Document 0139
 DOCN  M94A0139
 TI    Effect of low- and intermediate-purity clotting factor therapy on
       progression of human immunodeficiency virus infection in congenital
       clotting disorders. Transfusion Safety Study Group.
 DT    9412
 AU    Gjerset GF; Pike MC; Mosley JW; Hassett J; Fletcher MA; Donegan E;
       Parker JW; Counts RB; Zhou Y; Kasper CK; et al; Puget Sound Blood
       Center, Seattle, WA.
 SO    Blood. 1994 Sep 1;84(5):1666-71. Unique Identifier : AIDSLINE
       MED/94348094
 AB    Low- and intermediate-purity clotting-factor therapies are believed to
       accelerate human immunodeficiency virus (HIV) progression in
       hemophiliacs through adverse immune effects of the other plasma proteins
       in the preparations. To investigate this postulate, we evaluated data
       from six clinical centers that observed persons with congenital factor
       deficiencies at 6-month intervals. The present analysis is based on
       HIV-infected subjects who received intermediate purity factor VIII or
       factor IX concentrates, or cryoprecipitate. For long-term outcome, we
       classified 374 subjects by the type and amount of treatment during our
       first year of observation, and determined the subsequent rate of
       progression to a CD4 count less than 200 cells/microL. A second analysis
       of this group used a repeated-measures, random-effect model that allowed
       for individual differences in CD4 decline. Finally, we compared
       short-term rates of change in CD4 count in each treatment interval of
       525 subjects with the type and amount of factor therapy received in the
       same interval. There was no overall or dose-related deleterious effect
       of any form of treatment on CD4 trend. The CD4 decrease was less when
       cryoprecipitate was administered alone or combined with concentrate, but
       not significantly so. Our results counter the assertion that low- and
       intermediate-purity products accelerate the rate of CD4 decrease in
       HIV-1-infected hemophiliacs.
 DE    Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY/*ETIOLOGY/  IMMUNOLOGY
       Antigens, CD4/*BLOOD  Blood Coagulation
       Disorders/*COMPLICATIONS/*THERAPY  Christmas Disease/*THERAPY  Factor
       IX/STANDARDS/*THERAPEUTIC USE  Factor VIII/STANDARDS/*THERAPEUTIC USE
       Follow-Up Studies  Hemophilia/*THERAPY  Human  *HIV Seropositivity
       HIV-1  Support, U.S. Gov't, P.H.S.  Survival Analysis  Time Factors  T4
       Lymphocytes/*IMMUNOLOGY  JOURNAL ARTICLE  MULTICENTER STUDY

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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