IgE levels in pediatric HIV-1 infection

Background: Atopic symptoms such as sinusitis, eczema, and wheezing are common in human immunodeficiency virus (HIV)-infected children. Objective: To determine whether IgE levels are increased in HIV-seropositive children, and to determine whether there is a relationship between IgE, stage of disease, and atopic symptoms. Methods: Levels of serum IgE and parameters of HIV infection, including absolute CD4 and CD8 T lymphocyte counts, and serum levels of neopterin, β₂ microglobulin and HIV P24 antigen were measured. Clinical parameters including stage of disease, opportunistic infections, and atopic symptoms were recorded. Results: IgE was increased prior to 1 year of age and mean levels remained elevated through age 6 years but regressed to the normal mean in children ages 7 to 9. There was a strong association between increased IgE and the presence of secondary disseminated or systemic diseases including pulmonary lymphoid hyperplasia. Pneumocystis carinii pneumonia, or disseminated cytomegalovirus infection. There was no correlation between CD4 levels and IgE levels (r = .03). The relationship between IgE and serum P24 antigen, β₂ microglobulin, and neopterin levels was also analyzed. A weak positive correlation was found only with serum p24 antigen levels (r = .24). Atopic symptoms were found in a subpopulation of these children, with wheezing occurring in 27% of all patients, atopic dermatitis in 5%, drug reactions in 7% and sinusitis in 8% but IgE levels were not significantly elevated in patients with atopic symptoms. Conclusions: These findings demonstrate that serum IgE is increased in children very early after HIV infection and that IgE levels increase in association with HIV-associated systemic disease. Increased IgE is not associated with atopic symptoms in children.