ABSTRACT
Anti-cardiolipin antibodies (ACA) were determined by an ELISA assay in 116 HIV-1-infected patients. A positive test was found in 27 patients (23.3%) with a predominance of IgG ACA isotype. No significant difference in ACA positivity was observed between homosexuals (22.2%) and intravenous drug users (25.8%). The presence of different immunological markers was compared in ACA-positive and ACA-negative patients: ACA-positive patients had higher IgG levels (p less than 0.05) and a tendency to higher frequencies of anti-ss DNA, anti-ds DNA, anti-i antibodies, as well as circulating immune complexes. When patients were classified according to CDC criteria, no significant difference was observed for the prevalence of ACA in class II (21.2%), in class III (25%), and in class IV (21%). Our results indicate that ACA antibodies occur with other immunological alterations in HIV-1-infected patients, but do not confirm that ACA is a useful prognostic marker for development of AIDS.
Subject(s)
Antibodies/analysis , Cardiolipins/immunology , HIV Infections/immunology , HIV-1/immunology , Adult , Aged , Enzyme-Linked Immunosorbent Assay , Female , HIV Seropositivity/immunology , Humans , Immunoglobulin A/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Male , Middle AgedABSTRACT
Severe thrombocytopenia has been diagnosed in HIV seropositive patients independently of the clinical stage of disease. In view of its immunologic origin, attempts have been made to treat this condition with drugs which have proved effective in the treatment of autoimmune thrombocytopenia, though with little or no beneficial effect to these patients. This communication deals with the observation (5-22 months) of 5 HIV seropositive patients with severe thrombocytopenia who were resistant to steroids, high dose i.v. immunoglobulin and Danazol. They all responded well to splenectomy, with only one patient relapsing after 4 months. However, 2 patients showed deterioration of the immunodeficient state: in one patient the number of CD4 lymphocytes decreased and the other died of multifocal leuko-encephalopathy 4 months after splenectomy. Based on this small series, splenectomy seems to be effective in the treatment of thrombocytopenic HIV seropositive patients. However, long-term hazards still have to be assessed.
Subject(s)
Acquired Immunodeficiency Syndrome/complications , Splenectomy , Thrombocytopenia/complications , Adrenal Cortex Hormones/therapeutic use , Adult , Autoimmune Diseases/complications , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Platelet Count , Thrombocytopenia/immunology , Thrombocytopenia/therapy , gamma-Globulins/therapeutic useABSTRACT
87 patients with anti-HIV antibodies were divided into three groups based on the classification of the Centers for Disease Control and the following parameters reflecting polyclonal B cell activation were evaluated in these patients: immunoglobulin levels, circulating immune complexes and occurrence of autoantibodies. The results reported here indicate that intense polyclonal B cell activation occurs in both asymptomatic (CDC 2) and symptomatic patients (CDC 3 and CDC 4). Moreover, serological abnormalities were detected with similar frequency in the three groups studied.
