Document 3047
 DOCN  M94A3047
 TI    Cryoglobulinemia in HIV infected patients.
 DT    9412
 AU    Redeker S; Schmit JL; Fuentes V; Prin L; Infectious Disease Unit,
       University Hospital Amiens.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):166 (abstract no. PB0092). Unique
       Identifier : AIDSLINE ICA10/94369528
 AB    The aim of this study was to assess cryoglobulinemia in HIV infected
       patients. Fifty seropositive patients were studied. Eleven patients were
       IVDU, 20 homosexual males, 16 heterosexual individuals, 4 bisexuals, 4
       blood recepients and 7 patients coming from an endemic zone. Mean delay
       from first HIV seropositivity was 3.5 years (0-8). Twenty-two patients
       were seropositive for more than 4 years. Mean CD4 count was 284/mm3
       (3-1438). Three patients have had opportunistic infection. Thirty-nine
       patients received anti-retroviral drugs (AZT 29%, DDI 3%, combination
       8%, switch 23%). Viral co-infection, characterized by isolation of viral
       sequences from HBV or HCV, HBV serological profils suggesting evolutive
       hepatitis or positive viremia for CMV, was present in 46% patients.
       Twenty-one patients had increased p24 Ag levels. Using prewarmed
       equipement, we collected blood into anti-coagulant free tubes and
       maintained the samples at 37 degrees C until coagulation was complete.
       Serum was isolated by centrifugation at 37 degrees C and stored with an
       antiseptic at 4 degrees C for 8 days to detect low concentration and
       late precipitating cryoglobulines (CGs). CGs were isolated and
       characterized from 25 patients. All had mixed cryoglobulinemia; type II
       CGs were found in 14 patients and type III in 11. Viral co-infection was
       present in 17 patients: 6 had HCV hepatitis, 9 HBV hepatitis, 5 had HCV
       and HBV hepatitis and 3 had positive CMV viremia. For 7 patients no
       trigger circumstance was found. In the two groups, the mean delay from
       first seropositive test and CD4 count were comparable. Viral
       co-infection (HBV and/or HCV) was more frequent in the cryoglobulinemia
       group (68% vs 46%). Biological abnormalities suggesting auto-immunity
       were found in these patients: circulating immune complexes in 4
       patients, IgG anti-cardiolipidine antibodies in 5 patients. Viral
       co-infection and immunity might play an important role in the
       pathogenesis of cryoglobulinemia suggesting more investigation of CGs
       looking for viral sequences in the precipitate, mainly when no trigger
       circumstance can be found. Further studies on the relation between
       presence of cryoglobulinemia and progression of HIV disease are
       mandatory.
 DE    Adult  AIDS-Related Opportunistic Infections/BLOOD/DIAGNOSIS
       Bisexuality  Blood Transfusion  Cryoglobulinemia/BLOOD/*DIAGNOSIS
       Cryoglobulins/METABOLISM  Cytomegalovirus
       Infections/BLOOD/DIAGNOSIS/TRANSMISSION  Female  Hepatitis
       B/BLOOD/DIAGNOSIS/TRANSMISSION  Hepatitis C/BLOOD/DIAGNOSIS/TRANSMISSION
       Homosexuality  Human  HIV Infections/BLOOD/*DIAGNOSIS/TRANSMISSION  Male
       Risk Factors  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).