DECREASED CERVICOVAGINAL PRODUCTION OF BOTH IGA1 AND IGA2 SUBCLASSES IN WOMEN WITH AIDS

Paired sera and cervicovaginal secretions from 35 HIV-1-infected women representing different CDC stages of HIV infection were evaluated for total IgA, IgA1 and IgA2, for IgA, IgA1 and IgA2 to gp160, and for al bumin. Age-matched healthy women (n = 45) served as controls. The secr etion rates of total IgA, IgA1 and IgA2 were evaluated by calculating their relative coefficients of excretion by reference to albumin. In H IV-infected women, total IgA1 and IgA2 in sera and in cervicovaginal s ecretions increased proportionately as early as stages II + III and mo re markedly at stage IV. By contrast, the secretion rates of total IgA , IgA1 and IgA2 were markedly reduced in AIDS women, the IgA2 secretio n rate decreasing significantly as early as stages II + III. This appa rent discrepancy was probably the result of increased transudation of serum-borne immunoglobulins into the vaginal cavity, since albumin lev els in cervicovaginal secretions increased significantly according to the stages of disease. HIV-reactive IgA antibodies in serum, as in cer vicovaginal secretions, were principally found within the IgA1 subclas s. In women at stage IV, a high local production of IgA1 to gp160 occu rred in spite of the impairment of cervicovaginal IgA synthesis, proba bly because of marked genital HIV replication at advanced stages,