Versiti Blood Research Institute was awarded the very first grant to study HIV/AIDS benefiting hemophilia patients who require blood transfusions.
When donors give blood, it can be used in a variety of ways. For example, red cells are often used during surgeries, and patients undergoing cancer treatments may receive platelets. Donated blood is also used to create factor products for patients diagnosed with hemophilia, a disease affects nearly 20,000 people in the United States. Hemophilia patients often receive factor products, or lab-created substitutions for the factor proteins naturally missing from their blood. And because hemophilia patients require regular factor infusions, they are exposed to a variety of donors’ blood, and often.
In 1982, the Centers for Disease Control and Prevention (CDC) reported the first case of three hemophilia patients who were transfused with HIV-positive blood products, and contracted the virus. Versiti Blood Research Institute Senior Investigator Robert Montgomery, MD, Jay Menitove, MD, and the late Joan Cox Gill, MD, who at that time ran what became the Comprehensive Center for Bleeding Disorders, believed they could study this in patients with hemophilia cared for in Milwaukee. They were granted funding from the Blood Center Research Foundation (now the Versiti Blood Research Foundation), as well as the first NIH grant to study what we now know to be AIDS in patients with hemophilia. Their work in 1983 was the first to be published (New England Journal of Medicine) on the immune abnormalities of hemophilia, and permitted local patients treatment to be changed to a product that was ultimately proven to be safer.
“It’s important to have funding that allows us to rapidly pursue important targets,” Dr. Montgomery said. “The Research Foundation offers us the ability to follow through on significant research immediately.”
Within days, Dr. Montgomery and Dr. Gill received blood samples from a large group of hemophilia patients and found that, statistically, cities like New York City and San Francisco had larger donor bases and greater populations of people carrying HIV, unlike the Midwest. This meant that patients in larger cities on the coasts were at potentially higher risk of being transfused with HIV-positive factor product. Products made from donated plasma rather than paid donors turned out to be a safer source for using cryoprecipitate made from local donated blood. They also changed patients who had received the commercial concentrates to heat-treated concentrates—one of several steps still used today to reduce the potential risk of blood-borne viruses.
Through testing and the support of the Research Foundation, Dr. Montgomery and Dr. Gill quickly determined that heating the factor product concentrate post-donation and pre-transfusion purified proteins in the blood and destroyed HIV/AIDS in the factor product, making it safer to manufacture into commercial concentrates to transfuse into patients, and avoiding the risk of patients contracting HIV.
About the expert: Robert Montgomery, MD, is a senior investigator at Versiti Blood Research Institute and Professor of Pediatric Hematology in the Department of Pediatrics at the Medical College of Wisconsin.
- Gill JC, Menitove JE, Anderson PR, Casper JT, Devare SG, Wood C, Adair S, Casey J, Scheffel C, Montgomery RR. HTLV-III serology in hemophilia: relationship with immunologic abnormalities. J.Pediatr. 1986;108(4):511-516.
- Gill JC, Wheeler D, Menitove JE, Aster RH, Casper JT, Kirchner P, Montgomery RR. Persistence and progression of immunologic abnormalities in haemophilia. Thromb.Haemost. 1985;53(3):328-331.
- Gill JC, Menitove JE, Wheeler D, Aster RH, Montgomery RR. Generalized lymphadenopathy and T cell abnormalities in hemophilia A. J.Pediatr. 1983;103(1):18-22.
- Menitove JE, Spero JA, Richards WA, Lewis JH, Montgomery RR, Gill JC, Hasiba U, Wheeler DV, Sherwin JA, Russell-Vaskov S, Marlar RA, Maxwell NG, Aster RH. Prepooled cryoprecipitate for treatment of hemophilia A. Transfusion 1983;23(3):265-267.
- Menitove JE, Aster RH, Casper JT, Lauer SJ, Gottschall JL, Williams JE, Gill JC, Wheeler DV, Piaskowski V, Kirchner P, Montgomery RR. T-lymphocyte subpopulations in patients with classic hemophilia treated with cryoprecipitate and lyophilized concentrates. N.Engl.J.Med. 1983;308(2):83-86.