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Human immunodeficiency virus infection and anion gap
1Department of Pathology, University of Louisville, KY.
Annals of Clinical and Laboratory Science
|July 1, 1993
Summary
A decreased anion gap (AG) can indicate increased immunoglobulin G (IgG) levels, often seen in human immunodeficiency virus (HIV) infection. This finding may prompt consideration of HIV testing in patients with a low AG and elevated IgG.
Area of Science:
- Clinical Chemistry
- Immunology
- Infectious Diseases
Background:
- The anion gap (AG) is a key indicator in acid-base balance assessment.
- Decreased AG levels are associated with specific conditions like halogen ingestion, myeloma, and polyclonal immunoglobulin increases.
Observation:
- A case study revealed a decreased AG in a human immunodeficiency virus (HIV)-infected patient with significantly elevated polyclonal immunoglobulin G (IgG).
- The patient's electrophoretic profile suggested increased immunoglobulin synthesis, distinct from the decreased degradation seen in hepatic cirrhosis.
Findings:
- Examination of 18 additional HIV-positive patients showed generally higher AG levels compared to healthy individuals, though the significance is unclear.
- A consistent association was observed between decreased AG and elevated IgG levels in HIV-infected patients.
Implications:
- The frequent elevation of IgG in HIV infection may complicate the interpretation of AG values.
- A decreased AG coupled with a polyclonal increase in gamma-globulin warrants consideration for HIV infection workup, alongside clinical history and physical examination.