Effect of high purity factor VIII concentrates on CD4+ cell counts in hemophiliac patients infected with HIV

Objectives. To analyze the effect of high purity factor VIII concentrates on CD4+ cell counts in HIV-seropositive hemophiliac patients. Patients and methods. A study was conducted with 16 HIV seropositive patients with severe hemophilia A (mean age: 20 years) free from antiretroviral therapy and with CD4+ cell counts higher than 200/mu l 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 (CDL4+/mu l/month and % variation/month). The Wilcoxon test was used for statistical comparisons among paired tests. Results. No significant differences were observed among the mean values of the initial (656 +/- 246/mu l), change time (625 +/- 277/mu l) and final counts (493 +/- 246/mu l). During the intermediate purity period slopes (mean: -0.6 +/- 12 CD4+/mu l/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+/mu l/month; p < 0,05). Nevertheless, differences between the slopes of the two periods were not statistically significant. Conclusion. 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.