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

In Reply. —Dr Montoro and colleagues recategorized our data and used a test for linear trend instead of the more conservative overall Mantel-Haenszel ϰ 2 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