Defective B-lymphocyte function in homosexual men in relation to the acquired immunodeficiency syndrome.

Patients with the acquired immunodeficiency syndrome manifest a wide spectrum of immunologic abnormalities. Polyclonal and antigen-specific differentiation of B lymphocytes into immunoglobulin- and antibody-secreting cells was studied in vitro in three groups of homosexual volunteers: asymptomatic men; men who were symptomatic but lacked clinical criteria for the acquired immunodeficiency syndrome; and those having the syndrome. Although mean responses of all three groups were significantly lower than those of healthy heterosexual male controls, those of the asymptomatic group were least affected. Abnormalities in the symptomatic group were equal to or greater than those of patients with the syndrome, but responses of the latter group were the least augmentable by in vitro manipulations. Severe impairment of B-cell function appeared to favor clinical deterioration. Antibody replenishment might be of value as adjunctive therapy in persons with the acquired immunodeficiency syndrome or as prophylaxis in certain at-risk persons.