The role of IgG, IgA and IgM as immunological markers of HIV/AIDS progression

Patients with human immunodeficiency virus (HIV) infection exhibit a generalized, non-HIV-specific polyclonal B-cell activation resulting in hypergammaglobulinemia of all immunoglobulin isotypes as well as increased production of HIV-specific IgG and IgM. These immunoglobulins have the potential to be used as markers for monitoring the progression of HIV infection. With the inherent challenges of cost and convenience in the use of the conventional markers for HIV monitoring, that is, viral load and CD4+ count, there is the need to investigate the possible prognostic role of the above mentioned immunoglobulins in the management of HIV patients in Nigeria. The IgG, IgA and IgM profile as well as the CD4+ T cell count of forty HIV seropositive subjects was assayed before and after 3 months follow-up in a case series descriptive study. The Igs were measured using enzyme linked immunosorbent assay (ELISA), while CD4 count was done using flow cytometry. In the determination of concentration/value changes of parameters at baseline and follow up in HIV progression, only IgM, waist and hip circumference showed significant differences (p < 0.05) within the period under study. While in the determination of the effect of therapy on the subjects, significant differences (p < 0.05) were observed only in the values of CD4 count and BMI. While statistically significantly inverse relationship was observed between the CD4 counts and IgM concentrations, the values of IgG and IgA were inverse but not significant in relation to CD4 count. This study concluded that immunoglobulins (G, A and M) are not reliable in monitoring short term response to therapy unlike CD4 count although IgM has good diagnostic value like CD4 at baseline.