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艾滋病与血友病:特定人群中的发病率与死亡率

AIDS and haemophilia: morbidity and morality in a well defined population.

作者信息

Jones P, Hamilton P J, Bird G, Fearns M, Oxley A, Tedder R, Cheingsong-Popov R, Codd A

出版信息

Br Med J (Clin Res Ed). 1985 Sep 14;291(6497):695-9. doi: 10.1136/bmj.291.6497.695.

Abstract

One hundred and forty-three multitransfused patients with hereditary haemostatic disorders were examined for evidence of disease related to the acquired immune deficiency syndrome (AIDS). Ninety-nine patients with severe haemophilia A were tested for anti-HTLV-III and 76 were found to be positive. All except one of these seropositive patients had received commercial factor VIII concentrates at some time. Eighteen patients with haemophilia B were tested and all were anti-HTLV-III negative. Three out of 36 sexual partners of patients with haemophilia A positive for anti-HTLV-III were also seropositive. One, who had recently received blood transfusions, had AIDS with Pneumocystis carinii pneumonia. Three patients with severe haemophilia A died from Aids. A further 30 haemophiliacs had AIDS related complex or lymphadenopathy that could be related to HTLV-III infection. There was a significant correlation between lymphadenopathy and anti-HTLV-III seropositivity. No evidence of casual spread of AIDS was found since all 68 health care staff tested were anti-HTLV-III negative, including three surgeons who regularly worked with patients positive for anti-HTLV-III. The resources devoted to counselling and laboratory support in centres treating people at risk and their families need to be urgently reassessed.

摘要

对143例多次输血的遗传性止血障碍患者进行了检查,以寻找与获得性免疫缺陷综合征(艾滋病)相关疾病的证据。对99例重度甲型血友病患者进行了抗人嗜T淋巴细胞病毒III型(HTLV-III)检测,发现76例呈阳性。这些血清反应阳性的患者中,除1例之外,均曾在某个时候接受过商业性因子VIII浓缩剂。对18例乙型血友病患者进行了检测,结果均为抗HTLV-III阴性。甲型血友病抗HTLV-III阳性患者的36名性伴侣中,有3名血清反应也呈阳性。其中1名近期接受过输血,患有卡氏肺囊虫肺炎的艾滋病。3例重度甲型血友病患者死于艾滋病。另有30名血友病患者患有与艾滋病相关的综合征或淋巴结病,可能与HTLV-III感染有关。淋巴结病与抗HTLV-III血清反应阳性之间存在显著相关性。由于所检测的68名医护人员抗HTLV-III均为阴性,包括3名经常与抗HTLV-III阳性患者打交道的外科医生,因此未发现艾滋病有偶然传播的证据。迫切需要重新评估在治疗高危人群及其家人的中心用于咨询和实验室支持的资源。

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本文引用的文献

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The acquired immunodeficiency syndrome in patients with hemophilia.
Ann Intern Med. 1984 Apr;100(4):499-504. doi: 10.7326/0003-4819-100-4-499.
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Lancet. 1983 Apr 30;1(8331):956-8. doi: 10.1016/s0140-6736(83)92082-2.
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Pneumonia in the acquired immune deficiency syndrome.获得性免疫缺陷综合征中的肺炎
Br Med J (Clin Res Ed). 1985 May 4;290(6478):1299-301. doi: 10.1136/bmj.290.6478.1299.
10
HTLV-III, haemophilia, and blood transfusion.人类嗜T淋巴细胞病毒III型、血友病与输血
Br Med J (Clin Res Ed). 1985 Jun 22;290(6485):1901-2. doi: 10.1136/bmj.290.6485.1901.

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