HIV-Related Oligoclonal Paraproteinemia

Abstract

To the Editor.— Kouns et al 1 recently reported the presence of oligoclonal banding in the serum of patients with antibody to the human immunodeficiency virus (HIV). They state that such a finding is rare in other patients and suggest demonstration of oligoclonal banding as a surrogate test for HIV exposure. Although the association between oligoclonal banding and antibody to HIV is an interesting one, I do not believe that the authors' suggestion of oligoclonal banding as a diagnostic test is valid. Oligoclonal banding in serum is not rare. Small homogeneous bands in the γ-globulin region, often multiple, can be detected by high-resolution agarose gel electrophoresis in the serum of a substantial number of hospitalized patients. 2 The bands occur most commonly (62%) in patients with an increased γ-globulin concentration and with an acute-phase response. The presence of such bands does not correlate with age, sex, or medical diagnosis; it