FOREIGN-PROTEIN-MEDIATED IMMUNODEFICIENCY IN HEMOPHILIACS WITH AND WITHOUT HIV

Hemophilia-AIDS has been interpreted in terms of two hypotheses: the f oreign-protein-AIDS hypothesis and the Human Immunodeficiency Virus (H IV)-AIDS hypothesis. The foreign-protein-AIDS hypothesis holds that pr oteins contaminating commercial clotting factor VIII cause immunosuppr ession. The foreign-protein hypothesis, but not the HIV hypothesis, co rrectly predicts seven characteristics of hemophilia-AIDS: 1) The incr eased life span of American hemophiliacs in the two decades before 198 7, although 75% became infected by HIV because factor VIII treatment, begun in the 1960s, extended their lives and simultaneously disseminat ed harmless HIV. After 1987 the life span of hemophiliacs appears to h ave decreased again, probably because of widespread treatment with the cytotoxic anti-HIV drug AZT. 2) The distinctly low, 1.3-2%, annual AI DS risk of hemophiliacs, compared to the higher 5-6% annual risk of in travenous drug users and male homosexual aphrodisiac drug users - beca use transfusion of foreign proteins is less immunosuppressive than rec reational drug use. 3) The age bias of hemophilia-AIDS, i.e. that the annual AIDS risk increased 2-fold for each 10-year increase in age bec ause immunosuppression is a function of the lifetime dose of foreign p roteins received from transfusions. 4) The restriction of hemophilia-A IDS to immunodeficiency diseases - because foreign proteins cannot cau se nonimmunodeficiency AIDS diseases, like Kaposi's sarcoma. 5) The ab sence of AIDS diseases above their normal background in sexual partner s of hemophiliacs - because transfusion-mediated immunotoxicity is not contagious. 6) The occurrence of immunodeficiency in HIV-free hemophi liacs - because foreign proteins, not HIV, suppress their immune syste m. 7) Stabilization, even regeneration, of immunity of HN-positive hem ophiliacs by long-term treatment with pure factor VIII. This shows tha t neither HIV nor factor Vm plus HIV are immunosuppressive by themselv es. Therefore, AIDS cannot be prevented by elimination of HIV from the blood supply and cannot be rationally treated with genotoxic antivira l drugs, like AZT. Instead, hemophilia-AIDS can be prevented and has e ven been reverted by treatment with pure factor VIII.