IgG2 deficiency in children with human immunodeficiency virus infection

Abstract

Infection with the human immunodeficiency virus (HIV) induces a polyclonal B-cell activation. Despite elevated serum immunoglobulin levels, a significant deterioration of the antigen specific humoral immune response exists in most cases. We studied the influence of HIV infection on the serum levels of IgG subclasses in children. We investigated 76 children (aged 15 months to 18 years) with HIV-1-infection. Most children (88%) showed elevated serum immunoglobulin levels. IgA (87%) and IgM (74%) were more often above normal levels for age than IgG (60%). IgG subclass serum levels were significantly altered. The increase in total IgG was mainly due to a marked augmentation of the IgG1 fraction. In most cases IgG3 was simultaneously elevated. Ten children (13%) had very low IgG4 levels (less than 0.03 g/l). Out of 61 patients older than 2 years 8 (13%) had a profound IgG2 deficiency with normal or elevated total IgG. Four of them also had low IgG4 levels (less than 0.03 g/l). A correlation between IgG2 deficiency and HIV infection according to the Centres for Disease Control classification for acquired immunodeficiency syndrome could not be demonstrated (three patients with symptomatic and five with asymptomatic infection).

HIV infection drives IgM and IgG3 subclass bias in Plasmodium falciparum-specific and total immunoglobulin concentration in Western Kenya

“…HIV infected individuals in this study did not have a deficiency or imbalance toward malaria specific non-cytophilic (IgG2 and IgG4) antibodies, as has been seen in some populations with low malaria transmission and decreased clinical immunity [26]. Total IgG2 deficiency was found in this cohort similar as has been previously described [53] and interestingly IgG2, which primarily targets polysaccharide antigen, is considered important in pneumococcal immunity, a major cause of morbidity and mortality among people living with HIV in Africa [54, 55].…”

Practice parameter for the diagnosis and management of primary immunodeficiency

“…[396][397][398][399] If a diagnosis of SAD is being considered because of poor vaccine response (see below), IgG subclasses should be determined because a diagnosis of IGGSD might be more appropriate (Table E10). IGGSD has been observed in association with other primary immunodeficiencies, such as AT 400 and WAS 401 ; secondary immunodeficiencies, such as HIV infection or AIDS 402 ; and after HSCT. 403 Secondary IGGSD has also been described in patients treated with antiepileptic drugs (see SS 99).…”

<p>Immunoglobulin G2 Antibody as a Potential Target for COVID-19 Vaccine</p>

“…In addition to bacterial infections, the role of IgG2 has been also described in viral infections, such as HIV, where HIV infected children displayed selective deficiency of IgG2 with a normal level of total IgG. 28 The high level of IgG2 is very uncommon in HIV, as the class-switching is highly inhibited by the virus. 29 However, the high level of IgG2 antibodies to Gp41 was inversely correlated with HIV disease progression.…”