Fc gamma RIIa polymorphism in human immunodeficiency virus-infected children with invasive pneumococcal disease

Invasive pneumococcal disease (IPD) occurs frequently in HIV-infected children and adults. Defects in complement func tion, opsonic capsular antibodies, and Fc receptor antibody mediated phagocytosis could contribute to impaired host defense against Streptococcus pneumoniae. The objective of this study was to define the distribution of the three Fc gamma RIIa genotypes in HIV+ children, including those with IPD. Forty-eight HIV+ Hispanic children, including eight with IPD, followed at Bronx-Lebanon Hospital Center, Bronx, New York, nine HIV+ adults with IPD, and 56 HIV- Hispanic control subjects were studied. The children and adults were identified retrospectively except for one child who developed TPD during the study. Fc gamma RIIa genotypes were determined by PCR amplification of the Fc gamma RIIa locus from genomic DNA samples and hybridization of the PCR products with allele-specific oligonucleotides. Naturally occurring serum antibodies reactive with four pneumococcal polysaccharide serotypes were determined by ELISA in seven of eight children with IPD. There were no statistical differences in Fc gamma RIIa genotypes between HIV+ children with and without IPD, HIV+ adults with IPD, or HN-Hispanics. The predominant IgG subclass of pneumococcal polysaccharide binding antibodies in the seven HIV+ children with IPD studied was IgG,. The distribution of Fc gamma RIIa genotypes in HIV+ children with and without IPD is similar to that of the normal Hispanic population. The prospect of passive immunotherapy with specific anticapsular antibodies might be a promising alternative for the treatment and/or prevention of IPD in HIV+ children and other immunodeficient groups.