Monoclonal gammopathy and other serum protein electrophoresis patterns in patients with HIV infection in South Africa.
BACKGROUND
Monoclonal gammopathy has been noted with increased frequency in patients with HIV infection compared with the general population. The prevalence in patients on antiretroviral therapy (ART) has not been widely investigated. The present study aims to describe the prevalence and characteristics of monoclonal proteins in a population of HIV-infected patients in the Western Cape region of South Africa.


METHODS
Clinical information and blood and urine samples were collected from patients with proven HIV infection attending two clinics in the Western Cape. Serum protein electrophoresis was performed on all patients using agarose gel. Those with visible mono- or oligoclonal bands or increased gamma fractions were subjected to immunofixation electrophoresis.


RESULTS
Three hundred and sixty-eight patients were included in the study with a mean age of 37.7 y. Of these patients, 326 were on ART for a mean duration of 19.6 months. Monoclonal bands were found in 12 patients (3.2%) and oligoclonal bands in 14 (3.8%). These bands were associated with a shorter duration of ART, increased total protein, acute on chronic phase pattern on electrophoresis and an increased gamma fraction, but not associated with CD4 count and viral load. The majority were of low concentration and of the IgG isotype.


CONCLUSIONS
Our study confirms that the prevalence of monoclonal and oligoclonal bands is higher in this HIV-positive cohort on ART compared with that of the general population. However, the prevalence is lower than previously reported in other studies.
van Vuuren
M J
MJ
Division of Chemical Pathology, Department of Pathology, National Health Laboratory Service, Tygerberg Hospital and the University of Stellenbosch, Parow, 7505 Cape Town, South Africa. mvanvuuren@pathcare.co.za
Zemlin
A E
AE
Germishuys
J J
JJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D001798:Blood Proteins / Q000032:analysis* / Q000276:immunology; D004586:Electrophoresis / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010265:Paraproteinemias / Q000097:blood* / Q000150:complications*; D013019:South Africa; D055815:Young Adult
D019380:Anti-HIV Agents; D001798:Blood Proteins