Antibody-dependent enhancement of human immunodeficiency virus type 1 infection

Two components of human serum enhance human immunodeficiency virus type 1 (HIV-1) infection and mask HIV-1 neutralising antibody activity. The first is heat-stable, unique to HIV-1 seropositive sera, and is removed by protein-A chromatography. The second is heat-labile and ubiquitous; it is found in normal serum and is removed by heating at 60 degrees C for 1 h or by treatment with cobra venom anticomplementary protein. Additionally, complement component C3 deficient serum lacks the labile activity although Clq deficient serum contains the labile factor. The data suggest that the two components are antibody and the alternative pathway of complement fixation. The mechanism of action does not involve an increase in either complement-mediated cytolysis or syncytium formation. The activity has been identified in 11 of 16 patients tested to date.