title: Cryptococcus neoformans-reactive and total immunoglobulin profiles of human immunodeficiency virus-infected and uninfected Ugandans.
abstract: We determined total and Cryptococcus neoformans glucuronoxylomannan (GXM)-reactive antibody repertoires of human immunodeficiency virus (HIV)-infected and HIV-uninfected Ugandans in a retrospective, case-control study of participants in a randomized controlled trial of pneumococcal vaccination. The study included 192 adults: 48 who subsequently developed cryptococcal meningitis (CM); (HIV+ CM+); 2 individuals who matched them in CD4+ T-cell level, stage of HIV disease, and age but did not develop CM (HIV+ CM-); and 48 HIV-uninfected individuals. Total serum immunoglobulin concentrations and titers of immunoglobulin M (IgM), IgG, and IgA to GXM, pneumococcal polysaccharides, and antibodies expressing certain V(H)3 idiotypes were determined with banked sera obtained before the development of cryptococcosis for HIV+ CM+ subjects. The results showed that HIV-infected subjects had significantly lower levels of IgM to GXM but higher levels of total immunoglobulin and IgG and IgA to GXM than those of HIV-uninfected subjects. HIV-infected subjects with a history of pneumonia had higher levels, and those with a history of herpes zoster had lower levels of GXM-binding antibodies than subjects with no history of either disease. Minimal to no cross-reactivity was demonstrated between antibodies to GXM and polysaccharides in a pneumococcal vaccine. No significant differences between the antibody repertoires of HIV+ CM+ and HIV+ CM- subjects were identified, but among subjects without a history of pneumonia, there was a trend towards lower V(H)3-positive antibody levels among HIV+ CM+ than among HIV+ CM- subjects. Our findings demonstrate an association between previous infectious diseases and differences in the total and GXM-reactive antibody repertoires of HIV-infected subjects and suggest the question of whether certain microbes modulate subsequent antibody responses to GXM deserves further study.
authors.affiliation: Department of Microbiology and Immunology, Division of Infectious Diseases, Albert Einstein College of Medicine, Room 709 Forchheimer, 1300 Morris Park Avenue, Bronx, New York 10461, USA.
authors.forename: Krishanthi
authors.initials: K
authors.lastname: Subramaniam
authors.forename: Neil
authors.initials: N
authors.lastname: French
authors.forename: Liise-Anne
authors.initials: LA
authors.lastname: Pirofski
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000453:epidemiology* / Q000276:immunology / Q000382:microbiology; D000293:Adolescent; D000328:Adult; D000908:Antibodies, Fungal / Q000097:blood; D016022:Case-Control Studies; D003429:Cross Reactions / Q000276:immunology; D003453:Cryptococcosis / Q000276:immunology; D003455:Cryptococcus neoformans / Q000276:immunology*; D005260:Female; D015483:HIV Antibodies / Q000097:blood; D015658:HIV Infections / Q000276:immunology / Q000382:microbiology*; D006801:Humans; D007132:Immunoglobulin Isotypes / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014454:Uganda / Q000453:epidemiology
chemical_list: D000908:Antibodies, Fungal; D015483:HIV Antibodies; D007132:Immunoglobulin Isotypes