Immunoglobulin Levels Amongst Persons with and without Human Immunodeficiency Virus Type 1 Infection in Uganda and Norway

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Abstract
CD4+‐cell count and viral load monitoring are expensive and unavailable to most human immunodeficiency virus (HIV)‐infected people in Africa. In an attempt to evaluate alternative methods for monitoring antiretroviral (ARV) therapy, we measured concentrations of immunoglobulin (Ig)A, IgM, IgG and IgG1 amongst adults with and without HIV in Uganda and Norway. We adjusted for disease severity by stratifying HIV‐positive subjects on CD4+‐cell counts above and below 200 cells/µl. Median serum levels of IgG, IgG1 and IgA were significantly higher in HIV‐positive persons compared with HIV‐negative persons in both countries (P < 0.001 and P = 0.018 for IgA in Ugandan patients). Levels of IgA in Ugandan HIV‐negative subjects were significantly lower than those in HIV‐positive subjects with low CD4+ compared with those with high CD4+‐cell counts (P < 0.001 and P = 0.069, respectively). IgM levels were different between the HIV‐negative and the two HIV‐positive groups in Norway (P < 0.001). The mean levels of IgM, IgG and IgG1 in HIV‐negative and ‐positive African subjects were generally higher than those in comparable groups of Western subjects. Our results verify that levels of IgA, IgG and IgG1 vary between HIV‐negative and ‐positive individuals in both study populations. Their determination may be useful in monitoring both disease progression and response to ARV therapy.

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