Summary
A direct antiglobulin test (DAT) was performed in 70 patients with anti-HIV antibodies (group A: seropositive patients without or with minimal disease and group B: AIDS patients with or without malignancies). A positive DAT was found in 24 of 70 patients (34%, significantly higher compared to 0.1% in healthy controls) and a higher prevalence of positive DAT was observed in group B than in group A patients (55% versus 21% p<0.01). When comparing DAT-positive and negative patients within the same clinical group, no significant difference is seen in haemoglobin levels. There is no difference in serum bilirubin, haptoglobin or reticulocyte count between DAT-positive and negative patients altogether or in the same clinical group. AZT therapy seems to exert no significant influence on the onset of a positive DAT. The results confirm a high prevalence of positive DAT in patients with HIV antibodies, mainly in worse clinical conditions, and suggest that a positive DAT might be a prognostic factor in the clinical course of the disease.
Zusammenfassung
Bei 70 Patienten mit anti-HIV-Antikörpern wurde ein direkter Antiglobulin-Test durchgeführt. In Gruppe A waren seropositive Patienten ohne oder mit minimalen Krankheitszeichen, in Gruppe B AIDS-Patienten mit oder ohne maligne Erkrankung. Bei 24 von 70 Patienten (34%) war der DAT positiv. Im Vergleich dazu waren bei gesunden Kontrollen nur 0,1% positiv. Neben diesem signifikanten Unterschied fanden sich auch signifikante Unterschiede zwischen den beiden Gruppen mit 55% positivem DAT in Gruppe B und 21% in Gruppe A (p<0,01). DAT-positive und -negative Patienten in denselben klinischen Gruppen zeigten in ihren Hämoglobinspiegeln keine signifikanten Unterschiede. Auch fanden sich insgesamt und in den beiden klinischen Gruppen keine Unterschiede in den Werten von Serumbilirubin. Haptoglobin oder Retikulozytenzahlen bei DAT-positiven und -negativen Patienten. Die Behandlung mit AZT hat offensichtlich keinen wesentlichen Einfluß darauf, wann der DAT positiv wird. Unsere Ergebnisse bestätigen, daß bei Patienten mit HIV-Antikörpern eine hohe Rate an positiven DAT besteht und sich vor allem bei den ungünstigen klinischen Stadien positive Testergebnisse einstellen, so daß der positive DAT als prognostischer Faktor für den klinischen Verlauf der Erkrankung angesehen werden kann.
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De Angelis, V., Biasinutto, C., Pradella, P. et al. Clinical significance of positive direct antiglobulin test in patients with HIV infection. Infection 22, 92–95 (1994). https://doi.org/10.1007/BF01739012
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DOI: https://doi.org/10.1007/BF01739012