Exposure of cryptantigens on red blood cell membranes in patients with acquired immune deficiency syndrome or AIDS-related complex.

Patients with acquired immune deficiency syndrome (AIDS) or AIDS-related complex (ARC) are subject to recurrent and severe infections due to organisms known to cause red blood cell membrane modifications. These red cell modifications include the exposure of novel carbohydrate cryptantigens that can react with naturally occurring antibodies and potentially result in hemolysis. We examined the frequency of cryptantigen exposure on the surface of red cells from AIDS/ARC patients. Blood samples from 108 patients with AIDS/ARC and from 65 non-AIDS/ARC patients were tested for most common forms of cryptantigens. The lectin Arachis hypogaea agglutinated red cells from 7% (8/108) of the AIDS/ARC patients and 3% (2/65) of non-AIDS/ARC patients, indicating the presence of T, Tk, or Th cryptantigen exposure. One sample from an AIDS patient with E. coli sepsis had T activation with polyagglutinable red cells. None of the samples showed evidence of exposed Tn or acquired B antigens. These results show that red cell cryptantigen exposure does occur in AIDS patients with a prevalence similar to that previously reported in patients with sepsis or malignancy. For this reason, and because polyagglutination has been associated with in vivo hemolysis, cryptantigen exposure should be considered in the differential diagnosis in AIDS patients with suspected immune hemolysis; it can be tested for by performing a minor crossmatch with ABO compatible serum.