Seroconversion of human T cell lymphotrophic virus III (HTLV-III) in patients with haemophilia: a longitudinal study

Patients with hemophilia are at a risk for the acquired immuno-deficiency syndrome (AIDS). As part of a surveillance program on AIDS, a group of patients with hemophilia was studied for clinical and immunological features associated with the syndrome. 30 patients in England who had received factor VIII treatment within 5 years were studied. 29 (male) had hemophilia A, and 1 female heterozygote had been treated for postoperative bleeding. 1 man had been tattooed over 10 years previously. No other risk factors for AIDS were present. 5 patients had recently developed splenomegaly or lymphadenopathy, and 1 of these also had mild thrombocytopenia. No opportunistic infection or unexplained loss of weight was noted. A basal cell carcinoma of the face in a 59-year old was recorded. 20 patients had detectable HTLV-III antibodies at the most recent date of testing. After 1981 approximately 15% of the subjects seroconverted each year until 1984. Most of the seropositive patients had had large amounts of factor VIII treatment, predominantly commercial concentrate from the US. 4 patients who seroconverted during 1984 had had little treatment, including a man who had used only 3250 units during 1983 from the same batch of commercial concentrate. 5 patients had used only products from the National Health Service over 5 years, and all were seronegative. The results failed to identify features that might help distinguish between self limiting HTLV-III infection and leading to AIDS or a carrier state.