Can repeated plasma donation by asymptomatic HIV–infected individuals delay the onset of AIDS?

Abstract

Healthy HIV–positive regular donors of plasma in a programme of passive immunotherapy for AIDS patients were studied over a period of about two years. None developed symptoms of clinical progression; most seemed to make substantial gains of CD4 cells by comparison with asymptomatic individuals who were not donating. The effects of donation did not seem to diminish with repetition, and donor CD4 counts tended towards stabilizing within normal limits. Asymptomatic HIV–positive individuals were compared immunologically with ‘normals’ and people with AIDS, using a battery of 25 measurements on peripheral blood. The immunological profiles of donor and non–donor asymptomatics, indistinguishable at the start, became dissimilar: donors' profiles resembled AIDS less, non–donors became less like ‘normal’ and a few non–donor results could not be distinguished from AIDS. Improvement in the CD4 counts and amelioration of the immunological profile in donors provide prima facie evidence that plasmapheresis may be therapeutic for asymptomatic HIV–positive people. Further studies are justified.