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Summary In February 1986, 40 out of 75 adult patients with haemophilia A attending St. James's University Hospital were human immunodeficiency virus (HIV) antibody positive. Over a three‐year period these patients were prospectively studied with regard to possible prognostic indicators for the development of the acquired immune deficiency syndrome (AIDS). Using the Centres for Disease Control (CDC) classification of HIV infection, 17 patients (42.5%) developed group 4 disease during this time, giving an actuarial three‐year progression rate of 44%, and 5 patients (12.5%) died. The following parameters measured at recruitment were found independently to predict progression to AIDS: a serum β2‐m level of greater than 3.5 mg/l, (χ2= 1595, P < 0.001), a serum IgA level of greater than 4.5 g/l (χ2= 6.08, P < 0.02) and p24 antigenaemia (χ2= 5.7, P < 0.05). The actuarial three‐year progression rate in those patients abnormal by two or more of these parameters was 100% (n= 7), compared to only 7% in patients who were normal by all three values (n= 15). CD4 + lymphocyte counts and CD4 +: CD8+ ratios were significantly lower in HIV positive compared with HIV negative patients (P < 0.01), but did not predict the development of AIDS.

The blood pressure response to infused angiotensin II (0.3 to 3 ng. kg-1. min-1) was investigated in six normotensive patients with Type 1 (insulin-dependent) diabetes free of complications and in six healthy subjects matched for age, sex and weight. Basal blood pressures (111/68 and 114/72mmHg) and basal plasma angiotensinII levels (18.0 + 5.2 and 14.1 _+ 2.4 pmol/1; mean + SD) were similar in the diabetic and control groups as were 24 h urinary excretions of sodium (157+88 and 154 _+ 84 mmol/24 h). Equal increments in plasma angiotensin II were produced during the infusions in the two groups. Increases in both diastolic and systolic blood pressure were significantly greater in the diabetic patients throughout the infusion. Mean diastolic increments were: 6.7 versus 1.3 mmHg (0.3 ng dose), 11.0 versus 6.9 mmHg (1 ng dose) and 16.7 versus 12.3 mmHg (3 ng dose) (p<0.001). Corresponding figures for systolic pressure were: 8.7 versus 1.3 mmHg, 10.3 versus 3.7mmHg and 15.3 versus 8.7 mmHg (p<0.001). Vasopressor responsiveness to angiotensin II is thus increased in Type 1 diabetic patients without complications; it may, therefore, be a consequence of the diabetes rather than of the presence of microvascular disease or hypertension.