Abstract
Children with acquired immunodeficiency syndrome (AIDS) or AIDS related complex (ARC) may develop defective humoral immunity as evidenced by suboptimal antibody responses to a variety of immunogens. We recently identified two hemophiliacs who acquired anti-HBs from exposure to HBsAg in factor VIII concentrate, but later became anti-HBs seronegative following infection with Human immunodeficiency virus (Hiv). Neither patient demonstrated evidence of clinical hepatitis coincident with seroconversion to anti-HBs positivity. Both have exhibited generalized lymphadenopathy for greater than one year although neither have had opportunistic infections. Patient #1 seroconverted to anti-HBs positive status in 4/83, demonstrated anti-HBs in serum on <4 subsequent occasions between 4/83 and 8/85, but reverted to seronegative status on testing in 9/86 and 11/86. Seropositivity for anti-Hiv by the ELISA method was noted in 8/85; hypergammaglobulinemia (hyper IgG) was noted in 8/85 and 11/86 (1840-2130 mg%). Patient #2 seroconverted to anti-HBs positivity in 6/81, demonstrated anti-HBs in serum on 5 subsequent occasions until 1/85, but reverted to seronegative status in 7/85. He has remained anti-HBs seronegative to date. Seropositivity for anti-Hiv (ELISA method) was first documented in 7/85 and reversed T4/T8 ratio was noted in 1/83 and 11/86. Hyper IgG was detected in 6/85 and 11/86 (1930-2300 mg%). These preliminary data suggest that Hiv infected hemophiliacs may lose their capacity to maintain adequate titers of anti-HBs, thereby compromising their humoral immunity to hepatitis B.
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Bray, G., Reaman, G. LOSS OF NATURALLY ACQUIRED HEPATITIS B SURFACE ANTI-BODY (ANTI-HBs) IN TWO HEMOPHILIACS WITH AIDS RELATED COMPLEX. Pediatr Res 21 (Suppl 4), 309 (1987). https://doi.org/10.1203/00006450-198704010-00849
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DOI: https://doi.org/10.1203/00006450-198704010-00849