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Comparative Study
. 2024 Apr 4;62(10):2024-2029.
doi: 10.1515/cclm-2023-1018. Print 2024 Sep 25.

IgG and kappa free light chain CSF/serum indices: evaluating intrathecal immunoglobulin production in HIV infection in comparison with multiple sclerosis

Lars Hagberg  1   2 , Igal Rosenstein  2   3 , Jan Lycke  2   3 , Henrik Zetterberg  2   4   5   6   7   8 , Aylin Yilmaz  1   2 , Arvid Edén  1   2 , Magnus Gisslén  1   2   9
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Free article
Comparative Study

IgG and kappa free light chain CSF/serum indices: evaluating intrathecal immunoglobulin production in HIV infection in comparison with multiple sclerosis

Lars Hagberg et al. Clin Chem Lab Med. .
Free article

Abstract

Objectives: To study intrathecal kappa free light chain (KFLC) synthesis in people living with HIV (PLWH) in comparison with multiple sclerosis (MS).

Methods: Cross-sectional analysis including 56 untreated and 150 well treated PLWH, and compared with 58 controls, and 223 MS patients.

Results: 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.

Conclusions: 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.

Keywords: HIV; MS diagnosis; cerebrospinal fluid; intrathecal immunoglobulin; kappa free light chain; multiple sclerosis.

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