February 20, 1987

HIV-Related Oligoclonal Paraproteinemia

Author Affiliations

The Lankenau Hospital Philadelphia

The Lankenau Hospital Philadelphia

JAMA. 1987;257(7):927-928. doi:10.1001/jama.1987.03390070047014

To the Editor.—  Kouns et al1 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