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IGG2-subclass deficiency (UPDATE) (IgG SUBCLASS DEFICIENCY, 2010)
Jan 26, 2010

Hi Dr. Frascino,

I had a blood exam which showed my overall IgG level to be quite low, but still normal: 704 (normal range 700-1600). However, it turned out that I now don't only have a IgG2-subclass-deficiency, but a combined IgG2- and IgG4-subclass deficiency. My igG2 is 0,1 (normal value should be 1,89 and +), and my IgG4 to be even lower: 0,01 (normally should be 0,45 and +). My question to you ist whether I still can take my 12,5 week HIV-Duo-test to be conclusive. I'm hoping so much that it is because this uncertainty is cracking my nerves.

I am eagerly awaiting your answer. The Dude.

Response from Dr. Frascino

Hey Dude,

Here's the scoop on your IgG subclass deficiency and my take on your negative 12.5-week HIV test.

IgG2 is the most common IgG subclass deficiency and may also be associated with IgA deficiency. It usually causes recurrent respiratory tract infections in children.

IgG4 deficiency may be associated with IgG2 (and IgA) deficiency. (This occurs in a disease called ataxia telangiectasia). It can increase susceptibility to respiratory tract infections.

I would assume your 12.5-week HIV Duo Test is accurate, because IgG1 is the most abundant of the four IgG subclasses and it provides the largest immune response. It also is the dominate immune response to protein/polypeptide antigens (this would include HIV).

As I previously mentioned, if you or your doctor are still worried about the validity of your HIV-antibody test, you could get a qualitative HIV DNA PCR test, as this assay is not antibody dependent. Personally I don't feel it's warranted, but it is available.

Dr. Bob



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