Human immunodeficiency virus infection induces both polyclonal and virus-specific B cell activation

Peripheral blood lymphocytes (PBL) were obtained from HIV-1-infected patients at different stages of disease. The absolute number of IgM-, IgG-, and IgA-producing lymphocytes per 106 PBL was increased 2.8-, 3.4-, and 1.9-fold, respectively, com-pared with normal controls. 2-17 % of IgG-secreting patient cells reacted with the gpl60 envelope glycoprotein of HIV-1 (a 737-fold increase over background), while 1-9 % reacted with p24 (140-fold over background). In addition to this HIV-speci-fic B cell activation, the number of lymphocytes reactive with nonviral antigens such as DNA, myosin, actin, trinitrophenyl-ated keyhole limpet hemocyanin, and ovalbumin was increased by a mean of 17.9-fold. Evidence suggests that the latter changes reflect an HIV-induced polyclonal B cell activation unrelated to the production of anti-HIV antibodies. For exam-ple, the proportion of IgG anti-gpl6O- and anti-p24-secreting lymphocytes declined in patients with advanced disease, whereas the number of B cells producing antibodies to non-HIV antigens rose. Moreover, CD4 cell count and T4/T8 ratio showed a significant inverse correlation with the degree of poly-clonal activation but not with anti-HIV responsiveness. These observations demonstrate that both quantitative and qualitative changes in B cell activation accompany (and may be predictive of) disease progression in HIV-infected individuals. (J. Clin