Immunoglobulin Levels Amongst Persons with and without Human Immunodeficiency Virus Type 1 Infection in Uganda and Norway

CD4+‐cell count and viral load monitoring are expensive and unavailable to most human immunodeficiency virus (HIV)‐infected people in Africa. In an attempt to evaluate alternative methods for monitoring antiretroviral (ARV) therapy, we measured concentrations of immunoglobulin (Ig)A, IgM, IgG and IgG1 amongst adults with and without HIV in Uganda and Norway. We adjusted for disease severity by stratifying HIV‐positive subjects on CD4+‐cell counts above and below 200 cells/µl. Median serum levels of IgG, IgG1 and IgA were significantly higher in HIV‐positive persons compared with HIV‐negative persons in both countries (P < 0.001 and P = 0.018 for IgA in Ugandan patients). Levels of IgA in Ugandan HIV‐negative subjects were significantly lower than those in HIV‐positive subjects with low CD4+ compared with those with high CD4+‐cell counts (P < 0.001 and P = 0.069, respectively). IgM levels were different between the HIV‐negative and the two HIV‐positive groups in Norway (P < 0.001). The mean levels of IgM, IgG and IgG1 in HIV‐negative and ‐positive African subjects were generally higher than those in comparable groups of Western subjects. Our results verify that levels of IgA, IgG and IgG1 vary between HIV‐negative and ‐positive individuals in both study populations. Their determination may be useful in monitoring both disease progression and response to ARV therapy.

[1]  G. Albrektsen,et al.  Changes in Immunoglobulin Isotypes and Immunoglobulin G (IgG) Subclasses During Highly Active Antiretroviral Therapy: Anti-p24 IgG1 Closely Parallels the Biphasic Decline in Plasma Viremia , 2003, Journal of acquired immune deficiency syndromes.

[2]  P. Weidle,et al.  Assessment of a pilot antiretroviral drug therapy programme in Uganda: patients' response, survival, and drug resistance , 2002, The Lancet.

[3]  É. Cohen,et al.  Comparison of Human Immunodeficiency Virus (HIV)-Specific Infection-Enhancing and -Inhibiting Antibodies in AIDS Patients , 2002, Journal of Clinical Microbiology.

[4]  R. Kaul,et al.  Functional HIV-1 specific IgA antibodies in HIV-1 exposed, persistently IgG seronegative female sex workers. , 2001, Immunology letters.

[5]  J. Goudsmit,et al.  Potent antiretroviral therapy initiates normalization of hypergammaglobulinemia and a decline in HIV type 1-specific antibody responses. , 2001, AIDS research and human retroviruses.

[6]  F. Barré-Sinoussi,et al.  Immunoglobulin G (IgG) and IgA, but also Nonantibody Factors, Account for In Vitro Neutralization of Human Immunodeficiency Virus (HIV) Type 1 Primary Isolates by Serum and Plasma of HIV-Infected Patients , 2001, Journal of Virology.

[7]  N. Baumgarth,et al.  A two‐phase model of B‐cell activation , 2000, Immunological reviews.

[8]  F. Lucht,et al.  Neutralization of human immunodeficiency virus type 1 (HIV-1) mediated by parotid IgA of HIV-1-infected patients. , 2000, The Journal of infectious diseases.

[9]  H. Ullum,et al.  Prognostic value of single measurements of beta-2-microglobulin, immunoglobulin A in HIV disease after controlling for CD4 lymphocyte counts and plasma HIV RNA levels. , 2000, Scandinavian journal of infectious diseases.

[10]  L. Lopalco,et al.  Human immunodeficiency virus (HIV)-specific IgA and HIV neutralizing activity in the serum of exposed seronegative partners of HIV-seropositive persons. , 1999, The Journal of infectious diseases.

[11]  C. Sabin,et al.  Immune markers and viral load after HIV‐1 seroconversion as predictors of disease progression in a cohort of haemophilic men , 1998, AIDS.

[12]  D. Ho,et al.  HIV-1 Antigen–specific and –nonspecific B Cell Responses Are Sensitive to Combination Antiretroviral Therapy , 1998, The Journal of experimental medicine.

[13]  M. Wainberg,et al.  Immunoglobulin and complement complexes in blood following infection with human immunodeficiency virus type 1 , 1996, Clinical and diagnostic laboratory immunology.

[14]  J. Albert,et al.  The role of the humoral immune response in HIV infection , 1996, AIDS.

[15]  P. Kozlowski,et al.  Neutralization of HIV infection by serum IgA antibodies. , 1995, Advances in experimental medicine and biology.

[16]  I. Mohammed,et al.  IgG2 associated hypergammaglobulinaemia in some Nigerians with HIV infection. , 1994, African journal of medicine and medical sciences.

[17]  R. Matre,et al.  Serum immunoglobulin profiles in asymptomatic HIV-1 seropositive adults and in patients with AIDS in Dar es Salaam, Tanzania. , 1994, East African medical journal.

[18]  C. Sabin,et al.  CD8 lymphocyte counts and serum immunoglobulin A levels early in HIV infection as predictors of CD4 lymphocyte depletion during 8 years of follow-up. , 1993, AIDS.

[19]  K. James,et al.  B cell responses to HIV and the development of human monoclonal antibodies , 1992, Clinical and experimental immunology.

[20]  D. Klinman,et al.  Human immunodeficiency virus infection induces both polyclonal and virus-specific B cell activation. , 1992, The Journal of clinical investigation.

[21]  C. Carini,et al.  Isotypic distribution of HIV-1-specific antibodies in individuals from central Africa. , 1992, Viral immunology.

[22]  S. Kleinman,et al.  Interrelationships Between Serologic Markers of Immune Activation and T Lymphocyte Subsets in HIV Infection , 1990, Journal of acquired immune deficiency syndromes.

[23]  Jaap,et al.  Immunological abnormalities in human immunodeficiency virus (HIV)-infected asymptomatic homosexual men. HIV affects the immune system before CD4+ T helper cell depletion occurs. , 1988, The Journal of clinical investigation.

[24]  B. Wahrén,et al.  IgG subclass response to HIV in relation to antibody-dependent cellular cytotoxicity at different clinical stages. , 1988, Clinical and experimental immunology.

[25]  S. Zolla-Pazner,et al.  B-cell activation in HIV infection: relationship of spontaneous immunoglobulin secretion to various immunological parameters. , 1988, Clinical and experimental immunology.

[26]  A. Fauci,et al.  Serologic and immunologic studies in patients with AIDS in North America and Africa. The potential role of infectious agents as cofactors in human immunodeficiency virus infection. , 1987, JAMA.

[27]  A. Fauci,et al.  Serologic and immunologic studies in patients with AIDS in North America and Africa , 1987 .

[28]  A. Fauci,et al.  Abnormalities of B-cell activation and immunoregulation in patients with the acquired immunodeficiency syndrome. , 1983, The New England journal of medicine.

[29]  Grundbacher Fj Heritability estimates and genetic and environmental correlations for the human immunoglobulins G, M, and A. , 1974 .

[30]  F. J. Grundbacher Heritability estimates and genetic and environmental correlations for the human immunoglobulins G, M, and A. , 1974, American journal of human genetics.

[31]  A. Steinberg,et al.  Correlations between the concentrations of the four sub-classes of IgG and Gm Allotypes in normal human sera. , 1972, Journal of immunology.