1986 update of HIV seroprevalence, seroconversion, AIDS incidence, and immunologic correlates of HIV infection in patients with hemophilia A and B
1986 update of HIV seroprevalence, seroconversion, AIDS incidence, and immunologic correlates of HIV infection in patients with hemophilia A and B
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1986 年 A 型和 B 型血友病患者中 HIV 血清阳性率、血清转化率、艾滋病发病率以及 HIV 感染免疫相关性的更新
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发表时间：
1987
期刊：
影响因子：
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通讯作者：
J. Lewis
中科院分区：
文献类型：
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作者：
M. Ragni;A. Winkelstein;L. Kingsley;J. Spero;J. Lewis
对宾夕法尼亚州西部血友病中心治疗的181例血友病A(149例)和血友病B(32例)患者进行了跟踪调查，以确定人类免疫缺陷病毒(HIV)的血清阳性率、血清转换率以及与HIV感染的临床和免疫学相关性。截至1986年12月，82例(45%)HIV血清阳性，其中10例(12%)发展为艾滋病，28例(34%)有症状的HIV感染(CDC III、IV级)，其中14例(17%)有艾滋病相关复合体(ARC)，44例(54%)有无症状的HIV感染(CDC II级)。HIV血清阳性组包括82%的凝血因子VIII浓缩组(97%重度，5%中度)，48%的凝血因子IX浓缩组(92%重度，8%中度)，10%的冷沉淀组(67%重度，33%中度)，以及没有接受新鲜冰冻血浆治疗的患者。根据1977年至1986年连续采集的77例HIV血清阳性血友病患者的数据，血清转换高峰出现在1982年，其中14%(77例中的11例)发生在1984年以后。随着血清转换时间的延长，T4淋巴细胞数量和功能(以软琼脂生长[T菌落试验]衡量)逐渐下降；T4细胞数量下降到135+/-26个/mm~3(扫描电子显微镜)，集落计数下降1193+/-537个(对照3851+/-387个)。在那些患有艾滋病的人中，确诊时总T4降至100/mm3(33+/-8/mm3)以下。在这一队列中，艾滋病总发病率为5.5%(占艾滋病毒血清阳性者的12%)，在那些血清阳性5年或更长时间内，艾滋病发病率接近32%。
A cohort of 181 patients with hemophilia A (149) and hemophilia B (32) cared for at the Hemophilia Center of Western Pennsylvania was followed to determine human immunodeficiency virus (HIV) seroprevalence, seroconversion rate, and clinical and immunologic correlates of HIV infection. By December 1986, 82 (45%) were HIV seropositive, and of these, ten (12%) had developed AIDS, 28 (34%) had symptomatic HIV infection (CDC class III, IV), of whom 14 (17%) had AIDS-related complex (ARC), and 44 (54%) had asymptomatic HIV infection (CDC class II). The HIV seropositive group included 82% of those treated with factor VIII concentrate (97% severe, 5% moderate), 48% of those treated with factor IX concentrate (92% severe, 8% moderate), 10% of those treated with cryoprecipitate (67% severe, 33% moderate), and none of those treated with fresh frozen plasma. Based on 77 serially sampled HIV seropositive hemophiliacs (1977 to 1986), peak seroconversion occurred in 1982, with 14% (11 of 77) occurring since 1984. With increasing time from seroconversion, both T4 lymphocyte number and function (the latter measured by growth in soft agar [T colony assay]) progressively declined; T4 number declined to 135 +/- 26/mm3 (SEM), and colony count declined 1193 +/- 537 (control 3851 +/- 387) by 5 years after seroconversion. In those developing AIDS, total T4 fell below 100/mm3 (33 +/- 8/mm3) at diagnosis. In this cohort, the overall AIDS incidence is 5.5% (12% among the HIV seropositive) and in those seropositive 5 or more years, the AIDS incidence approaches 32%.