title: Nonorgan-specific autoantibodies in HIV-infected patients in the HAART era.
abstract: Nonorgan-specific autoantibodies (AAbs) are used for diagnosing autoimmune diseases but can also be detected in other conditions. We carried out a cross-sectional study with the aim to screen HIV1-infected patients in the era of highly active antiretroviral therapy (HAART) for AAbs and to analyze the association of their presence with hypergammaglobulinemia and immunovirological status.Blood samples from HIV1-infected patients without major concomitant illnesses followed in 2 hospitals in Paris, France were tested for immunovirological status, serum immunoglobulin G (IgG) level, antinuclear antibodies (ANAs), anti-double-stranded DNA (anti-dsDNA), anti-extractable nuclear antigens (anti-ENAs), anticardiolipin (aCL), anti-β2glycoprotein1 (anti-β2GP1), and antineutrophil cytoplasmic antibodies (ANCAs). Clinically relevant AAbs were defined as ANAs with titers ≥1:160, anti-dsDNA or anti-ENA antibodies; aCL or anti-β2GP1 antibodies with a level ≥40 U/ml; and ANCAs reacting with proteinase 3 or myeloperoxidase.We included 92 patients (mean age 47 years, men 55%, sub-Saharan African background 55%, HAART 85%, mean CD4 lymphocyte count 611/mm, viral load < 40 copies/mL 74%). At least 1 AAb was detected in 45% of patients, mostly ANAs (33%) and ANCAs (13%); 12% had ≥1 clinically relevant AAb. Above-normal IgG levels were found in 71% of patients. We found an inverse association between the presence of ≥1 AAb and CD4 lymphocyte count (P = 0.03) and between above-normal IgG levels and duration of virological control (P = 0.02) and non-sub-Saharan African background (P = 0.001).In sum, in HIV1-infected patients without any major concomitant illness in the HAART era, the prevalence of AAbs remains high but AAb patterns leading to high suspicion of autoimmune diseases are rather uncommon. AAb presence is associated with reduced CD4 lymphocyte count but not hypergammaglobulinemia.
authors.affiliation: Department of Internal Medicine, Saint Louis Hospital, University Paris Diderot Department of Immunology and Histocompatibility, Saint Louis Hospital, University Paris Diderot Department of Internal Medicine, Lariboisière Hospital, University Paris Diderot Department of Infectious Diseases, Saint Louis Hospital, University Paris Diderot Chemin Vert Biology Center, Paris, France.
authors.forename: Laura
authors.initials: L
authors.lastname: Iordache
authors.forename: Djaouida
authors.initials: D
authors.lastname: Bengoufa
authors.forename: Olivier
authors.initials: O
authors.lastname: Taulera
authors.forename: Agathe
authors.initials: A
authors.lastname: Rami
authors.forename: Caroline
authors.initials: C
authors.lastname: Lascoux-Combe
authors.forename: Nesrine
authors.initials: N
authors.lastname: Day
authors.forename: Maguy
authors.initials: M
authors.lastname: Parrinello
authors.forename: Pierre-Olivier
authors.initials: PO
authors.lastname: Sellier
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Molina
authors.forename: Alfred
authors.initials: A
authors.lastname: Mahr
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001323:Autoantibodies / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D001323:Autoantibodies