IDIOPATHIC CD4-LYMPHOCYTOPENIA IN HIV SERONEGATIVE MEN WITH HEMOPHILIA AND SEX PARTNERS OF HIV-SEROPOSITIVE MEN( T)

Persons with hemophilia or other HIV-1 risk factors may be more likely to have idiopathic CD4(+) T-lymphocytopenia (ICL). We determined the frequency of ICL in prospectively followed cohorts of HIV-1 seronegati ve hemophilic men and seronegative female sex partners of HIV-1 infect ed hemophilic men, and examined factors potentially associated with IC L. Seven of 304 (2.3%) seronegative hemophilic men and one of 160 (0.6 %) female partners met the ICL definition, but the condition resolved for two of the men and for the sole female partner. All five men with persistent ICL had lymphocytopenia (<1,200 total lymphocytes/mu l) and <300 total CD4+ lymphocytes/mu l; only one had a low CD4+ percentage. On the most recent measurement, 14.5% of the 304 seronegative hemophi lic men had lymphoctopenia. Compared with matched hemophilic controls, men with persistent ICL more often had a history of liver disease (3/ 5 cases, 0/21 controls, P = 0.007) or splenomegaly (3/5 cases, 4/21 co ntrols; P = 0.04), but not severe hemophilia, greater clotting factor concentrate exposure, high alanine aminotransferase levels, hepatitis B virus antigenemia, or detectable hepatitis C virus RNA in plasma. Al l five cases and 20/21 controls had antibodies to hepatitis C virus pr esent in their serum. In this cohort of hemophilic men, ICL was relate d to lymphocytopenia associated with liver disease rather than selecti ve loss of CD4+ lymphocytes. (C) 1995 Wiley-Liss, Inc.