EFFECT OF IVIG ON CIRCULATING IMMUNE COMPLEXES (CIC) IN PEDIATRIC AIDS/ARC

Abstract

CIC were studied by Raji cell assay in 23 patients with AIDS and ARC before and after IVIG. All patients had elevated CIC prior to initiative IVIG treatment. Patients were followed for an average of 20 months during which time they received biweekly infusions of Cutter IVIG, A significant reduction of CIC following IVIG was found in 13 patients, 2 of whom subsequently died during follow-up. In 10 other patients there was an increase of CIC after IVIG treatment. This group exhibited a mortality rate of 70%. There was a good correlation between elevated CIC and decreased antigenic and mitogenic responses, low T₄/T₈ ratio and evidence of viral infection with EBV, CMV and Herpes. Among those patients in whom CIC decreased following IVIG, 33% showed some restoration of mitogen induced proliferation. In contrast, the group that had increased CIC showed no such improvement. No correlation between the level of serum IgG and M and CIC-IgG and CIC-IgM was found and no uniform differences in CIC-IgG or CIC-IgM were observed after IVIG. The mean concentration of IgG and IgM in CIC was 54mg% and 32mg% respectively. After treatment with IVIG the molecular weight of the CIC had decreased from a pre IVIG level of 2 million.

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