Effect on lymphocyte subsets of clotting factor therapy in human immunodeficiency virus-1-negative congenital clotting disorders

J. Hassett, G. F. Gjerset, J. W. Mosley, M. A. Fletcher, E. Donegan, J. W. Parker, R. B. Counts, L. M. Aledort, H. Lee, M. C. Pike, D. J. Bregman, J. Buckley, J. Gaiennie, C. K. Kasper, M. J. Nowicki, E. A. Operskalski, J. W. Parker, M. C. Pike, M. Succar

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21 Scopus citations


Patients with hemophilia A without human immunodeficiency virus type 1 (HIV-1) infection have lower CD4+ counts and CD4+/CD8+ ratios than controls. This is usually interpreted as a therapy-induced immunodeficiency. Our data re-examine the effect of therapy on peripheral blood mononuclear cell immunophenotypic subpopulations in all congenital clotting disorders. Since late 1985 we have prospectively observed HIV-1 uninfected persons with all types and severity of disorder. Controls were household members without clotting disorders or HIV-1 infection. Analyses of immunophenotype and treatment included a longitudinal random effects model. Compared with controls, age-adjusted CD4+ counts were significantly lower in treated patients (P < .0001) and in patients with all types of clotting disorders who were seldom or never treated (P = .0005). Significantly lower values among both treated and untreated clotting disorder subjects (P < .05) were likewise found for total lymphocytes, several other T-cell subsets, and the CD4+/CD8+ ratio. For most indexes, including the CD4+ count and CD4+/CD8+ ratio, the type of clotting deficiency was not a significant variable. Comparing persons who had no or minimal therapy with those having the most showed increases in CD8+ (P = .0017) and CD20+CD21- counts (P = .0255), and a lower CD20+CD21+/CD20+ ratio (P = .0106) in the latter. Controls and persons with clotting disorders differ in CD4+ count. Among those with clotting factor disorders, there is no difference attributable to type of clotting disorder or factor therapy. Large amounts of treatment increased CD8+ and CD20+CD21- counts, but were not associated with a change in CD4+ count.

Original languageEnglish
Pages (from-to)1351-1357
Number of pages7
Issue number4
StatePublished - 1993
Externally publishedYes


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