IGA-ANTI-FAB AUTOANTIBODIES AND DISEASE PROGRESSION IN AIDS

There is increasing evidence that autoimmune phenomena contribute to t he pathogenesis of the acquired immunodeficiency syndrome (AIDS). We i nvestigated the relationship between IgA autoantibodies directed again st the Fab part of the IgG molecule and disease progression in 87 HIV- infected hemophilia patients. AIDS patients demonstrated a significant ly higher serum IgA-anti-Fab activity than HIV-positive (HIV+) patient s with AIDS-related complex (ARC) (P <0.02), HIV+ patients without AID S/ARC (P <0.0001), HIV negative (HIV-) patients (P = 0.0001), or healt hy controls (P <0.0001). Moreover, an inverse association was observed between serum IgA-anti-Fab activity and CD4+ cell counts (r = -0.396, P <10(-6)). This close association was confirmed in longitudinal stud ies of symptomatic patients. IgA-anti-Fab antibodies are suggested to play an important role in the immunopathogenesis of AIDS, and their de termination may be helpful in the monitoring of HIV-infected patients.