CLINICAL SIGNIFICANCE OF SERIAL EXAMINATION OF ANTI HUMAN IMMUNODEFICIENCY VIRUS ( HIV ) ANTIBODY AND HIV ANTIGEN IN HEMOPHILIACS WITH HIV INFECTION

Sayuri Odajima, J. Matsuda, T. Hamauzu, N. Saito, T. Kinoshita, T. Abe
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Abstract

CLINICAL SIGNIFICANCE OF SERIAL EXAMINATION OF ANTI HUMAN IMMUNODEFICIENCY VIRUS (HIV) ANTIBODY AND HIV ANTIGEN IN HEMOPHILIACS WITH HIV INFECTION Sayuri Odajima, Juzo Matsuda, Toshikazu Hamauzu, Noriko Saito, Tadatoshi Kinoshita and Takeshi Abe Department of Medicine, Teikyo University School of Medicine We tested for the anti HIV antibody and the HIV antigen in the sera of 81 hemophiliacs (A 68 cases, B 13 cases), who have been under treatment in our department. The anti HIV antibody was found to be present in 44.3% of the cases, including 7 cases who later changed to positive, and 6 with HIV antigen. In the sera of those 7 seroconverted cases, although the HN antigen was negative, the p24 antibody was detected by the Western blotting method and the gp41 antibody was detected by the Confirmatory EIA (ENVACORE, Abbott Lab., USA) earlier than by the immunofluorescence method and conventional ELISA. Moreover, in 4 cases who later developed AIDS, HIV turned out positive concurrently with or shortly after the enfeeblement and/or disappearance of the p24 antibody which was associated with a progressive decrease in the CD4/8 ratio of lymphocytes and the development of recurrent oppotunistic infections. Based on these results, it is suggested that the periodical examination for anti p24 and gp41 antibodies and HIV itself might be clinically useful for predicting the development of AIDS and thustreating them at an early stage.
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血友病合并HIV感染患者抗人类免疫缺陷病毒(HIV)抗体和HIV抗原系列检测的临床意义
对在我科治疗的81例血友病患者(A 68例,B 13例)进行了血清抗HIV抗体和HIV抗原的检测,结果表明:血友病患者(A 68例,B 13例)血清抗HIV抗体和HIV抗原检测的临床意义。44.3%的病例有抗HIV抗体,其中7例后转为阳性,6例有HIV抗原。在这7例血清转化患者的血清中,虽然HN抗原为阴性,但用Western blotting法检测p24抗体,用Confirmatory EIA (ENVACORE, Abbott Lab)检测gp41抗体。(美国)早于免疫荧光法和常规ELISA法。此外,在4例后来发展为艾滋病的病例中,HIV在p24抗体衰弱和/或消失的同时或不久之后呈阳性,这与淋巴细胞CD4/8比例的逐渐下降和复发性机会性感染的发展有关。因此,定期检测抗p24和gp41抗体以及HIV本身可能有助于临床预测艾滋病的发展,从而在早期进行治疗。
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