[Final Program, International Conference on AIDS (4th: 1988: Stockholm, Sweden), Book 2]

2533 A SIX MONTH FOLLOW-UP OF PATIENTS WITH AIDS AND ARC:
INTERFERON PRODUCTION AND CLINICAL DATA,
Kris Huygent, S Sprechera and H Taelmant,
* Pasteur Institute of Brabant, 1180 Brussels
I Institute for Tropical Medicine, 2000 Antwerp BELGIUM,
At the unset of the study, five HIV+ patients with ARC(I-5) and six with
AIDS(6-11) were examined for in vitro lymphokine production (using a total
blood assay) in response to Newcastle Disease Virus (IFN-a) and Phytohemagglutinin (IFN-Y,IL-2) and for presence of in vivo IFN-a in the serum:

Diagnosis
IV C-2
IV A
IV C-2
IV A
IV A
IV C-1
IV C-1
IV C-1
IV C-1
IV C-1
IV D

Serua IFN
+
+
++
+
+
+

IFN-a
low
low
normal
noreal
normal
low
low
low
low
low
low

IFN-I
low
impaired
normal
normal
normal
impaired
low
low
normal
low
normal

IL-2
low
low
normal
normal
low
low
low
low
normal
low
ND

T4/pl T4/T8
92 0,13
176 0,29
454 0,46
632 0,39
87 0,07

2534 A POSTULATED ROLE FOR DECREASING E-CR AND
TRIPLE POSITIVE DIRECT COOMBS' TEST IN THE
PATHOGENESIS OF HIV INFECTION
M Lange, Y Inada, EB Klein, W Ramey, LZ Cooper
MH Grieco.
St. Luke's-Roosevelt Hospital Center, Columbia University
New York, NY USA
Objective.As previously reported, we found a strong correlation between the presence of serum acid-labile alpha interferon and low or absent erythrocyte receptor activity for
ccmplement 3b(E-CR1) and the progression towards clinical
AIDS. We define here the relationship between E-CR1 activity
and the development of a direct Coombs' test for IgG(r),
IgM(u) andC3 on erythrocyte surfaces in a cohort of 108 hanosexuals.
Methods. 108 healthy homosexual volunteers (H/S) were recruited in 1981/82 and followed at 6 monthly intervals. E-CR1
and direct Cocmbs' tests were determined at 6 monthly
intervals since 5/83.
Results. 60 H/S were seropositive(H+), 42 seronegative(H-),
6 seroconverted(H+)for HIV antibody. Of 54 H+ H/S, 24 had
25% or less of normal CR1 activity and a triple positive
direct Concbs'(r,u,C3) on one or more ocasion in the 12-mo
interval between 5/83 and 5/84. Of these 19 progressed to
AIDS, 4 to ARC and 1 seroconverted. In controls of 34 H- volunteers tested during the same time interval, the above
cambination of 25% CR1 and r,u,C3 Cocmbs'was found in only
1 volunteer who developed multiple sclerosis.
Conclusion. Our previous report of more than 90% incidence
colonization with viruses other than HIV in this cohort
was not associated with a difference in incidence between
the H+ and H- group. CR1 functions in the inactivation and
elimination of pathogenic immune canplexes(IC).We therefore postulate that saturation of this system either due
to excess IC production and/or decreased macrophage phagocytosis is reflected in the-cmanbination of decreased CR1 and
triple Cocts'reflect a pathogenic mechanism directly involed in the progression to overt AIDS.

6
7
8
9
10
1

23
15
25
179
12
436

0,05
0,05
0,04
0,18
0,50
0,35

Presence of acid-labile IFN-a in the serum correlated to decreased IFN-Y/ IL-2
production, Both parameters reflected poor general health status and could be
used as prognostic markers for future evolution of the disease,
AZT was administered p,o, at 2 g/day during the first month, and at 1 g/day
during the next 5 months to patients 1,3,4,8,9 and 10, No significant changes
could be observed in IFN-production capacity or in serum IFN levels, during
this six month treatment period, Two of the AIDS patients died during the
follow-up period, pt 7 in the third month and pt 8 in the sixth month, AZT
treatment was well supported and subjective improvement and weight increases
were observed in most patients,

Notes:

2535 PROGNOSTIC VALUE OF SERUM INTERFERON ALPHA,
HIV ANTIGEN, AND HIV CORE ANTIBODIES IN HIVINFECTED PATIENTS
Jochen Abb
Institute of Microbiology, Ludwigsburg Hospital, Ludwigsburg, Federal Republic of Germany
Objective. To determine interferon (IFN) alpha, HIV antigen (HIV-Ag), and HIV core antibodies (anti-HIV core) in
sera from HIV-infected patients and to assess their prognostic value.
Methods. Serum IFN alpha was determined by measuring the
inhibition of viral cytopathic effect on bovine kidney
cells. HIV-Ag and anti-HIV core were determined by enzyme
immunoassay (Abbott).
Results. Data on the presence of IFN alpha, HIV-Ag, and
anti-HIV core in sera from patients with different manifestations of HIV infection are given in the table.
Table. IFN alpha, HIV-Ag, and anti-HIV core in sera from
HIV-infected patients.
CDC class. Serum IFN HIV-Ag Anti-HIV core
group Pos./total Pos./total Neg./total
I 2/ 5( 40%) 4/ 5(80%) 5/ 5(100%)
II 0/82( 0%) 0/82( 0%) 0/82( 0%)
III 23/41( 56%) 11/41(27%) 10/41( 24%)
IV 29/29(100%) 22/29(76%) 22/29( 76%)
Nine patients showed progression to clinical symptoms of
AIDS during the study period. The presence of serum IFN
alpha heralded the onset of AIDS in 9/9 patients; the
presence of HIV-Ag and lack of anti-HIV core was demonstrated in 7/9 patients.
Conclusions. The persistent presence of IFN alpha appears
to be the most reliable serological marker for disease
progression in individuals exposed to HIV.

2536
IMMUNOLOGICAL ABNORMALITIES IN HIV INFECTION
R. M&fiez*, A. Bofill**, T. Figuera**, T. Espafiol**.
"Intensive Care Department, "" Immunology Unit.
Hosp. General "Valle de Hebr6n". Barcelona. Spain.
Obiective. HIV infection is not always followed by the development
of AIDS. Immunological abnormalities, antigenemic load and
recurrent infections would be factors in the progression of the
disease. We have studied some immunological parameters: Ta, T4,
T,, IL-2 receptor positive cells, IL-2 and r-IFN productions and
PHA stimulation, in order to find diferences that could have
prognostic value.
Methods. 39 patients were studied 22 HIV asymptomatic carriers,
8 LAS, 9 AIDS and a control group of blood banc donors.
T lymphocytes and T subsets were measured with an indirect
immunofluorescence method with MoAb. IL-2 receptors were
investigated in 48 h. PHA-stimulated lymphocytes. This cultures
supernatants were stored for IL-2 and T-IFN levels. IL-2
microassay was performed in CTLL-2 microtest. r-IFN was measured
by RIA ("forward sandwich" principle).
Results. T-IFN production and mainly IL-2 receptors in stimulated
lymphocyte had statistically diferences (p ( 0.001) between
asymptomatic and symptomatic patients (LAS and AIDS), and IL-2
production and PHA stimulation (p < 0.05) between LAS and AIDS.
Conclusion, These immunological parameters have an important
prognostic value and could help to select suitable patients to be
treated.

109