Hemophiliacs With HIV Seroconversion Associated With Heat-Treated Products: Are They Actively Infected?-Reply

In Reply.— Dr Damjanovic correctly points out that our statement "all seropositive hemophiliacs have the potential to develop AIDS [acquired immunodeficiency syndrome]" was strictly based on our study of antibody-positive hemophiliacs who had received non-heat-treated factor VIII or IX concentrates. We agree that HIV-1 antibody-positive recipients who received only heat-treated, lyophilized factor concentrates may not have been infected but rather immunized by preserved viral proteins. However, we think it premature to suggest that "a majority of seropositive recipients of the heat-treated, lyophilized products should have a better prognosis," that they are at no risk of developing acquired immunodeficiency syndrome, and that they may have protective immunity. Time, of course, will tell whether these seropositive recipients develop acquired immunodeficiency syndrome, but Dr Damjanovic's suggestion can be tested easily now by HIV-1 cultures and polymerase chain reaction analysis of these patients. If he, or others, care for seropositive hemophiliacs who have received