To evaluate the abnormalities of cell mediated immunity in Korean hemophiliacs according to annual consumption of antihemophilic concentrate, we conducted an
immunological study of total lymphocyte count, T lymphocyte count, helper T cell(CD4), suppressor T cell(CD8), T helper/suppressor ratio(CD4/CD8), lymphocyte response
to mitogens phytohemagglutinin and concanavalin A, natural killer cell activity and production of interleukin-2 in HIV antibody negative 32 patients with hemophilia A and
HIV antibody positive 2 patients with hemophilia, who had been treated only with factor concentrate. Patients were assigned to 3 groups according to the annual amount of
factor concentrate replacement(Group 1 : ≤500 U/㎏/yr, Group 2 : 501-1000U/㎏/yr, Group 3 : ≥1001 U/㎏/yr).
The results are summarized as follows :
1. HIV antibody negative hemophiliacs had decreased CD4 levels, increased CD8 levels, decreased CD4/CD8 ratio and it was most severe in HIV antibody positive hemophiliacs.
2. Diminished lymphocyte responses to the mitogens, PHA and Con A, decreased interleukin-2 production were observed in the hemophiliacs.
3. There was no significant differences between the 3 groups in total lymphocyte count but low CD4/CD8 ratio was significantly correlated with the greater annual
consumption of factor concentrate.
4. Lymphocyte responses to PHA and Con A, and natural killer cell activity showed no significant differences between the 3 groups.
5. There was a significant correlation between lower interleukin-2 production and greater annual consumption of factor concentrate.
These findings suggest that hemophiliacs without evidence of infection such as AIDS or virus are at risk of developing abnormalities in cell mediated immunity and this is related to amount of factor concentrate exposure.