RESPONSE OF HEMOPHILIC PATIENTS TO POLIOVIRUS VACCINATION - CORRELATION WITH HIV SEROLOGY AND WITH IMMUNOLOGICAL PARAMETERS

Hemophilic patients may present immunological dysfunctions resulting f rom either human immunodeficiency virus (HIV) infection, or other fact ors like impure factor VIII concentrate and other viral infections. We evaluated prospectively the serologic response to polio vaccination o f Israeli hemophilic patients who were vaccinated during an outbreak o f poliomyelitis. Eighty-two hemophilic patients, 43 seronegative and 3 9 seropositive for human immunodeficiency virus (HIV), were vaccinated with enhanced inactivated poliovirus (eIPV). Titers of antibodies for poliovirus types 1-3 were determined before and 4 weeks after immuniz ation. T helper and suppressor lymphocytes (T4 and T8), B and T lympho cyte mitogenic response, and natural killer cells were tested and corr elated with the response to vaccination. Both groups responded to vacc ination with increased titers of antibodies to the three viral types, 4 weeks after immunization. HIV-seronegative patients, however, exhibi ted higher titers than the HIV-seropositive group. The same pattern wa s found when 21 patients were tested 1 year after the exposure to eIPV . HIV seropositive patients were grouped according to their T4 count ( between 16/mul and 500/mul). There was no statistically significant di fference in the response of these different groups to vaccination. No correlation was found between the response to vaccination and other im mune parameters. These results suggest that asymptomatic HIV-seroposit ive hemophilic patients respond well to eIPV, irrespective of their T4 count.