The clinical significance of human immunodeficiency virus type 1-
associated paraproteins
VL Ng, KH Chen, KM Hwang, H Khayam-Bashi and MS McGrath
Department of Medicine, University of California, San Francisco.
We observed and characterized paraproteins present in the serum of seven
human immunodeficiency virus type 1 (HIV-1)-infected individuals.
Immunoglobulin (Ig) subclass typing performed on these paraproteins
identified five as IgG1 kappa, one as an IgG3 lambda, and one as an IgA
lambda. The IgG1 kappa paraproteins, purified by high-pressure liquid
chromatography, contained the majority of anti-HIV-1 antibody reactivity
present in the five serum specimens (ranging from 1:5,000 to 1:500,000) as
demonstrated by immunoblot. All five IgG1 paraproteins had at least two
light chain species as demonstrated by sodium dodecyl sulfate
polyacrylamide gel electrophoresis (SDS-PAGE), and the antibodies were
reactive with multiple HIV-1 viral antigens. In contrast, the
electrophoretically purified IgG3 lambda and IgA lambda paraproteins did
not react with HIV-1 antigens and only one light chain species was detected
by SDS-PAGE. The subsequent clinical evaluation of these patients following
the initial observation of paraproteinemias failed to correlate the
presence of paraproteins with the development of lymphoma over a 2 to 3
year period. These data support the hypothesis that IgG1 paraproteins
present in the sera of HIV-1 infected individuals reflect a normal albeit
exuberant polyclonal immune response to HIV-1 viral antigens. In contrast,
the clinical significance of an IgG3 lambda or an IgA lambda paraprotein is
unclear at present.
Volume 74,
Issue 7,
pp. 2471-2475,
11/15/1989
Copyright © 1989 by The American Society of Hematology
