The effect of combination antiretroviral therapy on CD5 B‐ cells, B‐cell activation and hypergammaglobulinaemia in HIV‐1‐infected patients

Objectives This study assessed B‐cell activation, CD5 B‐cells and circulating immunoglobulin levels in HIV‐infected patients treated with combination antiretroviral therapy (CART). Methods Measurement of plasma immunoglobulin levels and electrophoresis of plasma proteins, and analyses of total numbe...

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Bibliographic Details
Published in:HIV medicine 2005-09, Vol.6 (5), p.307-312
Main Authors: Redgrave, BE, Stone, SF, French, MAH, Krueger, R, James, IR, Price, P
Format: Article
Language:English
Subjects:
ADP-ribosyl Cyclase 1 - blood
Adult
Aged
Aged, 80 and over
Anti-Retroviral Agents - therapeutic use
Antiretroviral Therapy, Highly Active
B-Lymphocyte Subsets - drug effects
B-Lymphocyte Subsets - immunology
B‐cells
CD38
CD5
CD5 Antigens - blood
CD8-Positive T-Lymphocytes - immunology
combination antiretroviral therapy (CART)
Female
HIV Infections - complications
HIV Infections - drug therapy
HIV Infections - immunology
HIV-1
Humans
Hypergammaglobulinemia - drug therapy
Hypergammaglobulinemia - immunology
Hypergammaglobulinemia - virology
immunoglobulin
Immunoglobulin A - blood
Immunoglobulin G - blood
Immunoglobulin M - blood
Lymphocyte Activation - drug effects
Lymphocyte Count
Male
Middle Aged
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Summary:Objectives This study assessed B‐cell activation, CD5 B‐cells and circulating immunoglobulin levels in HIV‐infected patients treated with combination antiretroviral therapy (CART). Methods Measurement of plasma immunoglobulin levels and electrophoresis of plasma proteins, and analyses of total numbers of B‐cells and B‐cells expressing CD38 and CD5 in whole blood, were undertaken in 47 consecutive HIV‐1‐infected patients attending an out‐patient clinic. Results All HIV‐infected patients had similar percentages and numbers of B‐cells. Proportions of CD5 B‐cells in all HIV‐infected patients were significantly lower than those in HIV‐negative controls. Aviraemic HIV‐infected patients on CART had lower percentages of CD5, CD38 and CD5 CD38 B‐cell subsets and lower plasma levels of immunoglobulin G (IgG) and immunoglobulin A (IgA) than viraemic HIV‐infected patients (untreated or on CART). However, 33–37% of aviraemic HIV‐infected patients had IgG and IgA levels above the 95th percentile of the normal range defined in HIV‐seronegative donors. In aviraemic HIV‐infected patients, plasma IgA levels correlated only with proportions of activated (CD38) B‐cells. IgG levels did not correlate with the proportions of B‐cell subsets or any marker of HIV disease activity. Monoclonal immunoglobulins were not detected in any plasma sample. Conclusions Aviraemic HIV‐infected patients on CART have lower plasma levels of IgG and IgA than viraemic HIV‐infected patients, but levels are often above the normal range. CD5 B‐cell numbers are depressed, so these cells are unlikely to contribute to hypergammaglobulinaemia in HIV‐infected patients.
ISSN:1464-2662
1468-1293
DOI:10.1111/j.1468-1293.2005.00312.x