Document 2373
 DOCN  M94A2373
 TI    Prognostic markers of immune decline in the case of a HIV-1 infected man
       with a pre-existing autoimmune disorder.
 DT    9412
 AU    Douvas A; Takehana Y; Ehresmann G; Univ. of Southern Calif. School of
       Med. Los Angeles.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(1):319 (abstract no. PC0208). Unique
       Identifier : AIDSLINE ICA10/94370202
 AB    OBJECTIVE: We tested the hypothesis that a pre-existing autoimmune
       disorder, which mimics early HIV-1 infection, provides immunologic
       markers prognostic of a decline in CD4+ T lymphocytes. METHODS: We have
       established that the autoimmune disorder mixed connective tissue disease
       (MCTD) mimics early HIV-1 infection in several respects. In particular,
       there is structural homology between the autoimmune antigen 70K (a RNA
       splicing protein) and gp120/41. This results in cross-reactivity between
       anti-70K antibodies and gp120/41. Conversely, HIV-1(+) sera cross-react
       with 70K. Here we present a longitudinal study of a 43 year old man,
       patient M, with a 27-year history of MCTD, who became HIV infected
       between 7/85 and 10/86. Sera from 1981 to 1994 were analyzed for
       reactivity to HIV-1 by ELISA and WB, and for reactivity to gp120, gp41
       and the V3 loop (both IIIB and MN strains) by ELISA. Analysis of
       reactivity to 70K was performed by ELISA and WB. The data were
       correlated with CD4+ T lymphocyte counts. Single serum samples from 12
       HIV-1 infected men with no pre-existing autoimmunity were analyzed for
       comparison. RESULTS: Between 10/86 (date of seroconversion) and 6/87,
       patient M's 70K WB declined to 47% of the 1981 level, with no changes in
       other immunologic parameters. Between 6/87 and 5/89, the 70K ELISA
       further declined 2.1 fold while CD4 counts were stable at 504 and 543,
       respectively. In 3/93, the 70K WB was 12.5% of the 1981 level (CD4 count
       = 268). All HIV-1 ELISA values remained unchanged between 1986 and 1994
       except for the V3 IIIB ELISA, which declined between 5/89 and 12/93 to
       33% of maximal value. The 12 HIV-1 infected controls were positive in
       all immunologic tests, including 70K ELISA and WB. CONCLUSIONS: A rapid
       decline in reactivity to 70K in the serum of patient M (to 47% of
       maximum) occurred less than one year from diagnosis of HIV(+) status. A
       further decline to 22% of maximum occurred in 5/89. CD4 counts remained
       stable in the 500 range between 7/87 and 12/92. These data suggest that
       a decline in 70K reactivity in all HIV-1(+) sera, may precede the
       decline in CD4+ T cells by months to years.
 DE    Adult  Autoantigens/IMMUNOLOGY  Autoimmune
       Diseases/*COMPLICATIONS/IMMUNOLOGY  Enzyme-Linked Immunosorbent Assay
       Human  HIV Antibodies/ANALYSIS  HIV Infections/COMPLICATIONS/*IMMUNOLOGY
       HIV Seropositivity  *HIV-1/IMMUNOLOGY  Leukocyte Count  Male  Mixed
       Connective Tissue Disease/*COMPLICATIONS  Prognosis  T4 Lymphocytes
       MEETING ABSTRACT

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