Pivotal role of HIV and EBV replication in the long-term persistence of monoclonal gammopathy in patients on antiretroviral therapy.
A high prevalence of monoclonal gammopathy (MG) has been observed in HIV-infected patients. We explored the conditions associated with long-term persistence of serum monoclonal protein (M protein) in HIV-infected patients on antiretroviral therapy (ART). Of 21 patients with MG, M protein disappeared in 12 patients (58%) over 5 years of ART. Higher level of serum γ-globulin and higher percentages of circulating plasmablasts and plasma cells were observed in patients with persistent MG compared with patients with transient MG. MG persistence was associated with the cumulative time of detectable plasma HIV RNA after ART initiation, detection of Epstein-Barr virus (EBV) DNA in plasma, and a high level of EBV DNA in B cells. Poor control of HIV replication and detectable EBV replication in plasma were both associated with long-term MG persistence in patients on ART. In the case of viral control, MG associated with HIV infection is usually transient.
Institut National de la Santé et de la Recherche Médicale U1058, Université Montpellier 1, Montpellier, France;
David Eric
DE
Ouedraogo
Alain
A
Makinson
Jean-Pierre
JP
Vendrell
Marie-Laure
ML
Casanova
Nicolas
N
Nagot
Renaud
R
Cezar
Karine
K
Bollore
Yassine
Y
Al Taaba
Vincent
V
Foulongne
Stéphanie
S
Badiou
Johannes
J
Viljoen
Jacques
J
Reynes
Philippe
P
Van de Perre
Edouard
E
Tuaillon
D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D060085:Coinfection; D004279:DNA, Viral / Q000037:antagonists & inhibitors*; D020031:Epstein-Barr Virus Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D005260:Female; D006023:Glycoproteins / Q000097:blood / Q000235:genetics / Q000276:immunology; D015658:HIV Infections / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000276:immunology; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010265:Paraproteinemias / Q000188:drug therapy* / Q000276:immunology / Q000821:virology; D010950:Plasma Cells / Q000187:drug effects / Q000276:immunology / Q000821:virology; D013997:Time Factors; D019562:Viral Load / Q000187:drug effects; D014779:Virus Replication / Q000187:drug effects*; D005719:gamma-Globulins / Q000235:genetics / Q000276:immunology
D044966:Anti-Retroviral Agents; D004279:DNA, Viral; D006023:Glycoproteins; D005719:gamma-Globulins; C023587:protein M (glycoprotein)