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HTLV-III Infection in Homosexuals and Hemophiliacs in Sweden¹

Department of Immunology, National Bacteriological Laboratory, Stockholm, Sweden [G. B., B. B.]; Department of Dermatology and Venerology, Södersjukhuset, Stockholm, Sweden [A. K., E. S.]; Department of Infectious Diseases, Karolinska Institute, Roslagstull Hospital, Stockholm, Sweden [L. M-M.]; Coagulation Laboratory, Karolinska Hospital, Stockholm, Sweden [M. B.]; Coagulation Laboratory, Malmö General Hospital, Malmö, Sweden [I-M. N.]; Stockholm City Blood Center, Stockholm, Sweden [B. W.]; and Laboratory of Tumor Cell Biology, National Cancer Institute, Bethesda, Maryland [C. S., R. G.]

Two hundred and three homosexual (HS) men and 114 hemophiliacs in Sweden were examined for serum antibodies to human T-lymphotropic virus type III (HTLV-III) and for alterations of T-lymphocyte subsets. Sera were screened for HTLV-III antibodies by an enzyme-linked immunosorbent assay and/or a dot immunobinding assay, and positive reactions were confirmed by Western blotting. HTLV-III antibodies were demonstrated in 13 of 13 (100%) HS men with acquired immune deficiency syndrome, in 63 of 67 (94%) HS men with persistent generalized lymphadenopathy, in 17 of 45 (38%) symptomatic HS men, and in 6 of 78 (8%) asymptomatic HS men but in none of 108 male blood donors. Seropositive HS men had significantly lower T4/T8 (helper/suppressor) cell ratios and T4 cell numbers than had seronegative HS men. Seronegative HS men had decreased T-cell ratios compared to controls but not decreased T4 cell numbers. Among hemophilia A patients, HTLV III antibodies were demonstrated in 40 of 48 (83%) cases treated with American factor VIII concentrate and in 17 of 29 (59%) cases treated with both American and Swedish concentrates but in none of 13 cases treated exclusively with Swedish factor VIII. Twenty-one hemophilia B patients treated with Swedish factor IX concentrates were all seronegative, whereas one of 3 hemophilia B cases treated with imported factor IX was seropositive. T4/T8 cell ratios were significantly lower in seropositive as compared to seronegative hemophilia A patients.