[Differences in laboratory parameters in clinical categories (CDC/93) of HIV infection]. / Diferencias en parámetros de laboratorio entre las categorías clínicas (CDC/93) de la infección por VIH.

OBJECTIVE: To establish the difference between the evolutive clinical categories (CDC/93) of the HIV infection, on the basis of diverse laboratory parameters. MATERIAL AND METHOD: 332 samples of blood, from 118 patients with HIV infection revised every three months from 1986, were studied. Determinations: haematologic, biochemical and immunologic study. Classification in each review by CDC/93 system. Statistical analysis (R-SIGMA) comparing by ANOVA and NEWMANN-KEULS the averages of the laboratory variables in the clinics categories ("A", "B" and "C"). RESULTS: There are very significant laboratory differences (p < 0.01) between the asymptomatic patients ("A") and the AIDS cases ("C"), with important decrease of hemoglobin, platelets, leukocytes, albumin, CD4+ and CD8+ T cells in the "C" category. On the contrary there is a marked increase of erythrocyte sedimentation, triglycerides, immunoglobulin A and beta 2-microglobulin in those patients with AIDS. CONCLUSION: AIDS patients present very significant differences in ten laboratory parameters, compared to the asymptomatic HIV infected patients. The follow up of these parameters may have prognostic value of AIDS evolution and be useful for the therapeutic decision making.

[HIV infection at the Central Military Hospital of Madrid]. / La infección por VIH en el Hospital Militar Central de Madrid.

UNLABELLED: We describe the infection by HIV observed in the scope of the Military Hospital and we evaluate the clinical usefulness of the current classification systems. We have retrospectively studied (1986-1993) 80 confirmed cases of infection by HIV: 21 women and 59 men (age range: 17-65 years). Quarterly clinico-biological controls. Initial and final classification according to CDC 87/93 systems. STATISTICAL ANALYSIS: RSIGMA. We have detected in 26% of the patients heterosexual contagion; in 55%, toxicomania and in 17%, homosexuality; 39% had less than 200 CD4/microL upon admission. During the follow-up, 35 patients fulfilled AIDS criteria (17% due to tuberculosis); 17 died (21%) and 30 gave up (37%). CONCLUSIONS: HIV infection is less frequent in the military sociofamiliar environment, with lower incidence of tuberculosis. There is a greater proportion of women, heterosexual transmission and asymptomatic patients. CDC-93 classification is the system best adapted to the natural history of the HIV infection.

[Discriminative value for AIDS case of erythrocyte sedimentation rate, immunoglobulins IgA and IgM, and beta 2-microglobulin in combination with the CD4+ lymphocyte count]. / Valor discriminante para caso de sida de la velocidad de sedimentación globular (VSG), inmunoglobulinas (IgA e IgM) y beta 2-microglobulina (beta 2M) en combinación con el recuento de linfocitos CD4+.

OBJECTIVE: To establish the probability to discriminate the evolution to "AIDS case" in relation to the common laboratory parametres in the follow-up of the HIV infection. MATERIAL AND METHODS: We have studied a cohort of 118 patients (1986-95) with HIV infection, 14 of them (12%) had clinical criteria for AIDS (CDC/93) during the follow-up. Clinical evaluations and CD4+ and CD8+ lymphocytes, beta 2M, IgG, IgA, IgM and E.S.R determinations were done. Multivariate analysis (RSIGMA) was done. with the initial laboratory values, according to the clinical diagnostic (AIDS and NO AIDS) done during the follow-up. RESULTS: By multiple logistic regression those laboratory variables with more predictor value for "AIDS CASE" were selected. With the initial value of these variables (E.S.R., beta 2M, IgA, IgM and CD4+ lymphocytes) and the clinical diagnostic of AIDS done during the follow-up, we did the linear discriminatory analysis between two groups (AIDS, NO AIDS) obtaining generalized distance between both groups of 3,4609 and a probability of classification error of 4%. A very significant difference (p < 0.001) was obtaining when we compare the variables' mean of each of the clinical groups. CONCLUSION: In the HIV infection the values of ESR, beta 2M, IgA and IgM in combination with the absolute value of the CD4+ lymphocytes allows to discriminate those patients who will develop AIDS with a probability of classifications error of 4%. This has clinical interest in absence of viral load and helps to take therapeutical decisions.

[Antiphospholipid antibodies in megakaryocytic thrombopenias]. / Anticuerpos antifosfolípidos en las trombopenias megacariocíticas.

We investigated the prevalence of antiphospholipid antibodies (APA) in megakaryocytic thrombopenias in order to establish their clinical significance and prognostic value. We studied 82 thrombopenic patients: 38 women and 44 men (age: 17-91 years). We assessed circulating lupus antibody (LA) through thromboplastin inhibition test (TIT), anticardiolipin antibodies (ACL) through ELISA and antiplatelet antibodies through flow cytometer. We conducted a statistical study RSIGMA, comparing patients with ACL + against ACL-. We found ACL positive in 21%, LA in 33% and antiplatelet antibodies in 42%. We observed a direct correlation (p < 0.05) between ACL and LA and between ACL and anticore antibodies, but not between ACL and antiplatelet antibodies. There was also a significant correlation between ACL and abortion, thrombosis and bleeding in thrombopenic patients. We conclude that APAs are present in 39% of the megakaryocytic thrombopenias and that they are not correlated with antiplatelet antibodies. Positivity of APA in thrombopenic patients is associated to poor prognosis and long term follow-up.

[Skin graft protection by treatment of recipients with ultraviolet irradiated fragments of the donor spleen]. / Protección de injertos de piel por tratamiento de los receptores con fragmentos de bazo del donante irradiados con ultravioleta.

We have tested de possible protective effects of UVA radiated spleen fragments upon simultaneous skin allografts in 84 rats. Under these circumstances skin graft rejection was less evident with a 20 day graft disappearance rate of 46.87% rate in the treated series, that compares favourably with a 80% in the control series. This study shows a parallel increase in the mean survival time of skin grafts in treated specimens. The figures being 19.8 days in the treated series against 12.9 days in untreated controls. Spleen implants are finally shown to produce a healing stimulus in the skin graft zone. These differences are statistically significant.