Increased Circulating Immune Complex Levels In Hemophilia Patients Post-Infusion

Elevated levels of circulating immune complexes (CIC) have been reported in a significant proportion of hemophilia patients tested by Raji cell, Clq binding, and staphylococcal binding (SBA) methods. The clinical significance of these complexes is unclear, as is their relationship to transfused material. By SBA, we found elevated CIC levels (>10 ug/ml) in 90% of severe hemophiliacs and 75% of multiply-transfused controls, all more than 72 hours post-transfusion. This was in contrast to our previous finding elevated CIC in 50% of hemophiliacs and 29% of controls by Raji cell assay.

Using the SBA, seven patients were tested at intervals after Factor VIII concentrate infusion. Five showed increased CIC levels. The peak level occurred after the Factor VIII clotting activity had peaked and was declining. Two subjects showed rapid clearance of the complexes, while the others remained elevated at 24 hours. Factor VIII-related antigen was detected in isolated complexes from 2 patients. Our previous finding of HB^sAg in such complexes suggests heterogeneity and perhaps different clearance patterns.