The spectrum of autoantibodies in hn infection

Introduction The clinical manifestations of HIV Infection sometimes resemble those of autoimmune diseases (AD). Immune dysregulatfon with perturbed B cell function and hypergammaglobullnaemla is an established consequence of HIV Infection. Polyclonal B cell activation is thought to contribute to the development of self-reactive antibodies In AD such as systemic lupus erythematosus. Previous studies have demonstrated the high prevalence of cardlolipln antibodies (aCLa) in HIV Infection but have yielded conflicting results regarding antlnuclear antibodies (ANA). However, the spectrum of autoantibody (AAb) production in HIV Infection is uncertain. This study sought to estimate the point prevalence of organ specific and nonorgan specific AAbs, and to determine the relationship of AAb production and the polyclonal gammopattiy of HIV Infection. Method All patients attending the HIV clinics at RPAH were invited to participate in the study. Informed consent was obtained. Patients responded to a questionnaire regarding symptoms; blood was drawn for measurement of Immunoglobulin (lg) levels, protein electrophoretogram, and AAbs. Results 90 patients (88 males) were enrolled. The mean CD4 T cell count was 179 × 10 6 /L. There was significant elevation of the Ig levels compared with the healthy population (mean IgG 17.0 g/L; pc.00/ t-tesf). 9 patients had three AAbs, 27 had 2 and 32 had 1, while 24 patients had no AAbs. aCLa (52/90) and smooth muscle antibodies (SMA, 45/90).accounted for the majority of the positives. Only 8/90 were ANA positive. C-ANCA occurred in 4 patients and glomerular basement membrane antibodies (GBMa) In 3. Antibodies to SS-A, SS-B, dsDNA, RNP, Sm, Jo-1 parietal cells and mitochondria were not detected. The relationship between the number of AAbs and Ig levels was not statistically significant (one-way ANOVA). Conclusion Although the overall prevalence of AAbs is high in HIV Infected individuals, the spectrum of AAb production is narrow. aCLA and SMA are common, C-ANCA. GBMa and ANA are uncommon. 8 of the AAbs sought did not occur at all. The Infrequency of most AAbs and the lack of relationship with Ig levels suggests that polyclonal B cell activation selectively generates aCLas and SMA rather than a random spectrum of AAbs.