Cervicovaginal Overproduction of Specific IgG to Human Immunodeficiency Virus (HIV) Contrasts with Normal or Impaired IgA Local Response in HIV Infection

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Abstract
Paired sera and cervicovaginal secretions (CVS) from 30 women infected with human immunodeficiency virus (HIV) type 1 (before AIDS) were analyzed for IgG and IgA antibodies to HIV and for IgG, IgA, and human serum albumin. Subjects were compared with 30 age-matched healthy controls. In HIV-infected women, cervicovaginal immunoglobulins were markedly increased, and IgG predominated. An increased immunoglobulin transudation was implicated, since cervicovaginal albumin levels were 2.3-fold above those of normal controls. Furthermore, IgG excretion by reference to albumin was increased 1.9-fold, whereas the IgA secretion tended to decrease, suggesting a possible enhanced local IgG synthesis. Mean IgG and IgA anti-HIV antibody titers were, respectively, 30- and 12-fold higher in serum than in CVS, but their mean specific activities were higher in CVS than in serum, suggesting a local synthesis of both isotypes. The IgA antibody response to HIV remained poor compared with the strong IgG response.

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