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IgG-2 deficiency
Jan 3, 2010

Hi Dr. Bob,

What you do on this site is greatly appreciated. I (27 years old, male) have a question for you and would be very delighted if you could answer it. As a kid I was diagnosed with an IgG deficieny of the subset 2. My IgG count was mostly between 400 and 500 so that I received gammaglobulin infusions (sandoglobulin) for a few years but that was stopped about 15-18 (I don't know exactly) years ago as I seemed not to have as many infections as I did before, so since then I would consider my health pretty normal and am not sick too often, even though I have the occasional cold or influenza. Unfortunately, I cannot say whether I still have that IgG-2-deficiency. My medicinal records don't give me any clue as to that, because for my doctors and parents back then the only important thing was that my overall health seemed to be quite stable without the gaamaglobulin infusions. I have now tested out to 12 weeks with EIA 1/2 (negative), but am unsure whether...

1.) I still have an asymptomatic IgG-2-deficiency (I don't know whether this is something that can "disappear" or cure itself at some point) and if yes, if... 2.) this could interfere with my HIV-tests (according to no adequate antibody reaction) so that my 12 week test is not conclusive and whoo-hooable.

I you consider it not conclusive because of a possible asymptomatic IgG-2-deficiency should I...

3.) retest with an antibody test at a later time, or... 4.) take some other kind of test?

Your thoughts about this are very much appreciated. Sorry for my english, but it is not my native language.

All the best to you. :-)

Response from Dr. Frascino

Hello,

1. It's possible IgG subclass deficiency can change over time. You are no longer getting frequent infections which could indicate your IgG2 levels have now improved. If you're unsure about your IgG2 status, have your doctor check your IgG subclass levels.

2. I strongly doubt your HIV-antibody test result would be affected, even with an IgG2 subclass deficiency. However, this has never been formally studied to my knowledge.

3. I would consider your negative 12-week test definitive. Taking another HIV-antibody test at a later date would not be warranted or helpful.

4. If you had significant IgG subclass deficiency and there was concern about your ability to make anti-HIV antibodies, you could get an HIV PCR test. (I recommend the qualitative HIV PCR DNA.)

Dr. Bob



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