Acquired Immunodeficiency via Autoimmunity: a new AIDS epidemic?

The authors of a recent study in the New England Journal of Medicine (N Engl J Med 2012;367:725-734) screened for autoantibodies against a series of germane immunological cytokines in a set of severely immunodeficient adult patients in Thailand and Taiwan. The patients were selected based on the presence of various stages of opportunistic infection but not HIV. Notably, neutralizing anti-interferon-γ autoantibodies were detected in 88% of adults with multiple opportunistic infections and were associated with an adult-onset immunodeficiency akin to that of advanced HIV infection. The applicability of these results to non-Asian populations has not yet been determined, but these findings certain open up new possibilities for the etiology of acquired immunodeficiency. These results also raise interesting strategies for treatment of this new disease complex.