Progressive Increase in IgA Concentrations in Children with Human Immunodeficiency Virus Infection

Abstract

This study presents immunologic data during a 5-year period of observation in six children infected with human immunodeficiency virus (HIV) via blood transfusions in the neonatal period. Serum IgG concentrations were increased in most patients by 1 year of age, but the levels did not change over time. By contrast, IgA concentrations steadily increased during the study period, so that levels at 5 years of age were significantly higher than levels at 1 year of age (p = 0.028). At 5 years of age, IgG concentrations averaged 4.6 standard deviations above the mean for age, whereas IgA concentrations averaged 9.4 standard deviations above the mean for age (p = 0.02). IgM concentrations generally were normal during the study period. The number of CD4 lymphocytes declined steadily during the study period. There was an inverse correlation between IgA concentrations and the number of CD4 lymphocytes (p = 0.02). The results of this study indicate that HIV infection is associated with a progressive increase in serum IgA concentrations that is out of proportion to the elevation in IgG concentrations. This suggests that there are independent factors responsible for the aberrant production of IgA and IgG in HIV infection. Moreover, IgA concentrations may be a useful marker of immunologic deterioration.