HIV infection rather than to chronic antigenic stimulation with foreign proteins in blood products.