Selective alterations of the antibody response to HIV-1

HIV infection leads to progressive alterations of humoral immune functions, including B-cell hyperplasia, hypergammaglobulinemia, elevated autoantibody titers, a poor response to neoantigens and mitogens, polyclonal B-cell activation, monoclonal gammopathies, and a significant deterioration of the antigen-specific humoral response. There is also an important isotypic imbalance of the antibody (Ab) response in the systemic compartment and a profound modification of mucosal immune functions. These abnormalities may contribute to disease progression and development of opportunistic infections, despite the presence of serum-neutralizing anti-HIV Abs. Equally important are the abnormal selection mechanisms of the Ab repertoire that seem to be responsible for B-cell clonal deletions. The V_H3 gene family, which encodes for approx 50% of immunoglobulins expressed by peripheral B-cells from normal adults, is underrepresented in human monoclonal antibodies to HIV-1 and in the peripheral B-cells of AIDS patients. These abnormalities, together with features of germinal center alteration, could be responsible for the clonal elimination of a subset of B-cells, and could contribute to HIV pathogenesis.