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January 1, 1997

Dose of Non-Heat-Treated Factor VIII Concentrate and HIV-1 RNA Levels-Reply

Author Affiliations

National Cancer Institute Bethesda, Md
Research Triangle Institute Rockville, Md
Milton S. Hershey Medical Center Hershey, Pa

JAMA. 1997;277(1):20-21. doi:10.1001/jama.1997.03540250028019

In Reply.  —Dr Montoro and colleagues recategorized our data and used a test for linear trend instead of the more conservative overall Mantel-Haenszel ϰ2 test that we used. They point out that subjects who received lower annual doses of non-heat-treated factor VIII concentrate (between 1978 and 1984) had somewhat higher HIV-1 RNA levels. An association between lower factor VIII dose and higher HIV-1 RNA levels would be consistent with a recent report by Montoro et al that lower factor-concentrate dose was associated with faster progression to AIDS in 225 HIV-1-infected Spanish hemophiliac patients.1 Therefore, we examined the relationship between factor VIII dose, HIV-1 RNA levels, and time to development of AIDS in our study, the Multicenter Hemophilia Cohort Study (MHCS).Although only a small subset of MHCS subjects were tested for HIV-1 RNA, data on factor VIII dose and clinical outcome were available for 1094 HIV-1-infected adults and children. As