Department of Infectious Diseases, 70712 Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg , Gothenburg, Sweden.
Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Clin Chem Lab Med. 2024 Apr 4;62(10):2024-2029. doi: 10.1515/cclm-2023-1018. Print 2024 Sep 25.
To study intrathecal kappa free light chain (KFLC) synthesis in people living with HIV (PLWH) in comparison with multiple sclerosis (MS).
Cross-sectional analysis including 56 untreated and 150 well treated PLWH, and compared with 58 controls, and 223 MS patients.
Elevated serum/cerebrospinal fluid (CSF) IgG and KFLC indices were observed in untreated PLWH. Seventy percent of untreated PLWH had KFLC index above 6.1, a threshold associated with clinically isolated syndrome/MS diagnosis. No association was found between KFCL index and CSF markers of neuronal injury in either PLWH or MS patients.
HIV-related immune system dysfunction is often associated with an elevated KFLC index akin to those observed in MS. HIV infection should be considered as a differential diagnosis for patients presenting with neurological symptoms and increased intrathecal immunoglobulin synthesis.
研究人类免疫缺陷病毒（HIV）感染者（PLWH）与多发性硬化症（MS）患者相比，鞘内κ 游离轻链（KFLC）合成情况。
纳入 56 例未经治疗和 150 例治疗良好的 PLWH，与 58 例对照和 223 例 MS 患者进行横断面分析。
未经治疗的 PLWH 存在血清/脑脊液（CSF）IgG 和 KFLC 指数升高。70%未经治疗的 PLWH 的 KFLC 指数高于 6.1，这是与临床孤立综合征/ MS 诊断相关的阈值。在未经治疗的 PLWH 或 MS 患者中，均未发现 KFCL 指数与 CSF 神经元损伤标志物之间存在相关性。
HIV 相关免疫系统功能障碍常与 KFLC 指数升高有关，类似于 MS 中观察到的情况。对于出现神经症状和鞘内免疫球蛋白合成增加的患者，应考虑 HIV 感染作为鉴别诊断。
