Extremely prolonged HIV seroconversion associated with an MHC haplotype carrying disease susceptibility genes for antibody deficiency disorders
| Autor: | Suzanne M. Crowe, Chris Birch, Martyn A. French, Alan Breschkin, David E Leslie, Matthew Kaye, Kim Wilson, Emma Tippett, Eman Aleksic, Alicia Arnott, Dale A. McPhee, Lachlan Robert Gray, Paul R Gorry, Alex Padiglione, Megan Crane, Sharon R Lewin, Anne Ellett |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Time Factors Receptors CCR5 HIV Antigens Immunology HIV Core Protein p24 HIV Infections Pneumocystis carinii Virus Replication Antibodies Immunoglobulin G Major Histocompatibility Complex Acquired immunodeficiency syndrome (AIDS) Neutralization Tests HIV Seropositivity medicine Humans Immunology and Allergy Pneumocystis jirovecii Genetic Predisposition to Disease Hepatitis B Vaccines Seroconversion Immunodeficiency Hepatitis A Vaccines biology Histocompatibility Testing Pneumonia Pneumocystis Common variable immunodeficiency Immunologic Deficiency Syndromes Middle Aged Viral Load biology.organism_classification medicine.disease Antibodies Neutralizing Virology Common Variable Immunodeficiency Haplotypes Influenza Vaccines Antibody Formation HIV-1 biology.protein RNA Viral Viral load |
| Zdroj: | Clinical Immunology. 137:199-208 |
| ISSN: | 1521-6616 |
| DOI: | 10.1016/j.clim.2010.07.003 |
| Popis: | Severe immunodeficiency during primary human immunodeficiency virus (HIV) infection is unusual. Here, we characterized viral and immunological parameters in a subject presenting with Pneumocystis jirovecii pneumonia in the setting of prolonged primary HIV illness and delayed seroconversion. HIV antibody was only detected by enzyme-linked immunosorbent assay 12 months after presentation, and Western blot profiles remain indeterminate. Isolated virus was of R5 phenotype, exhibited poor viral fitness, but was otherwise unremarkable. Analysis of HIV antibody isotypes showed failure to mount a detectable HIV IgG response over nearly 2 years of infection, in particular IgG(1)- and IgG(3)-specific responses, despite normal responses to common infections and vaccines. Genetic analysis demonstrated homozygosity for part of an MHC haplotype containing susceptibility genes for common variable immunodeficiency (CVID) syndrome and other antibody deficiency disorders. Thus, a primary disorder of specific antibody production may explain exceptionally slow antibody development in an otherwise severe seroconversion illness. This highlights the need for multiparameter testing, in particular use of a fourth generation HIV test, for confirming HIV infection and underscores the importance of host factors in HIV pathogenesis. |
| Databáze: | OpenAIRE |
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