Serum immunoglobulin profiles in asymptomatic HIV-1 seropositive adults and in patients with AIDS in Dar es Salaam, Tanzania.

Researchers compared data on 50 HIV-1 seropositive adults with data on 50 healthy seronegative adults to determine the levels of immunoglobulin isotypes in sera from a region in Tanzania with a heterosexual HIV-1 transmission pattern and to determine any characteristic changes in these levels in HIV-1 seropositive adults. All the seropositive and seronegative subjects were blood donors at the blood bank of the Muhimbili Medical Centre in Dar es Salaam. Mean serum levels of IgG IgA IgM and IgD were significantly higher in HIV-1 seropositive subjects than in HIV-1 seronegative controls (p = .0001 for all except IgM p < .0001). The proportion of HIV-1 seropositive people with immunoglobulin levels higher than the mean control levels were 88% for IgG 68% for IgA and IgM and 76% for IgD. Asymptomatic HIV-1 seropositive individuals had lower immunoglobulin concentrations (except for IgE) than did those with AIDS (p = .0001 for IgD to .092 for IgG). The increase in IgD levels occurred in all sera from AIDS patients and in 63.3% of asymptomatic sera. With progression to AIDS the mean levels for total IgG IgG1 and IgG2 did not change but the IgG4 level fell significantly (1.16 g/l for asymptomatic vs. 0.38 g/l for AIDS p = .0009) and the IgG3 level increased significantly (4.29 g/l vs. 7.34 g/l; p = .022). These findings demonstrate that polyisotypic hypergammaglobulinemia and serum IgG subclass changes take place in HIV-1 seropositive people in a region where heterosexual HIV-1 transmission predominates. These results are similar to those in people infected through homosexual practices and the parenteral route suggesting that these changes do not depend on mode of HIV-1 transmission. Clinicians can monitor disease progression by observing the changes in the IgG3 IgG4 and IgD levels with progression from asymptomatic HIV-1 infection to AIDS.