EARLY ABNORMALITIES OF THE ANTIBODY-RESPONSE AGAINST MYCOBACTERIUM-TUBERCULOSIS IN HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Among human immunodeficiency virus (HIV)-infected persons, those who r eact against purified protein derivative (PPD) have higher risk of tub erculosis. Since PPD testing has limited predictive power in HIV-posit ive populations, new markers of antituberculous immunity were sought b y analyzing antibodies to Mycobacterium tuberculosis antigens (PPD and its fraction A60) in 102 HIV-positive subjects, some PPD-positive and some PPD-negative, and in 23 HIV-positive tuberculosis patients. ELIS A and Western blotting were used. Forty HIV-negative healthy subjects and 40 HIV-negative tuberculosis patients were evaluated as controls. While all those HIV-negative and PPD-positive had IgG antibodies recog nizing the 38-, 28-, and 19-kDa M. tuberculosis antigens, only 26% of those HIV-positive and PPD-positive (all with <400 CD4+ cells/mm3) and none of the HIV-positive tuberculosis patients recognized them, indic ating that the lack of IgG against those antigens, in the presence of a specific IgM response, is a marker of immunodeficiency.