HEMOPHILIA AND NONPROGRESSING HUMAN-IMMUNODEFICIENCY-VIRUS TYPE-1 INFECTION

Seven of 112 hemophiliacs infected with human immunodeficiency virus t ype-1 (HIV-1) before 1986 through contaminated plasma products are cur rently healthy, with CD4 T-cell counts above 500 celIs/mu L, and have never received antiretroviral therapy (long-term nonprogressors [LTNP- s]). Seven age and sex-matched hemophiliacs infected in the same perio d but who have progressive HIV disease (progressors) and one additiona l slow-progressing individual were also studied. One hundred-fold, 20- fold, and in-fold lower levels of full-length HIV RNA in plasma, perip heral blood mononuclear cells (PBMCs), and proviral DNA in PBMCs, resp ectively, were found in LTNPs compared with progressors. Plasma and ce ll-associated HIV RNA and proviral DNA were lower in LTNPs who tested negative for viral isolation from PBMCs or who were positive only afte r removal of CD8(+) cells. No substantial differences were observed in the in vitro production of chemokines including RANTES, MIP-1 beta, M IP-1 beta, MCP-1, and interleukin-8 (IL-8) in supernatants of activate d PBMCs or CD8-depleted PBMCs of LTNPs, even when HIV isolation was si multaneously accomplished exclusively after removal of CD8(+) cells. L ow levels of HIV load and replication in peripheral blood are the stro ngest correlates of nonprogression in this small number of infected he mophiliacs. (C) 1997 by The American Society of Hematology.