Elevated Cerebrospinal Fluid Anti-CD4 Autoantibody Levels in HIV Associate with Neuroinflammation

Da Cheng, Zhenwu Luo, Xiaoyu Fu, Sophie Stephenson, Clara Di Germanio, Philip J. Norris, Dietmar Fuchs, Lishomwa C. Ndhlovu, Quan Zhen Li, Henrik Zetterberg, Magnus Gisslen, Richard W. Price, Shifang Peng, Wei Jiang

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


The mechanisms of persistent central nervous system (CNS) inflammation in people with HIV (PWH) despite effective antiretroviral therapy (ART) are not fully understood. We have recently shown that plasma anti-CD4 IgGs contribute to poor CD41 T cell recovery during suppressive ART via antibody-mediated cytotoxicity (ADCC) against CD41 T cells, and that plasma anti-CD4 IgG levels are associated with worse cognitive performance and specific brain area atrophy. However, the role of anti-CD4 IgGs in neuroinflammation remains unclear. In the current study, plasma and cerebrospinal fluid (CSF) samples from 31 ART-naive and 26 treated, virologically suppressed PWH, along with 16 HIV-seronegative controls, were evaluated for CSF levels of antiCD4 IgG, white blood cell (WBC) counts, soluble biomarkers of neuroinflammation, and neurofilament light chain (NfL). We found that 37% of the PWH exhibited elevated CSF anti-CD4 IgG levels, but few or none of the PWH were observed with elevated CSF antiCD4 IgM, anti-CD8 IgG, or anti-double-strand DNA IgG. CSF anti-CD4 IgG levels in PWH were directly correlated with neuroinflammation (WBC counts, neopterin, and markers of myeloid cell activation), but not with CSF NfL levels. Using cells from one immune nonresponder to ART, we generated a pathogenic anti-CD4 monoclonal IgG (JF19) presenting with ADCC activity; JF19 induced the production of soluble CD14 (sCD14) and interleukin-8 (IL-8) in human primary monocyte-derived macrophages via CD4 binding in vitro. This study demonstrates for the first time that elevated CSF anti-CD4 IgG levels present in a subgroup of PWH which may play a role in neuroinflammation in HIV. IMPORTANCE This study reports that an autoantibody presents in the CNS of HIV patients and that its levels in the CSF correlate with some markers of neuroinflammation.

Original languageEnglish (US)
Article numbere01975-21
JournalMicrobiology Spectrum
Issue number1
StatePublished - Feb 2022
Externally publishedYes


  • Anti-CD4 IgG
  • Anti-CD4 autoantibody
  • Cerebrospinal fluid
  • HIV
  • HIV-1 infection
  • Neuroinflammation

ASJC Scopus subject areas

  • Physiology
  • Ecology
  • Immunology and Microbiology(all)
  • Genetics
  • Microbiology (medical)
  • Cell Biology
  • Infectious Diseases


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