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Background: Early diagnosis of perinatally acquired HIV-infection is based on either direct HIV detection--by means of viral culture and/or PCR--or anti-HIV antibody detection. However, due to the passive, transplacental passage of maternal immunoglobulin G, antibody detection is nor reliable until 15-18 months of age. In this regard, clonotypic analysis of specific antibodies performed by isoelectricfocusing and reverse blotting (IEF-RB) can be very helpful, as it recognizes possibly different patterns between mother and infant., Objectives: We used IEF-RB in order to analyze the kinetics of development of anti-HIV antibodies in infants born to seropositive mothers., Study Design: Sera from ten mother/infant pairs (all mothers were HIV-infected) were retrospectively analyzed in order to detect different patterns, between mother and infant, in anti-gp120 V3-loop clonotype., Results: We diagnosed the real HIV status of the examined infants no later than month 6 and in one case as early as month 2., Conclusions: Considering the small size of sample number, these data are preliminary and should be confirmed by larger scale studies. However, they show IEF-RB, when applied to infants born to seropositive mothers, may be useful in evaluating the infants' dynamics of anti-HIV humoral immune response.

In order to investigate the role played by zidovudine (ZDV) as immune modulator, particularly on B-cell response, the anti-V3 loop spectrotype in 115 sera from 26 HIV-infected individuals was evaluated, prior to and during treatment with ZDV, by isoelectric focusing and reverse blotting (IEF-RB), a technique useful for indirectly measuring the activity and the number of B-cell clones. All 18 patients showing seroreactivity by IEFRB displayed a clear oligoclonal banding pattern, with no change in the spectrotype (i.e. new bands), in sequential analysis over the course of therapy. Only minor changes in band intensity were found, without any correlation with ZDV treatment or CD4+ cell count. In addition, among the sera reactive in spectrotypic analysis, the percentage of those with p24 antigen positivity was significantly lower than those with no detectable p24 antigen (19.8% vs 80.2%, respectively, p = < 0.0001, Fisher's exact test). In conclusion, it could not be demonstrated by IEFRB that there was any effect of ZDV on the activity and the number of anti-V3 specific B-cell clones. This data is in line with previous studies showing the constancy of anti-gp120 antibody spectrotype over the long course of the disease.

HIV-1 infection results in progressive failure of the immune system with decline in the number and/or function of B-cell clones originally recruited in specific humoral responses. Spectrotypic analysis, done by isoelectric focusing and reverse blotting (IEF-RB), is one technique for evaluating the activity and the number of specific B-cell clones and is adaptable to the direct measurement of antibodies to conformationally intact epitopes. The anti-HIV-1 (IIIB) rgp120 spectrotype was measured in 30 early-stage HIV-infected volunteers undergoing vaccine therapy with recombinant gp160 (rgp160). Twenty-five of the patients displayed a clear oligoclonal banding pattern; seven (28%) showed the same pattern in all samples, while 18 (72%) showed changes. Ten of the latter had an increase in band intensity over the course of immunization, and eight had an increase in both band intensity and number of bands. In contrast, serum samples from eight patients receiving placebo (alum) showed no changes over a comparable period. These findings suggest that vaccine therapy with rgp160 may be able to expand the anti-HIV-1 (LAI) gp120 B-cell clone pool in some HIV-infected patients as well as increase antibody synthesis by established B-cell clones recruited during natural infection. These data provide further evidence that postinfection vaccination may provide an alternative strategy in the treatment of chronic viral diseases.

Human immunodeficiency virus (HIV) infection is characterized by a progressive decline in immune functions. The behavior of B-cell clones specifically engaged in the anti-HIV response could play a relevant role in the pathogenesis of such impairment. The spectrotype observed on isoelectric focusing and reverse blotting after antigen challenge is the serum image of antigen-specific B-cell activity and may provide some insight into Ag-dependent B-cell clone recruitment. In this study, we examined the spectrotype of anti-gp120 antibodies in a group of sera from 56 HIV-infected patients, belonging to groups II, III, and IV of the Centers for Disease Control classification, as well as in a group of 31 sera from 12 patients in a 21-month follow-up evaluation (range 7-36 months). All tested sera were positive for gp120 antibodies on Western blot. In the first group of 56 HIV-infected subjects, only 19 displayed well-focused banding patterns. Among these, the spectrotype was found to be consistently oligoclonal, thus confirming clonal restriction of anti-gp120 antibodies previously described by other investigators. No correlation could be established between a particular spectrotype and phase of the disease. The follow-up evaluation in the second group of 31 sera revealed the tendency in each patient to maintain the same spectrotype throughout the course of the disease. These findings confirm clonal restriction of anti-gp120 antibodies in HIV infection and suggest that the number of B-cell clones recruited in the anti-gp120 response remains stable over the course of the disease, at least in the time range explored by us.