title: Abnormal antibody responses in patients with persistent generalized lymphadenopathy.
abstract: Persistent, generalized lymphadenopathy (PGL) is a recognized component of human immunodeficiency virus (HIV) infection. We conducted longitudinal studies of B and T cell function in seven homosexual men with HIV infection and PGL. All seven had abnormal antibody-mediated immunity as studied by sequential assessment of in vivo antibody responses after immunization with the T-dependent neoantigens bacteriophage phi X 174 and keyhole limpet hemocyanin (KLH), the T-independent tetradecavalent pneumococcal polysaccharide vaccine, and the recall antigens diphtheria and tetanus toxoid. Compared to HIV-negative heterosexual controls, PGL patients responded with lower antibody titers and, following immunization with phage, failed to develop immunologic memory and to switch from IgM- to IgG-isotype antibody. In vitro antigen-induced antibody production was markedly diminished; and some patients showed depressed mitogen responses. There was a correlation between the degree of compromised immunity and the clinical condition; those with the most severe symptoms showed the most extensive immune deficiency. Yet despite obvious immunologic impairment five of the seven men have remained clinically stable over a 3-year follow-up period.
authors.affiliation: Department of Pediatrics, School of Medicine, University of Washington, Seattle 98195.
authors.forename: H D
authors.initials: HD
authors.lastname: Ochs
authors.forename: A K
authors.initials: AK
authors.lastname: Junker
authors.forename: A C
authors.initials: AC
authors.lastname: Collier
authors.forename: F S
authors.initials: FS
authors.lastname: Virant
authors.forename: H H
authors.initials: HH
authors.lastname: Handsfield
authors.forename: R J
authors.initials: RJ
authors.lastname: Wedgwood
mesh_terms: D000386:AIDS-Related Complex / Q000276:immunology*; D000328:Adult; D000941:Antigens / Q000276:immunology*; D010584:Bacteriophage phi X 174 / Q000276:immunology; D004168:Diphtheria Toxoid / Q000276:immunology; D006433:Hemocyanins / Q000276:immunology; D006801:Humans; D006942:Hypergammaglobulinemia / Q000276:immunology*; D007114:Immunization; D008297:Male; D011135:Polysaccharides, Bacterial / Q000276:immunology; D013296:Streptococcus pneumoniae / Q000276:immunology; D006377:T-Lymphocytes, Helper-Inducer / Q000166:cytology; D050378:T-Lymphocytes, Regulatory / Q000166:cytology; D013745:Tetanus Toxoid / Q000276:immunology
chemical_list: D000941:Antigens; D004168:Diphtheria Toxoid; D011135:Polysaccharides, Bacterial; D013745:Tetanus Toxoid; D006433:Hemocyanins; C032808:keyhole-limpet hemocyanin