Characterization of immunologic function in homosexual men with persistent, generalized lymphadenopathy and acquired immune deficiency syndrome.

A syndrome of persistent, generalized lymphadenopathy (PGL), related to the acquired immune deficiency syndrome (AIDS), has been described in homosexual men. To further characterize and correlate the immunologic status of patients with PGL with those in AIDS, we studied spontaneous and pokeweed mitogen (PWM)-induced IgG synthesis by B-cells, T-cell subsets in peripheral blood (PB), natural cytotoxicity (NC), and Interleukins (IL)-1 and IL-2 production in 39 homosexual patients (21 PGL; 13 AIDS; five asymptomatic homosexual men), in whom 32 of 35 tested (91%) had antibodies to human T-lymphotropic virus-III (HTLV-III). A profound abnormality in B-cell function was found in AIDS and PGL, consisting of high spontaneous IgG production, with paradoxic suppression of IgG synthesis after PWM. IL-2 values were more often low in AIDS when compared with PGL (P less than 0.001). The PB lymphocyte count was normal in PGL and reduced in AIDS (P less than 0.001). OKT4 "helper" cells were decreased in PGL, but even lower in AIDS (P less than 0.001), while OKT8 "cytotoxic/suppressor" cells were normal in AIDS and increased in PGL (P less than 0.01). The T4:T8 ratio was reversed in both, but more abnormal in AIDS (P less than 0.001). A decrease in NC killing was observed in AIDS when compared with heterosexual controls. Thus, patients with PGL and AIDS both demonstrate a spectrum of immunologic dysfunction, involving the cellular and humoral arms of the immune system.