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Just diagnosed with IgG deficiency
Jul 29, 2009

Hi Doctor. Im hiv negative with a negative partner, but Im looking for some guidance from an expert since Ive just been diagnosed with a condition my doctor called immunoglobulin subclass deficiency. Is this basically the same thing as CVID? Ive been in a monogamous relationship with my partner for over ten years and, to the best of my knowledge, my only hiv exposures were with a pos partner about a year before that. Happily, we always used a condom, but just to be safe I got tested after the relationship ended and the results were negative.

Can I still trust my negative antibody test results? Here are the numbers from my Ig tests: IgG1 407, IgG2 429, IgG3 15, IgG4 22. IgA, IgM, etc. were all close to the middle of normal range. For what its worth I was positive for Epstien Barr (dont know why the doctor ran that test), and was negative (again) for hiv. My doctor says I have a problem making antibodies, which explains my long history of various infections. Ive always known that I get sick more often than normal people (lots of problems when I was a kid, such as encephalitis, pneumonia, etc.) and now I guess I know why.

He wants me to come in again for some more blood work, which of course Ill do, but Im just not comfortable talking about anything hiv related with him (friend of the family). So I'll ask you instead and hope for the best!

1. Because of my condition, are my hiv antibody test results still valid, or are they worthless? 2. How can I test positive for EB virus if I dont make antibodies? 3. With my IgG deficiency, wouldnt I have some pretty serious symptoms by now if I got hiv over a decade ago?

I see in the archives that you recommend CVID patients get tested with a qualitative hiv test, but I have no idea how Im going to ask my doctor for that. It would be much easier on me if I could simply rely on my two negative antibody tests.

Thanks so much for your time!

Response from Dr. Frascino

Hi,

IgG subclass deficiency is not the same thing as common variable immunodeficiency disease (CVID). Yes, you can still trust your negative HIV-antibody test results from a decade ago!

Responding to your specific questions:

1. They remain valid.

2. You make plenty of antibodies! You just don't make a particular subset (subclass) of a particular type of antibody called IgG. This can predispose you to certain infections, particularly bacterial infections.

3. Yes.

4. Qualitative HIV PCR DNA testing is not warranted.

Dr. Bob



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