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. 2003 Nov;62(11):1106–1111. doi: 10.1136/ard.62.11.1106

Anticardiolipin, anti-ß2-glycoprotein I and antiprothrombin antibodies in black South African patients with infectious disease

S Loizou 1, S Singh 1, E Wypkema 1, R Asherson 1
PMCID: PMC1754364  PMID: 14583576

Abstract

Objectives: To investigate IgG, IgM, and IgA, antiphospholipid antibodies (aPL), against cardiolipin (aCL), ß2-glycoprotein I (anti-ß2GPI), and prothrombin (anti-PT), in black South African patients with infectious disease. Unlike patients with systemic lupus erythematosus (SLE) and the antiphospholipid syndrome (APS), raised levels of aPL in infectious diseases are not usually associated with thrombotic complications.

Patients and methods: Serum samples from 272 patients with a variety of infectious diseases (100 HIV positive, 112 leprosy, 25 syphilis, 25 malaria, and 10 HCV patients) were studied and compared with autoantibody levels in 100 normal controls. All three aPL were measured using commercial enzyme linked immunosorbent assay (ELISA) kits.

Results: Raised levels of all thee aPL were found in all patient groups studied: aCL in 7%, anti-ß2GPI in 6%, and aPT in 43% of 100 HIV patients, in 29%, 89%, and 21% of 112 patients with leprosy, in 8%, 8%, and 28% of 25 patients with syphilis, in 12%, 8%, and 28% of 25 patients with malaria, and in 20%, 30%, and 30% of 10 HCV patients studied, respectively.

Conclusions: The prevalence of aCL and anti-ß2GPI in black South African HIV positive patients, or those with syphilis, malaria, or hepatitis C virus is lower than reported for mixed race or white populations. aPT were the most prevalent aPL detected in these patient groups, except in patients with leprosy, for whom anti-ß2GPI was the most prevalent, and where the spectrum of aPL was similar to that seen in patients with SLE and APS.

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Figure 1 .

Figure 1

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IgG aCL, anti-ß2GPI and aPT antibody levels in normal controls (NC) and in patients with HIV, leprosy (Le), syphilis (Sy), malaria (Ma), hepatitis C (HC). The upper limit of normal, set at 5SD above the mean level of the normal controls, was 16 GPL for aCL, 6.7 AEU for anti-ß2GPI, and 13.8 AEU for aPT.

Figure 2 .

Figure 2

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IgM aCL, anti-ß2GPI, and aPT antibody levels in normal controls (NC), and in patients with HIV, leprosy (Le), syphilis (Sy), malaria (Ma), hepatitis C (HC). The upper limit of normal set at 5SD above the mean level of the normal controls, was 9.6 MPL for aCL, 4.5 AEU for anti-ß2GPI, and 16 AEU for aPT.

Figure 3 .

Figure 3

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IgA aCL, anti-ß2GPI, and aPT antibody levels in normal controls (NC), and in patients with HIV, leprosy (Le), syphilis (Sy), malaria (Ma), hepatitis C (HC). The upper limit of normal set at 5SD above the mean level of the normal controls, was 8.7 APL for aCL, 4.6 AEU for anti-ß2GPI, and 13.5 AEU for aPT.

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