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Delayed-type hypersensitivity skin testing predicts progression to AIDS in HIV-infected patients
S P Blatt1, C W Hendrix, C A Butzin
1Wilford Hall U.S. Air Force Medical Center, San Antonio, Texas.
Annals of Internal Medicine
|August 1, 1993
Summary
Delayed-type hypersensitivity (DTH) skin testing predicts AIDS progression in HIV-infected individuals. A positive DTH response indicates better cellular immunity and a lower risk of developing AIDS.
Area of Science:
- Immunology
- Infectious Diseases
- HIV/AIDS Research
Background:
- Human immunodeficiency virus (HIV) infection impairs cellular immunity.
- Assessing immune function is crucial for predicting disease progression in HIV-infected individuals.
Purpose of the Study:
- To determine the prognostic value of cutaneous delayed-type hypersensitivity (DTH) skin testing in individuals with HIV.
- To evaluate DTH skin test responses as a predictor of progression to acquired immunodeficiency syndrome (AIDS).
Main Methods:
- A cohort study of 889 HIV-infected personnel and dependents was conducted.
- Patients underwent DTH skin testing with multiple antigens and CD4+ T-cell counts.
- Kaplan-Meier survival analysis was used to assess the relationship between DTH response and progression to AIDS.
Main Results:
- Higher CD4+ T-cell counts correlated with positive DTH skin test responses.
- Anergy (lack of response) and single positive DTH responses were associated with increased risk of AIDS progression.
- DTH skin test response independently predicted progression to AIDS, even after controlling for CD4 count and disease stage.
Conclusions:
- Cutaneous DTH skin testing serves as a functional measure of cellular immunity.
- DTH skin test response is an independent prognostic indicator for AIDS progression in individuals with HIV.
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