Molina Alejandro R, Lorenzo Herrero J I, Haya Guaita S, Querol Fuentes F, Aznar Lucea J A
Unidad de Coagulopatias Congénitas, Hospital La Fe, Valencia.
Rev Clin Esp. 1996 Jun;196(6):365-9.
To analyze the effect of high purity factor VIII concentrates on CD4+ cell counts in HIV-seropositive hemophiliac patients.
A study was conducted with 16 HIV seropositive patients with severe hemophilia A (mean age: 20 years) free from anti-retroviral therapy and with CD4+ cell counts higher than 200/microliters who had their intermediate purity factor VIII concentrates changes to high purity concentrates immunoadsorbed with monoclonal antibodies (monoclonal FVIII). For each patient two consecutive period were compared, one before (median: 21 months) and the other after (median: 19 months) the therapeutic change. All patients had three or more CD4+ cell counts determined in each period, which were used to calculate the slope with time (CD4+/microliters/month and % variation/month). The Wilcoxon test was used for statistical comparisons among paired tests.
No significant differences were observed among the mean values of the initial (656 +/- 246/microliters), change time (625 +/- 277/microliters) and final counts (493 +/- 246/microliters). During the intermediate purity period slopes (mean: -0.6 +/- 12 CD4+/microliters/month) were not significantly different from zero. In contrast, they were significant during the period of treatment with monoclonal FVIII (mean: -8.5 +/- 14 CD4+/microliter/month; p < 0,05). Nevertheless, differences between the slopes of the two periods were not statistically significant.
In contrast with the results obtained in prospective studies, no favorable effect of monoclonal FVIII on CD4+ cell counts was observed among HIV-positive hemophiliac patients.
分析高纯度因子VIII浓缩物对HIV血清阳性血友病患者CD4+细胞计数的影响。
对16例未接受抗逆转录病毒治疗、CD4+细胞计数高于200/微升的严重甲型血友病HIV血清阳性患者进行了一项研究，这些患者将其中等纯度因子VIII浓缩物更换为用单克隆抗体免疫吸附的高纯度浓缩物（单克隆FVIII）。对每位患者比较两个连续时间段，一个是治疗改变前（中位数：21个月），另一个是治疗改变后（中位数：19个月）。所有患者在每个时间段均进行了三次或更多次CD4+细胞计数，用于计算随时间的斜率（CD4+/微升/月和%变化/月）。采用Wilcoxon检验进行配对检验间的统计学比较。
初始计数（656±246/微升）、改变时间计数（625±277/微升）和最终计数（493±246/微升）的平均值之间未观察到显著差异。在中等纯度阶段，斜率（平均值：-0.6±12 CD4+/微升/月）与零无显著差异。相比之下，在用单克隆FVIII治疗期间斜率显著（平均值：-8.5±14 CD4+/微升/月；p<0.05）。然而，两个阶段斜率之间的差异无统计学意义。
与前瞻性研究结果相反，在HIV阳性血友病患者中未观察到单克隆FVIII对CD4+细胞计数有有利影响。
