Plasmapheresis followed by immunoglobulin infusion for treatment of human immunodeficiency virus (HIV) infected patients with hypergammaglobulinaemia

AIDS patients often develop a conspicious although functionally ineffective hypergammaglobulinaemia. The authors have treated nine patients affected by AIDS or AIDS-related diseases with repeated courses of plasma exchange coupled with immunoglobulin infusions. The schedule of each course was as follows: one apheretic treatment once a week for 5 consecutive weeks; each treatment amounted to an average exchange of 3,000 ml of plasma, replaced by plasma/protein and 5% albumin/physiological saline solutions, and was followed by infusion of 15 g of human immunoglobulins. Each apheretic course was completed with further weekly administrations of the same amount of human immunoglobulins. Following treatment, a fast cessation of fever, weight gain and an overall clinical amelioration with decrease of infections, asthenia and anorexia were noted. Haematological, serological and immunological parameters (particularly IgG serum levels) significantly improved after treatment, too.