Question

how does Hypogammaglobulinemia influence the outcome of the patient's HIV IgG ELISA

name three factors regarding a patient that would influence the outcome of their HIV IgG ELISA and explain why these factors are important to the outcome

Answer 1

: Hypogammaglobulinemia is an immunological problem in which gamma globulin antibodies are produced in very low amount/level in blood circulation. This type of conditions can be seen in common variable immunodeficiency (CVID) or in the cases where the deficiency of B cells or the deficiency of CD40/CD40L (CD154) is/are present. In most of the viral infection immunoglobulin (IgG) level increased and sustain for few months after the clearance of infection. This increased level of IgG antibody used for the diagnosis of different types of viral infection. In case of HIV infection the increased level of IgG post HIV infection can also be used for the diagnosis of the disease but due to Hypogammaglobulinemia condition IgG antibody is not produced and false negative result of HIV infection can be reported.

            Factors responsible for the development of Hypogammaglobulinemia are:

1) Use of immunosuppressive drugs (especially Rituximab; the drug that elimainate the B cells that is producer of immunoglobulin)

2) Presence of common variable immunodeficiency (CVID): means lack of immune cells especially B cells

3) Lack of costimulation of B cells CD40/CD40L (CD154) which is essential for the generation of immunoglobulins.