INCREASED LEVELS OF SOLUBLE TUMOR-NECROSIS-FACTOR RECEPTOR-I(P55) ANDDECREASED IGG1 REACTIVITIES IN HIV-1 PATIENTS WITH CYTOMEGALOVIRUS DISEASE

The purpose of the study was to investigate potential associations bet ween tumour necrosis factor (TNF), soluble TNF receptors (sTNF-Rs), im munoglobulin (Ig)G subclasses and development of cytomegalovirus (CMV) disease amongst human immunodeficiency virus (Hn;)-1 patients. We enr olled HIV-1 patients with CD4 counts less than 100/mu l in a prospecti ve study and followed them over 1 year for development of CMV disease. Concentrations of TNF, sTNF-RI, sTNF-RII and IgG subclass reactivitie s were measured by ELISA; levels of CMV pp65 antigenaemia were determi ned as numbers of pp65 expressing cells/100 000 cells and were measure d by staining of leucocytes; and HIV-1 RNA loads were measured by poly merase chain reaction (PCR). Eighteen patients studied with CMV diseas e had higher levels of sTNF-RI than 18 similar patients without CMV di sease. Concentrations of sTNF-RI correlated with levels of CMV antigen aemia in blood samples collected before the development of CMV disease . Patients with CMV disease had lower levels of IgG(1) reactivities to CMV than patients without CMV disease. We conclude that increased lev els of sTNF-RI and decreased IgG1 reactivities are associated with an increased risk of development of CMV disease among HIV-1 patients.