Different types of antiphospholipid antibodies in AIDS: A comparison with syphilis and the antiphospholipid syndrome

Alloimmune antiphospholipid antibodies react with phospholipids and are an epiphenomenon of an infectious disease. Most autoimmune antiphospholipid an tibodies recognise phospholipid-protein complexes or proteins, such as beta (2) glycoprotein I or prothrombin and are related to the clinical features of the antiphospholipid syndrome. Lupus anticoagulant, anticardiolipin anti bodies, antiprothrombin, and anti-beta(2) glycoprotein I antibodies were st udied in 61 human immunodeficiency virus (HIV) patients, 55 syphilis patien ts, and 45 selected patients with antiphospholipid syndrome. Lupus anticoag ulant was present in 72% of HIV and 81% of antiphospholipid syndrome patien ts. None of the syphilis patients had lupus anticoagulant, Anticardiolipin antibodies were found at comparable prevalence in the three groups (HIV 67 %, syphilis 67 %, antiphospholipid syndrome 84%), HIV had more frequently a nti-beta(2) glycoprotein 1(13%) and antiprothrombin (12%) antibodies than s yphilis (0 and 4%, respectively), but significantly less than antiphospholi pid syndrome (61 and 40%,respectively). Autoimmune antiphospholipid antibod ies in HIV without clinical features of antiphospholipid syndrome might be a reflex of the immunological chaos and/or the constant antigenic virus sti mulus. (C) 1999 Elsevier Science Ltd. All rights reserved.