Redeker S, Schmit JL, Fuentes V, Prin L; International Conference on AIDS.
Int Conf AIDS. 1994 Aug 7-12; 10: 166 (abstract no. PB0092).
Infectious Disease Unit, University Hospital Amiens.
The aim of this study was to assess cryoglobulinemia in HIV infected patients. Fifty seropositive patients were studied. Eleven patients were IVDU, 20 homosexual males, 16 heterosexual individuals, 4 bisexuals, 4 blood recepients and 7 patients coming from an endemic zone. Mean delay from first HIV seropositivity was 3.5 years (0-8). Twenty-two patients were seropositive for more than 4 years. Mean CD4 count was 284/mm3 (3-1438). Three patients have had opportunistic infection. Thirty-nine patients received anti-retroviral drugs (AZT 29%, DDI 3%, combination 8%, switch 23%). Viral co-infection, characterized by isolation of viral sequences from HBV or HCV, HBV serological profils suggesting evolutive hepatitis or positive viremia for CMV, was present in 46% patients. Twenty-one patients had increased p24 Ag levels. Using prewarmed equipement, we collected blood into anti-coagulant free tubes and maintained the samples at 37 degrees C until coagulation was complete. Serum was isolated by centrifugation at 37 degrees C and stored with an antiseptic at 4 degrees C for 8 days to detect low concentration and late precipitating cryoglobulines (CGs). CGs were isolated and characterized from 25 patients. All had mixed cryoglobulinemia; type II CGs were found in 14 patients and type III in 11. Viral co-infection was present in 17 patients: 6 had HCV hepatitis, 9 HBV hepatitis, 5 had HCV and HBV hepatitis and 3 had positive CMV viremia. For 7 patients no trigger circumstance was found. In the two groups, the mean delay from first seropositive test and CD4 count were comparable. Viral co-infection (HBV and/or HCV) was more frequent in the cryoglobulinemia group (68% vs 46%). Biological abnormalities suggesting auto-immunity were found in these patients: circulating immune complexes in 4 patients, IgG anti-cardiolipidine antibodies in 5 patients. Viral co-infection and immunity might play an important role in the pathogenesis of cryoglobulinemia suggesting more investigation of CGs looking for viral sequences in the precipitate, mainly when no trigger circumstance can be found. Further studies on the relation between presence of cryoglobulinemia and progression of HIV disease are mandatory.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- CD4 Lymphocyte Count
- Cryoglobulinemia
- Disease Progression
- HIV Infections
- HIV Seropositivity
- Hepacivirus
- Homosexuality, Male
- Humans
- Male
Other ID:
UI: 102208354
From Meeting Abstracts