Hemophiliacs and AIDS: really at risk.

Hemophiliacs and AIDS: Really at risk

Of all the population groups deemed at high risk of contracting AIDS, hemophiliacs -- who frequently receive blood-clotting factors derived from pooled human plasma -- have remained most uncertain about their fate. Until 1984, these blood products did not receive effective heat or chemical treatments to kill viruses, leaving them in many cases contaminated with HIV, the AIDS-causing virus.

A substantial majority of the approximately 15,000 hemophiliacs in the United States who received non-heat-treated clotting factor concentrates now have HIV antibodies. But researchers have debated whether this indicates true HIV infection -- especially since some unconfirmed studies have suggested a relatively low incidence of clinical AIDS developing in antibody-positive hemophiliacs. Perhaps, some have suggested, AIDS viruses sometimes become noninfectious during normal preparation and storage of clotting factors, even without heat treatment. If so, the antibodies seen in hemophiliacs might in many cases be simply a response to a few noninfectious fragments of HIV proteins.

Not so, says J. Brooks Jackson of the University of Minnesota in Minneapolis, reporting with his colleagues in the Oct. 21 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION. In a study of 56 HIV-antibody-positive hemophiliacs who received non-heat-treated clotting factors, all but one had HIV DNA in their blood when tested with the extremely sensitive polymerase chain reaction test -- indicating they are indeed infected with the virus and at high risk of contracting AIDS.