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Natural History of Human Immunodeficiency Virus Infections in Hemophiliacs: Effects of T-Cell Subsets, Platelet Counts, and Age

M. ELAINE EYSTER, M.D.; MITCHELL H. GAIL, M.D., Ph.D.; JAMES O. BALLARD, M.D.; HAMID AL-MONDHIRY, M.D.; and JAMES J. GOEDERT, M.D.
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Grant support: in part by grants ME-82051 and ME-82130 from the Pennsylvania Department of Health, a grant from the Brandywine Valley Hemophilia Foundation, and by grant N01-CP-31041-03 from the National Cancer Institute.

▸Requests for reprints should be addressed to M. Elaine Eyster, M.D.; The Milton S. Hershey Medical Center, P.O. Box 850; Hershey, PA 17033.


Hershey, Pennsylvania; and Bethesda, Maryland


©1987 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1987;107(1):1-6. doi:10.7326/0003-4819-107-1-1
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Serial T-cell subsets and platelet counts were determined in a cohort of 84 hemophiliacs in whom time of seroconversion for human immunodeficiency virus (HIV) antibody could be ascertained. An abrupt decrease in the number of T-helper (T4) cells was seen in 9 patients 12 to 24 months before the acquired immunodeficiency syndrome (AIDS) was diagnosed (p = 0.0007 compared with those who did not develop AIDS). Thrombocytopenia also was associated with an increased risk for AIDS (p = 0.02), as was older age at the time of seroconversion (p = 0.03). Ten patients developed AIDS at 24 to 95 months after seroconversion, for a cumulative incidence (± SE) of 18.0% ± 7.1% at 6 years. Hemophiliacs who had T4 cell counts of less than 200 cells/µL had a 50% ± 16% cumulative incidence of AIDS within 2 years, indicating that decreasing or very low T4 cell counts have predictive value for the development of AIDS. Furthermore, the data suggest that thrombocytopenia and older age may be markers for a cofactor that increases the risk for AIDS in hemophiliacs.

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