Lack of relation of granulocyte antibodies (antineutrophil antibodies) to neutropenia in children with human immunodeficiency virus infection

Background. Neutropenia in children and adults with HIV infection is frequently observed, perhaps as a result of impaired myelopoiesis, drug myelotoxicity, immune destruction or opportunistic infection. The presence of antineutrophil antibodies (granulocyte antibodies) has been associated with severe neutropenia in some reports but not in others, and such antibody assays can be confounded by the presence of immune complexes and HLA antibodies. Methods. To determine both the prevalence of granulocyte antibodies in children with HIV infection and whether such antibodies were related to neutropenia, we screened the sera of 30 HIV-infected children by performing granulocyte immunofluorescence, granulocyte agglutination and lymphocytotoxic anti-HLA antibody assays. Reactivity was graded by a standard numeric score calculated per number of reactive cells. Results. Of 26 evaluable sera, 16 (62%) had granulocyte antibodies, 6 (23%) had HLA antibodies and 4 (15%) had neither. There was no correlation between presence of granulocyte antibodies and degree of neutropenia. Conclusions. We conclude that granulocyte antibodies are highly prevalent in children with HIV infection but do not correlate with the degree of neutropenia. Antineutrophil antibody determination as currently performed does not appear to be useful in the evaluation of the HIV-infected neutropenic child.