Increased Risk Among Individuals with Hemophilia and a Similarity to Hepatitis B

In a December 10, 1982, update on AIDS among patients with severe hemophilia A, the CDC reported that all three of the cases reported in the July 16, 1982, MMWR had died and that, in the intervening four months, four additional confirmed cases and one suspected case of AIDS in heterosexual patients had been reported. Two of the patients were children under 10 years of age. In an accompanying editorial note, the CDC stated that the hemophilia patients had all received large amounts of a commercially manufactured anticoagulant known as AHF (antihemophilic factor). None of the patients had any prior opportunistic infections, all had been profoundly lymphopenic, and all had exhibited reversed ratios of CD4:CD8 lymphocytes. According to the CDC, these cases provided a new perspective on AIDS by showing that children with hemophilia were at risk for the disease. The report also stated that the number of cases was continuing to increase and that patients with hemophilia might be at significant risk for AIDS. The CDC also reported that a national survey of hemophilia treatment centers had determined that 30 percent or more of all hemophiliacs had abnormal immunological tests. The coincidence of symptoms of AIDS and serologic evidence of hepatitis in the individuals with hemophilia added weight to the theory that AIDS was a disease with a pattern of transmission that mimicked that of hepatitis B (CDC, MMWR, December 10, 1982).

By December 1982, a total of 788 AIDS cases had been reported. Of the 788 reported cases, 42 (5.3 percent) belonged to no known risk group (e.g., homosexuals, IV drug users, hemophiliacs, and Haitians). Two of the 42 cases with no known risk factors were patients who had received blood products (not related to the treatment of hemophilia) within two years of the onset of AIDS (CDC, MMWR, December 10, 1982).

Further Evidence of Sexual and Blood-Borne Transmission of AIDS

The December 10, 1982 MMWR also reported a suspected case of transfusion-associated AIDS in a 20-month-old San Francisco infant who had none of the known risk factors for AIDS. One of the 19 donors of the blood components received by the infant during his first month of life was subsequently reported to have AIDS. The report suggested that blood transfusion was the means by which the infant had acquired AIDS. In an accompanying editorial note, CDC stated that

… if platelet transfusion contained an etiologic agent for AIDS, one must assume that the agent can be present in the blood of a donor before onset of



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