LACK OF RELATION OF GRANULOCYTE ANTIBODIES (ANTINEUTROPHIL ANTIBODIES) TO NEUTROPENIA IN CHILDREN WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Background. Neutropenia in children and adults with HIV infection is f requently observed, perhaps as a result of impaired myelopoiesis, drug myelotoxicity, immune destruction or opportunistic infection. The pre sence of antineutrophil antibodies (granulocyte antibodies) has been a ssociated with severe neutropenia in some reports but not in others, a nd such antibody assays can be confounded by the presence of immune co mplexes and HLA antibodies. Methods. To determine both the prevalence of granulocyte antibodies in children with HIV infection and whether s uch antibodies were related to neutropenia, we screened the sera of 30 HIV-infected children by performing granulocyte immunofluorescence, g ranulocyte agglutination and lymphocytotoxic anti-HLA antibody assays. Reactivity was graded by a standard numeric score calculated per numb er of reactive cells. Results. Of 26 evaluable sera, 16 (62%) had gran ulocyte antibodies, 6 (23%) had HLA antibodies and 4 (15%) had neither . There was no correlation between presence of granulocyte antibodies and degree of neutropenia. Conclusions. We conclude that granulocyte a ntibodies are highly prevalent in children with HIV infection but do n ot correlate with the degree of neutropenia. Antineutrophil antibody d etermination as currently performed does not appear to be useful in th e evaluation of the HIV-infected neutropenic child.