Mannucci P M, Gringeri A, de Biasi R, Baudo F, Morfini M, Ciavarella N
Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, IRCCS Maggiore Hospital, Milano, Italy.
Thromb Haemost. 1992 Mar 2;67(3):310-3.
It has been postulated that high-purity factor VIII (FVIII) concentrates, since they contain less alloantigenic proteins than intermediate-purity concentrates, might cause lesser deterioration of the immune systems of hemophilic patients infected with the human immunodeficiency virus (HIV). To evaluate this hypothesis, we have prospectively compared T-lymphocytes subsets and delayed hypersensitivity reactions to skin tests in 17 asymptomatic HIV-positive hemophiliacs randomly assigned to continue treatment with an intermediate-purity concentrate with those of 16 hemophiliacs changed to a high-purity concentrate. For both groups, during the 24-month follow-up period CD4 cell counts showed similar rates of fall from baseline values. There was also no difference in the number of patients anergic to skin tests. Three patients treated with the intermediate purity concentrate and one treated with the high-purity concentrate developed symptoms of HIV infection. On the whole, no striking benefit is conferred to the immune status of asymptomatic HIV-positive hemophiliacs by using this high-purity concentrate for 2 years.
据推测，高纯度的凝血因子VIII（FVIII）浓缩剂，因其所含的同种异体抗原性蛋白质比中纯度浓缩剂少，可能会使感染人类免疫缺陷病毒（HIV）的血友病患者免疫系统的恶化程度降低。为了评估这一假设，我们前瞻性地比较了17名无症状HIV阳性血友病患者（随机分配继续使用中纯度浓缩剂治疗）与16名改用高纯度浓缩剂的血友病患者的T淋巴细胞亚群以及皮肤试验的迟发型超敏反应。对于两组患者，在24个月的随访期内，CD4细胞计数从基线值下降的速率相似。对皮肤试验无反应的患者数量也没有差异。3名接受中纯度浓缩剂治疗的患者和1名接受高纯度浓缩剂治疗的患者出现了HIV感染症状。总体而言，无症状HIV阳性血友病患者使用这种高纯度浓缩剂两年，其免疫状态并未获得显著益处。
