Autoantibodies directed against phospholipids or human beta 2-glycoprotein I in HIV-seropositive patients: relationship with endothelial activation and antimalonic dialdehyde antibodies.
BACKGROUND
We investigated the possible role of antiphospholipid (APA) and anti-human 2-glycoprotein I (beta2-GPI) antibodies (Ab) in thrombosis and atherosclerosis in human immunodeficiency (HIV)-positive patients, in whom they seem to be more frequent.


METHODS
We measured APA and anti-beta2-GPI Ab in 58 HIV-positive patients together with markers of disease progression, circulating beta2-GPI, plasma lipids, biological markers of endothelial activation and integrity (plasma thrombomodulin, von Willebrand factor, vascular cell adhesion molecule 1) and with antimalonic dialdehyde antibodies (anti-MDA Ab).


RESULTS
We found a 41% frequency of IgG APA in the HIV-positive patients. APA IgMs were rarely positive (7%), and anti-beta2-GPI IgGs were positive in 3-4% patients. There was no correlation between APA or anti-beta2-GPI Ab and the presence of opportunistic infections. Although plasma thrombomodulin, von Willebrand factor and vascular cell adhesion molecule 1 were significantly increased in the HIV-positive patients, APA was correlated only with vascular cell adhesion molecule 1, suggesting that APAs are correlated with endothelial activation but not with vascular endothelial lesions. A correlation between APA and anti-MDA IgG was demonstrated using multivariate analysis (r=0.542, P < 0.0001), suggesting a relationship between the targets of these antibodies. Finally, IgG APAs are frequent in HIV infection but are not correlated with biological markers of endothelial injury.


CONCLUSIONS
Our results do not support a role for APA or anti-beta2-GPI in HIV-associated silent vascular endothelial damage. However, the role of these autoantibodies in clinically relevant thrombotic events should be investigated in HIV-positive patients.
Constans
J
J
Hôpital Saint-André, Bordeaux, France.
Guérin
V
V
Couchouron
A
A
Seigneur
M
M
Ryman
A
A
Blann
A D
AD
Amiral
J
J
Amara
A
A
Peuchant
E
E
Moreau
J F
JF
Pellegrin
I
I
Pellegrin
J L
JL
Fleury
H
H
Leng
B
B
Conri
C
C
D000328:Adult; D017152:Antibodies, Antiphospholipid / Q000097:blood*; D001053:Apolipoproteins / Q000097:blood / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D004730:Endothelium, Vascular / Q000276:immunology* / Q000473:pathology; D005260:Female; D006023:Glycoproteins / Q000097:blood / Q000276:immunology*; D006679:HIV Seropositivity / Q000276:immunology* / Q000821:virology; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008315:Malondialdehyde / Q000276:immunology*; D008875:Middle Aged; D053482:beta 2-Glycoprotein I
D017152:Antibodies, Antiphospholipid; D001053:Apolipoproteins; D001323:Autoantibodies; D015415:Biomarkers; D006023:Glycoproteins; D008055:Lipids; D053482:beta 2-Glycoprotein I; D008315:Malondialdehyde