Hypergammaglobulinemia associated with human immunodeficiency virus infection

The serum concentrations of 11 Ig isotypes (IgG, IgG1, IgG2, IgG3, IgG4, IgA, IgA1, IgA2, IgM, IgD, and IgE) were measured in four relatively small groups of homosexual (or bisexual) males. All these patients were seropositive for HIV. Two of the groups (nonprogressors) were clinically stable for approximately 2 years and were characterized either as asymptomatic or with PGL. The third group (progressors) developed AIDS 2-38 months after blood specimens were taken. The fourth group had AIDS. A fifth group of anti-HIV-seronegative heterosexual males completed the study. The geometric mean IgA serum concentration was more markedly elevated over normal control sera than any of the other study groups and was the only Ig isotype that was significantly higher in the progressor than in the nonprogressor group. The geometric IgG1 serum concentration was significantly higher in asymptomatic nonprogressors, PGL-nonprogressors, progressors, and AIDS patient groups than that in HIV-seronegative normals. In contrast, the geometric mean IgG2 serum concentration is depressed in all the anti-HIV-seropositive patients (but not significantly with the AIDS group). Multivariate analysis showed the Ig-isotype assays to have much less predictive power for progression to AIDS than the T-helper cell assays.