title: Serum protein electrophoresis patterns in human immunodeficiency virus-infected individuals not on antiretroviral treatment.
abstract: BACKGROUND
  B lymphocyte stimulation is described in human immunodeficiency virus (HIV) infection and results in ongoing immunoglobulin production with abnormal serum protein electrophoresis patterns. We hypothesized that serum protein electrophoresis patterns would be abnormal in untreated HIV subjects and correlate with markers of disease severity.
  
  
  METHODS
  Serum protein electrophoresis was performed on 70 HIV-positive, clinically well treatment-naïve subjects and 42 HIV-negative controls and correlated with markers of disease severity, namely CD4+ counts, viral loads, IgG and albumin.
  
  
  RESULTS
  The mean age for both groups was 33 years, and female-to-male ratios were 4:1. All were of Black ethnicity. Mean CD4 counts ± SD for HIV group and controls were 419.5 ± 218.6 and 960.4 ± 378.5 cells/mm(3), respectively. Of the HIV-infected group, 44% showed polyclonal hypergammaglobulinaemia versus 10% of controls (P < 0.01). The HIV group had 27% with an abnormal pattern requiring immunofixation which revealed nine (12.5% of total) had oligoclonal bands, seven (10.3% of total) had polyclonal hypergammaglobulinaemia and three (4% of total) had monoclonal bands. CD4+ counts were lower in those with polyclonal hypergammaglobulinaemia or abnormal serum protein electrophoresis. Interestingly, viral load results showed no statistically significant differences.
  
  
  CONCLUSIONS
  We found a remarkably high level (53%) of polyclonal hypergammaglobulinaemia in our untreated population compared with uninfected controls (10%). Only 4% of the HIV-positive group had a monoclonal band. Polyclonal hypergammaglobulinaemia correlated significantly with lower CD4+ counts. These results highlight the generalized B cell stimulation in untreated HIV infection. Future longitudinal studies will be important to determine the prognostic value of these findings.
authors.affiliation: Division of Chemical Pathology, Department of Pathology, University of Stellenbosch and NHLS, Tygerberg Hospital, South Africa azemlin@sun.ac.za.
authors.forename: Annalise E
authors.initials: AE
authors.lastname: Zemlin
authors.affiliation: Division of Haematology, Department of Pathology, University of Stellenbosch and NHLS, Tygerberg Hospital, South Africa.
authors.forename: Hayley
authors.initials: H
authors.lastname: Ipp
authors.affiliation: Division of Chemical Pathology, Department of Pathology, University of Stellenbosch and NHLS, Tygerberg Hospital, South Africa.
authors.forename: Sechaba
authors.initials: S
authors.lastname: Maleka
authors.affiliation: Division of Chemical Pathology, Department of Pathology, University of Stellenbosch and NHLS, Tygerberg Hospital, South Africa.
authors.forename: Rajiv T
authors.initials: RT
authors.lastname: Erasmus
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents; D015704:CD4 Antigens / Q000097:blood*; D003430:Cross-Sectional Studies; D004586:Electrophoresis / Q000379:methods*; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000175:diagnosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019562:Viral Load / Q000379:methods; D055815:Young Adult; D005719:gamma-Globulins / Q000032:analysis*
chemical_list: D044966:Anti-Retroviral Agents; D015704:CD4 Antigens; D005719:gamma-Globulins
keywords: Electrophoresis; acquired immunodeficiency syndrome; analytes; clinical studies; laboratory methods; proteins