Search

Antibodies against HTLV-III, neopterin levels in blood and urine, TH/TS ratio and hepatitis marker were determined in 34 clinically symptom-free persons known to be intravenous drug abusers. 15 persons were positive in the ELISA and Western-blot tests. There was a strong reaction to protein p24 compared with that to protein p41. In 12 of 14 persons who were antibody-positive the neopterin level in morning urine was elevated; an abnormal TH/TS ratio was present in nine of 13 persons. In future, determination of neopterin and of antibodies against certain proteins of HTLV-III may make it possible to provide a simple way of prognosticating on the course of an HTLV-III infection.

Risk of HIV transmission during the different modes of treatment depends on the HIV prevalence within the patient population and the instruments used during invasive procedures. Generally HIV may be transmitted from patient to the health care worker, from patient to patient and from health care worker to patient. Prevention of all modes of transmission is sterilisation or single use of equipment and if this is not possible proper disinfection of the equipment. HIV may be transmitted to patients by transplants that have not been sufficiently checked or pretreated. The most common route of HIV transmission is by stab wounds or puncture wounds by sharp instruments including needles. All reagents used for disinfection of other infectious agents are also valid for HIV. Infected staff should when ever possible avoid or refrain from performing operative procedures. HIV transmission is easily to prevent and part of all daily activities in medicine.

The presence of antibodies to HIV-1 (anti-HIV-1) was tested in 167 hemophiliacs surveyed and treated at Munich hemophilia center. Increasing numbers of HIV infected patients were observed in the years 1981 to 1986 from 0% to 51,5% (86 positive patients in January 1987 of 167 followed patients). Most of the seroconver-sions occured between 1982 and 1984. The 150 clinically severe affected hemophiliacs (F-VIII-levels up to 5% and need of replacement therapy) showed positive HIV-test results in 55,3% (83 patients) and negative results in 44,7% (67 patients). 5 patients died since 1981, one because of AIDS. 17 patients were not seen since 1984, 14 of those belong to the severly affected group, 12 of them were negative. Since spring 1985 only heat or chemically treated clotting factor preparations are used for substitution. Despite this still 5 seroconversions were observed. Two may be attributed to the use of a preparation heat inactivated in dry state, this preparation is no longer used. The other 3 seroconversions possibly were caused by an occasional use of an noninactivated preparation in the beginning of the change to inactivated clotting factor preparations. 38 of the anti-HIV-1 positive sera were tested for the presence of HIV-2 antibodies also. The methods were ELISA,immunofluorescence and immunoblot. HIV-2 (LAV-2) for these tests was kindly provided by L. Montagnier. Antibodies specific for HIV-2 antigens were not detected, but crossreactions were observed between anti-HIV-1 with HIV-2 antigens particularly epitopes on HIV-2-p27.The data indicate that the use of adequately inactivated clotting factors can prevent infection of hemophilia patients by this route and that HIV-2 was not present in the clotting factor preparations used for the substitution of this group of patients. The incidence of full blown AIDS since 1981 in our group of hemophiliacs is still low (1,2%).