Key words: Human immunodeficiency virus (HIV) infection, Hemophilia, acquired immuno deficiency syndrome (AIDS), AIDS-related complex (ARC), Pneumocys

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1 Key words: Human immunodeficiency virus (HIV) infection, Hemophilia, acquired immuno deficiency syndrome (AIDS), AIDS-related complex (ARC), Pneumocystis carinii (P. carinii) infection

2 Table 1 Priles 35 Hemophiliacs

3 867 昭和62年8月20日 Table 2 Clinical against Symptoms and Laboratory Data 18 Hemophiliacs with Positive Antibody HIV *: Clinical **: Clinical stages in classification symptoms: O; oral AIDS, As; candidiasis, F; asymptomatic fever, carrier. L; lymphadenopathy D; diarrhea, E; easy fatigability. ***: Laboratory ratios data: HIV-Ab OK-T4 elevated, : (helper within Fig. 1A titers T normal Multinucleated were cells) assayed and OK-T8 by an indirect (supresser immunluorescent T cells), IgG; method. T4/T8; immunoglobulin G, ; ranges. giant cells (center) were formed. patients with ARC, peripheral blood leukocyte cells MT4 and H9 cells. 1B: HIV antigen expression To isolate HIV from were co-cultivated with was tested by indirect immunluorescence. 流 血 中 のP.carnii抗 原 をELISAで カ リ ニ 肺 炎 を 発 症 し たAIDSの 調 べ た 結 果, 症 例 にP.carinii 感 染 をAsymptomatic alized carrier, 考 ア メ リ カ 合 衆 国CDCの 察 レ ポ ー トで はHIVの gener- lymphoadenopathy(pgl),aids-related complex(arc),aidsの4段 抗 原 が 検 出 で き た. persistent る5).PGLの 階 に 分 類 し て い 定 義 は 左 右 対 称 性 の リン パ節 腫 大 を 呈 す る 症 候 群 で,全 身 倦 怠 感,発 熱,盗 汗,体 重

4 868 感 染 症学 雑 誌 Fig. 2 ARC. virions Transmission 2A: were electron Budding also 減 少,下 痢 な どの 臨 床 症 状 や,T4リ T4/T8比 virions observed micrographs from the inside the ンパ球 の 減 少, の 減 少 が み られ る時 期 で あ る.更 に進 行 surface cells HIV cells isolated ( ~42,000). from patient 2B: Clusters 第61巻 with ( ~36,000). る.こ れ に 日和 見 感 染 や 悪 性 腫 瘍(Kaposi肉 腫や 非 ポ ジキ ン リンパ 腫)が 合 併 した 時期 がAIDSで して 口腔 カ ン ジ ダ症 や 脾 腫 な どの 症 状 が加 わ り, あ る.こ れ らの 病 型 が重 症 化 してAIDSに 上 記 検 査 値 も一 段 と悪 化 す る とARCと る頻 度 は そ れ ぞ れPGLの10%,ARCの25%と 診 断 され 第8号 進行 す 推

5 Table 3 Antibody Titers against HIV and P. carinii *: Lymphocytes count (/mm3). **: Antibody titers assayed by an indirect immunluorescence (IF) method.

6 5) Centers for Disease Control.Morbid. Morysl. Weekly Rep., 34: , ) Daniels, V.G.: AIDS. MTT Press, Lancaste- Boston, A.: Peumocystic carcinii peumonia and mucosal cadindiasis in previously healthy homosexual men. N. Engl. J. Med., 305: ) Barre-Sinoussi, F., Chermann, J.C., Rety, F., Nugeyre, M.T., Chamaret, S., Grusertm, J., Dauguet, C., Alexer-Blin, C., Vezinit-Brun, F., Rouzioux, C., Rozenbaum, W. & Montagnier, L.: Isolation a T-lymphotropic retrovirus from a patient at risk for acquired immune deficiency syndrome (AIDS). Science, 220: 868 3) Gallo, R.C., Sarin, P.S., Gelmann, E.P., Robert- Gurf, M., Richardson, E., Kalyanaramann, V. S., Mann, D., Slidue, G.D., Stahl, R.E., Zolla- Pazner, S., leibowitch, J. & Popovic, M.: Isolation human T-cell leukemia virus in acquired immune deficiency syndrome (AIDS). 8) Kovacs, J.A., Hiemenz; J.W., Macher, A.M., et al.: Pneumocystic carinii pneumonia: A comparison between patients with the acquired immunodeficiency syndrome and patients with other immunodeficiency syndrome and patients 1) Gottlieb, M.S., Schrf, R., Schanker, H.M., with other immunodeficiencies. Ann. Intern, Weisman, J.D., Fan, P.T., Wolf, R.A. & Saxon, Med., 100 : , ) Furuta, T., Tanabe, K., Hayami, M., Ohta, Y. & Tanaka, H.: Detection antibodies to Pneumocystic carinii by enzymelinked immunosorbent assay in patients with acquried immunodeficiency syndrome (AIDS). Jap, J. Parasitol., 35: , ) Zolla-Pazner, S., William, D., El-Sadr, W., et al.: Quantitation beta-2 microgloblin and othe rimmkune characteristics in a prospective study men at risk for acquired immune deficiency syndrome. J.A.M.A., 251: ) Eyster, M.E., Goedert, J.J., Poon, M.C., et al.: Acid-labile alpha interferon: A possible preclinical marker for the acquired immunodeficiency syndrome in hemophilia. N. Engl. J. Med., 309: , Examinations for Human Immunodeficiency Virus (HIV) Infection in Hemophiliacs Kiyokatsu TANABE1, Yoshihiro OHTA2), Masanori HAYAMI2) & Kaoru SHIMADA1 1) Department Internal Medicine, Institute Medical Science, University Tokyo 2) Department Veterinary Institute Medical Science, University Tokyo Thirty five hemophiliacs treated with imported blood products were tested for HIV antibody by ELISA technique. Eighteen cases were antibody-positive (53%) and other two cases were in cut-f values. These 18 positive sera were confirmed by immunluorecence and immunoblot testing. HIV was isolated in two cases ARC by co-cultivating peripheral blood lymphocytes and HIV-sensitive cell lines such as H9 and MORT-4. After a few week cultivation, cells were examined for an expression HIV antigen. Virus particles were recognized by an electron microscopic technique. Clinical symptoms and laboratory data were discussed. One hemophiliac with AIDS died Pneumocystis carinii pneumonia. Other three cases with oral candidiasis were in a stage AIDS-related complex.

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