Effect of low- and intermediate-purity clotting factor therapy on progression of human immunodeficiency virus infection in congenital clotting disorders

George F. Gjerset, Malcolm C. Pike, James W. Mosley, Joseph Hassett, Mary Ann Fletcher, Elizabeth Donegan, John W. Parker, Richard B. Counts, Yi Zhou, Carol K. Kasper, Eva A. Operskalski

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Low- and intermediate-purity clotting-factor therapies are believed to accelerate human immunodeficiency virus (HIV) progression in hemophiliacs through adverse immune effects of the other plasma proteins in the preparations. To investigate this postulate, we evaluated data from six clinical centers that observed persons with congenital factor deficiencies at 6-month intervals. The present analysis is based on HIV-infected subjects who received intermediate purity factor VIII or factor IX concentrates, or cryoprecipitate. For long-term outcome, we classified 374 subjects by the type and amount of treatment during our first year of observation, and determined the subsequent rate of progression to a CD4 count less than 200 cells/μL. A second analysis of this group used a repeated-measures, random- effect model that allowed for individual differences in CD4 decline. Finally, we compared short-term rates of change in CD4 count in each treatment interval of 525 subjects with the type and amount of factor therapy received in the same interval. There was no overall or dose-related deleterious effect of any form of treatment on CD4 trend. The CD4 decrease was less when cryoprecipitate was administered alone or combined with concentrate, but not significantly so. Our results counter the assertion that low- and intermediate-purity products accelerate the rate of CD4 decrease in HIV-1- infected hemophiliacs.

Original languageEnglish
Pages (from-to)1666-1671
Number of pages6
JournalBlood
Volume84
Issue number5
StatePublished - Sep 1 1994
Externally publishedYes

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Congenital, Hereditary, and Neonatal Diseases and Abnormalities
Blood Coagulation Factors
Virus Diseases
CD4 Lymphocyte Count
Viruses
HIV
Factor VIII
Individuality
HIV-1
Blood Proteins
Observation
Therapeutics
prothrombin complex concentrates

ASJC Scopus subject areas

  • Hematology

Cite this

Gjerset, G. F., Pike, M. C., Mosley, J. W., Hassett, J., Fletcher, M. A., Donegan, E., ... Operskalski, E. A. (1994). Effect of low- and intermediate-purity clotting factor therapy on progression of human immunodeficiency virus infection in congenital clotting disorders. Blood, 84(5), 1666-1671.

Effect of low- and intermediate-purity clotting factor therapy on progression of human immunodeficiency virus infection in congenital clotting disorders. / Gjerset, George F.; Pike, Malcolm C.; Mosley, James W.; Hassett, Joseph; Fletcher, Mary Ann; Donegan, Elizabeth; Parker, John W.; Counts, Richard B.; Zhou, Yi; Kasper, Carol K.; Operskalski, Eva A.

In: Blood, Vol. 84, No. 5, 01.09.1994, p. 1666-1671.

Research output: Contribution to journalArticle

Gjerset, GF, Pike, MC, Mosley, JW, Hassett, J, Fletcher, MA, Donegan, E, Parker, JW, Counts, RB, Zhou, Y, Kasper, CK & Operskalski, EA 1994, 'Effect of low- and intermediate-purity clotting factor therapy on progression of human immunodeficiency virus infection in congenital clotting disorders', Blood, vol. 84, no. 5, pp. 1666-1671.
Gjerset, George F. ; Pike, Malcolm C. ; Mosley, James W. ; Hassett, Joseph ; Fletcher, Mary Ann ; Donegan, Elizabeth ; Parker, John W. ; Counts, Richard B. ; Zhou, Yi ; Kasper, Carol K. ; Operskalski, Eva A. / Effect of low- and intermediate-purity clotting factor therapy on progression of human immunodeficiency virus infection in congenital clotting disorders. In: Blood. 1994 ; Vol. 84, No. 5. pp. 1666-1671.
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