The acquired immune deficiency syndrome (AIDS) in hemophiliacs: a hypothesis

Healthy hemophiliacs receiving antihemophilic (AHF) concentrates have decreased T-helper/suppressor (H/S) ratios, similar to the changes observed in healthy homosexuals considered at risk for the acquired immune deficiency syndrome (AIDS). We present a hypothesis which focuses on the role of natural killer (NK) cells and elevated serum levels of alpha interferon (IFN alpha) in hemophiliacs with AIDS. This hypothesis suggests that alloantigens in AHF concentrates provide an important inducing event which compromises the immune system of the hemophilia patient and enhances his susceptibility to infection by a transmissible agent. It provides an explanation for the predominance of NK cells with T-cell markers, impaired NK cell function, elevated serum IFN alpha levels, and the deficit in T-helper/inducer cells in hemophilic patients with AIDS. Furthermore, it could account for the T-cell subset imbalance in relation to total AHF units transfused, and to the development of an inverted H/S ratio which is a constant feature of AIDS.