Kim H C, Nahum K, Raska K, Gocke D J, Kosmin M, Karp G I, Saidi P
Am J Hematol. 1987 Feb;24(2):169-76. doi: 10.1002/ajh.2830240208.
During the 5-year period from 1981 to 1985, we have observed 8 cases of acquired immunodeficiency syndrome (AIDS) among our 85 patients with hemophilia A. Thus, the prevalence of AIDS with hemophilia A is 9.4% in our patient population. By utilizing stored serum or plasma samples dating back to 1978, antibody against HTLV-III was detected in all 8 cases with AIDS. Based on the time interval from the appearance of antibody to HTLV-III to the diagnosis of AIDS in these patients, the incubation period ranged from 27 months to 60 months, with a median of 36 months. Before the diagnosis of full-blown AIDS, all patients exhibited a variety of prodromal manifestations of non-specific nature, including weight loss, oral candidiasis, unexplained non-productive chronic cough, generalized lymphadenopathy, and thrombocytopenia lasting several months to several years. Serial T-lymphocyte subset studies were available in some patients during the HTLV-III seropositive period and showed progressive lymphopenia, depletion of T4 cells with an average absolute count of 94 +/- 128 per mm3 (mean +/- 1 S.D.), and a markedly reversed T4/T8 ratio of 0.26 +/- 0.19 (mean +/- 1 S.D.). These findings suggest that the incubation period of AIDS is considerably long and that prospective study of serial immunologic markers and HTLV-III markers may be warranted in hemophilic patients at risk.
在1981年至1985年的5年期间，我们在85例甲型血友病患者中观察到8例获得性免疫缺陷综合征（艾滋病）。因此，在我们的患者群体中，甲型血友病合并艾滋病的患病率为9.4%。通过利用可追溯到1978年的储存血清或血浆样本，在所有8例艾滋病患者中均检测到抗人类嗜T淋巴细胞病毒III型（HTLV-III）抗体。根据这些患者出现抗HTLV-III抗体至诊断为艾滋病的时间间隔，潜伏期为27个月至60个月，中位数为36个月。在确诊为典型艾滋病之前，所有患者均表现出各种非特异性的前驱症状，包括体重减轻、口腔念珠菌病、原因不明的无痰慢性咳嗽、全身淋巴结肿大以及持续数月至数年的血小板减少。在一些患者的HTLV-III血清阳性期间进行了连续的T淋巴细胞亚群研究，结果显示淋巴细胞进行性减少，T4细胞耗竭，平均绝对计数为每立方毫米94±128（平均值±1标准差），T4/T8比值明显倒置，为0.26±0.19（平均值±1标准差）。这些发现表明，艾滋病的潜伏期相当长，对于有风险的血友病患者，可能有必要对连续的免疫标志物和HTLV-III标志物进行前瞻性研究。
