Skip to main content
Log in

Human immunodeficiency virus infection in multi-transfused patients with thalassaemia major

  • Original Investigations
  • Published:
European Journal of Pediatrics Aims and scope Submit manuscript

Abstract

We investigated the incidence, clinical and immunological characteristic of human immuno-deficiency virus (HIV) infection in a group of multi-transfused patients with thalassaemia major who were exposed to transfusion-associated HIV infection. Seropositivity to HIV by Western blot and immunofluorescence analysis was detected in 26 out of 590 patients. At a follow up 21–40 months later, none of these seropositive patients had developed acquired immuno-deficiency syndrome (AIDS), and six manifested the AIDS related complex (ARC). ARC was unusually mild and consisted of moderate laterocervical and submandibular lymph node enlargement associated with hypergammaglobulinaemia and a reduced CD4/CD8 ratio resulting from the decreased number of CD4 lymphocytes. These findings suggest that multi-transfused patients with thalassaemia major are relatively resistant to the development of severe manifestations of HIV infection, presumably because their immune status is relatively better preserved than that of other infected population. Longer follow up is, however, necessary to determine whether the incidence of AIDS will be lower in this population or whether overt AIDS merely takes longer to develop.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

Abbreviations

HIV:

Human immuno-deficiency virus

AIDS:

Acquired immuno-deficiency syndrome

ARC:

AIDS-related complex

WBA:

Western blot analysis

ELISA:

Enzyme linked immuno assay

References

  1. Amman AJ (1985) The acquired immunodeficiency syndrome in infants and children. Ann Intern Med 103:734–737

    Google Scholar 

  2. Amman AJ, Cowan MJ, Wara DW, Weintrub P, Dritz S, Goldman H, Perkins HA (1983) Acquired immunodeficiency in an infant: possible transmission by means of blood products. Lancet I:956–958

    Google Scholar 

  3. Boiteaux F, Vilmer E, Girot R, Muller JY, Rouzioux C, Chamaret S, Montagnier L (1985) Lymphadenopathy syndrome in two thalassemic patients after LAV contamination by blood transfusion. N Engl J Med 312:648–649

    Google Scholar 

  4. Church JA, Isaacs H (1984) Transfusion-associated acquired immune deficiency syndrome in infants. J Pediatr 105:731–737

    Google Scholar 

  5. Church JA, Allen JR, Stiehm ER (1986) New scarlet letter(s), pediatric AIDS. Pediatrics 77:423–427

    Google Scholar 

  6. Cooper DA, Maclean P, Finlayson R, Michelmore HM, Gold J, Donovan B, Barnes TG, and Brooke P (1985) Acute AIDS retrovirus infections. Definition of a clinical illness associated with seroconversion. Lancet I:537–540

    Google Scholar 

  7. Curran JW, Lawrence DN, Jaffe H, Kaplan JE, Zyla LD, Chamberland M, Weinstein R, Lui KJ, Schonmberg LB, Spira TJ, Alexander WJ, Swinger G, Amman A, Solomon S, Auerbach D, Mildvan D, Stoneburner R, Jason JM, Haverkos HW, Evatt BL (1984) Acquired immunodeficiency syndrome (AIDS) associated with transfusions. N Engl J Med 310:69–75

    Google Scholar 

  8. Feorino PM, Jaffe HW, Palmer E, Peterman TA, Francis DP, Kalyanarman VS, Weinstein RA, Stoneburner RL, Alexander WI, Raevsky C, Getchell JP, Nicholson JKA, Curran JW (1985) Transfusion associated acquired immunodeficiency syndrome: evidence for persistent infection in blood donors. N Engl J Med 312:1293–1295

    Google Scholar 

  9. Francis DP, Jaffe HW, Fultz PN, Getchell JP, Macdougal JS, Feorino PM (1985) Natural history of infection with the Lymphadenopathy associated virus Human T-Lymphotropic Virus type III. Ann Intern Med 103719–722

    Google Scholar 

  10. Gallo RC, Salahuddin SZ, Popovic M, Shearer GM, Kaplan M, Haynes BF, Palker TJ, Redfield R, Oleske J, Safai B, White G, Foster P, Markham PD (1984) Frequent detections and isolation of cytopatic retroviruses (HTL V III) from patients with AIDS and at risk for AIDS. Science 224:500–502

    Google Scholar 

  11. Gill JC, Menitove JE, Wheeler D, Aster RH, Montgomery RR (1983) Generalized lymphadenopathy and T cell abnormalities in Hemophilia A. J Pediatr 103:18–22

    Google Scholar 

  12. Hardy AM, Allen JR, Morgan WM, Curran JW (1985) The incidence rate of acquired immunodeficiency syndrome in selected populations. JAMA 253:215–220

    Google Scholar 

  13. Kaplan J, Sarnaik S, Gitlin J, Lusher J (1984) Diminished helper/suppressor lymphocyte ratios and natural killer activity in recipients of repeated blood transfusions. Blood 64:308–310

    Google Scholar 

  14. Kaplan J, Sarnaik S, Levy J (1985) Transfusion-induced immunologic abnormalities not related to AIDS virus. N Engl J Med 313: 1227

    Google Scholar 

  15. Kessler CM, Schulof RS, Goldstein AL, Naylor PH, Luban NLC, Kelehr JF, Reaman GH (1983) Abnormal T lymphocytes subpopulations associated with transfusions, of blood derived products. Lancet I:991–992

    Google Scholar 

  16. Landesman SH, Ginzburg HM, Weiss SH (1985) The AIDS epidemic. N Engl J Med 312:521–524

    Google Scholar 

  17. Lederman MM, Ratnoff OD, Scillian JJ, Jones PK, Schacter B (1982) Impaired cell-mediated immunity in patients with classical hemophilia. N Engl J Med 308:79–83

    Google Scholar 

  18. Lilleyman JS (1986) Haemophillia, blood transfusion, and the AIDS virus. Arch Dis Child 61:105–107

    Google Scholar 

  19. Maloney MJ, Cox F, Wray BB, Guill MF, Hagler J, Williams D (1985) AIDS in a child 51/2 years after a transfusion. N Engl J Med 312:1256

    Google Scholar 

  20. Pahwa S, Kaplan M, Fikrig S, Pahwa R, Sarngadharan MG, Popovic M, Gallo RC (1986) Spectrum of human T-cell lymphotropic virus type III infection in children: recognition of symptomatic, asymptomatic and seronegative patients. JAMA 255:2299–2305

    Google Scholar 

  21. Rossi P, Carbonari M, Bonomo R, Galli M, Manconi PE, Scarpati B, Scano G, Gaetano C, Ensoli B, Aiuti F (1985) Epidemiological aspects of HTLV III infection in Italy. Eur J Epidemiol 1:288–293

    Google Scholar 

  22. De Savigny T, Valler A (1980) The communication of ELISA data from laboratory to clinician. J Immunoassay 1:105–108

    Google Scholar 

  23. Scott GB, Buch BE, Leterman JG, Bloom FL, Parks WP (1984) Acquired immunodeficiency syndrome in infants. N Engl J Med 310:76–81

    Google Scholar 

  24. Shannon K, Ball E, Wasserman RL, Murphy FK, Luby J, Buchanan GR (1983) Transfusion-associated cytomegalovirus infection and acquired immune deficiency syndrome in an infant. J Pediatr 103:859–863

    Google Scholar 

  25. Shannon KM, Amman AJ (1985) Acquired immune deficiency syndrome in childhood. J Pediatr 106:332–342

    Google Scholar 

  26. Shearer GM, Levy RB (1984) Blood transfusion and susceptibility to AIDS. N Engl J Med 310:1601

    Google Scholar 

  27. Sullivan JL, Brewster FE, Brettler DB, Forsberg AD, Cheeseman SH, Byron KS, Baker SM, Willitts DL, Lew RA, Levine PH (1986) Hemophiliac immunodeficiency: influence of exposure to factor VIII concentrate, LAV/HTLV III, and herpes virus. J Pediatr 108:504–515

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Manconi, P.E., Dessí, C., Sanna, G. et al. Human immunodeficiency virus infection in multi-transfused patients with thalassaemia major. Eur J Pediatr 147, 304–307 (1988). https://doi.org/10.1007/BF00442701

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00442701

Key words

Navigation