[Acquired protein S deficiency in HIV infections]

A prospective study of protein S was carried out in 17 consecutive HIV-infected patients. One subject was excluded because of severe chronic liver disease. Of the 16 evaluable patients (10 men, 6 women), 3 had AIDS, 7 ARC, 4 lymphadenopathy and 2 were asymptomatic. Total protein S and C4bBP (bound protein) were normal in all of them. In contrast, all but one subject had a free protein S deficiency: 35.5% (range: 0-68) for the whole group; 12.4% (range: 0-29) for the women: 50.9% (range: 27-68) for the men. From these results, we concluded that: a) free protein S deficiency is common in HIV-infected patients, b) this deficiency is more pronounced in female than male subjects, and c) this deficit is not linked to elevated C4bBP levels. The mechanism and the clinical consequences of this deficiency are discussed.