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Found low IgG1 and IgG3. Had joint and chest pain. Having constant lung infections. Could this be HIV or CMV?

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HIV AIDS Specialist
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Been Sik for 5 years, finally they found low IgG1 and very low IgG3

Have had joint and chest pain and been ill for a long time, lung infections are constant...could thi be HIV or CMV
Posted Thu, 22 Aug 2013 in HIV and AIDS
Answered by Dr. S. Murugan 50 minutes later
Welcom to XXXXXXX

Thanks for posting your query.

Ig G levels in both infections of HIV and CMV will be raised and not decreased.
Both viral infections are known to affect the Cell Mediated Immunity. To overcome this effect, as compensatory measure body's humeral immunity will be increased. So IgG levels also will be increased.
So you condition is unlikely to be due either HIV or CMV.
Low levels of IgG may be due to Prednisolole which you are on already.
To confirm the same, you can go for blood test for HIV and CMV and confirm the same.
Get well soon.
Dr S.Murugan
Above answer was peer-reviewed by
Follow-up: Found low IgG1 and IgG3. Had joint and chest pain. Having constant lung infections. Could this be HIV or CMV? 6 hours later

Thanks for your quick response - you have no Idea how much I appreciate it, for 8 years now I have been seeing doctors and trying to get answers for chest pain and cough.

My second or third respiratory doctor noticed I had reduced immuno numbers but did nothing, I eventually went and saw an immunologist, and she did a lot of bloods, apparently she missed the result for the Serum IgG Subclasses, and my latest respiratory guy found it in my history and confirmed it again today.

I had a test already and am CMV IgG Positive but not HIV - still waiting on Antibody Titre then Intragram assesment (I have no idea what those last two are could you explain) - been in hospital with Influenza A and Heomopholus Influenza (spelling) and coughing up blood, they did a lot of tests and biopsies as they were expecting Sarcoid, but they didnt find it.

My IgG results are below, can you explain them to me

Total IgG 5.3
IgG1 3.2
IgG2 1.6
IgG3 0.09
IgG4 0.15

I have an enlarged spleen as well

I am pretty unsure what all this means and would like to know the likely future plan, I am not scared to die, so you can be blunt with me, to be honest the only issue I have is I want to be sure that there is not a sexually transmittble disease that can cause this, I would hate to have made my partner sick too, and she has the same chest pain around the spleen as I have - ironically the person before us in the unit also fell sick?

When they admitted me they had to pump me full of steroids - because my lungs were full of puss and blood and inflamation - so I dont know if this affects the test

My spleen is 14cm - not sure what else I can tell you but I assume I will soon see a heamatologist and Immunologist, I can buy 3 weeks off work, but is this more serious, they are talking about a monthly IV antibiotic - the CMV would have been with me for quite a few years probably something like 7 untreated...I am allergic to penacillan
I had a course of Methotrexate and prednisone many years ago as they thought I had an overactive immune system (how ironic) but this all started after two things.

1/ I had some antiretoroviral drugs for 2 weeks after exposure to a suspected HIV carrier
2/ I cant help but think this all started when I got an immunisaton before I went Overseas in 2008 - everything went down hill from there
Answered by Dr. S. Murugan 21 minutes later

Welcome back.

You are HIV negative but CMV positive.
CMV positive is such a common phenomena that anybody can have. It usually would not manifest or cause any symptoms. It would go as a sub-clinical infection and nothing to bother about the same. Ig G indicates a past infection and not a fresh infection. That is, it came and healed. It can acquired through sexual route also. Only in immuno-compromised individual it will manifest as a disease and needs treatment.

But in your case, as you already had prednisolone and Methotraxate which might have decreased your immunity and you may likely to manifest the disease with spleen and lymph node enlargement.
So follow your physician's advice, you will be alright.
Regarding your lung problem and the results of serum sub-classes of immunoglobulin you will have to consult a pulmonologist and immunologist. They will be in a position to give you correct explanation. I am not the right person to comment about the same.
Dr S.Murugan

Above answer was peer-reviewed by
Follow-up: Found low IgG1 and IgG3. Had joint and chest pain. Having constant lung infections. Could this be HIV or CMV? 15 hours later
Thanks Doc, last three questions

1/ I was given anti retrovirals in Thailand - my problems started after this - I dont know the name of the drug but I would know if someone said its name, they were orange rubbery pills that had to be kpt in the fridge at all times - I took a 3 week course - could this have caused my issue my doctor is saying I have CVID - how serious is this?

2/ I also had a vaccine for measles at the same time - could this have caused issues with my blood?

3/ Is there any sexually transmitted diseases that I could have caught that can cause the low IgG levels - I can handle a shortened life - but if I have done anything to my Girlfriend I dont know how I would cope
Answered by Dr. S. Murugan 2 hours later

Welcome back.

I can assure you that your immune deficiency or fall in levels of immunoglobin is not due to the ART prophylaxis or due to measles vaccination. We had come across so many patients taking ART as prophylaxis or as a treatment for years together. Similarly millions are undergoing measles vaccination. So far such side effects were not reported. Similarly no other sexually transmitted infection also would not produce such a condition.
As your physician said that it could be genetically acquired one. Not to worry about STD/HIV.
Take care of yourself as per the guidance of your physician's word.
Wish you a speedy recovery.
Dr S.Murugan
Above answer was peer-reviewed by
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