AEROALLERGEN-SPECIFIC IGE CHANGES IN INDIVIDUALS WITH RAPID HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE PROGRESSION

Background: Progression of human immunodeficiency virus type 1 (HIV-1) infection to the acquired immunodeficiency syndrome (AIDS) is associa ted with elevated total IgE; however, previous cross-sectional studies have differed in their assessment of concurrent changes in allergic d isease prevalence. Objective: Assessment of changes in aeroallergen-sp ecific IgE during progression from early to late HIV disease. Methods: Total IgE, aeroallergen-specific IgE (rye grass, ragweed, Alternaria, dust mite, and cat), IFN-gamma, IL-4, and soluble CD23 (sCD23) were m easured in a longitudinal study of 20 subject who had progressed from early-HIV infection (mean CD4 lymphocyte count of 650/mm(3)) to AIDS ( mean CD4 lymphocyte count of 40/mm(3)) over an average of 4 years. Res ults: Prevalence of positive aeroallergen specific-IgE assays in early HIV disease (II subjects with 13 positives) decreased with progressio n to late disease (five subjects with nine positives, P = .057), while total IgE increased from a median of 69 to 116 IU/mL. IFN-gamma and I L-4 were unchanged, while sCD23 decreased from a median of 72 to 9 U/m L (P = .0005) with disease progression in the full cohort. In contrast to other subjects, the subgroup of individuals with total IgE > 150 I U/mL in both early and late HIV disease demonstrated an increased freq uency of aeroallergen-specific IgE. Conclusions: The elevation of tota l IgE associated with rapid HIV-1 disease progression was unexplained by concurrent changes in aeroallergen-specific IgE, IL-4, IFN-gamma, o r sCD23. Overall, aeroallergen-specific IgE expression was less preval ent with HIV-1 progression, except in those individuals with elevated total IgE both before and after progression to AIDS.