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Delayed-type hypersensitivity testing in Tanzanian adults with HIV infection
W C Miller1, N M Thielman, N Swai
1Duke University Medical Center, Durham, North Carolina, USA.
Summary
Delayed-type hypersensitivity (DTH) testing and lymphocyte counts effectively assess immune function in HIV patients in Tanzania. These inexpensive tests can help predict HIV infection and monitor disease progression.
Area of Science:
- Immunology
- Infectious Diseases
- Public Health in Africa
Background:
- Cell-mediated immune function is crucial in managing HIV disease.
- Assessing immune status in resource-limited settings like Tanzania presents unique challenges.
- Delayed-type hypersensitivity (DTH) testing and total lymphocyte counts are established measures of immune function.
Purpose of the Study:
- To evaluate the utility of DTH testing and total lymphocyte counts for assessing immune function in HIV-seropositive and HIV-seronegative patients in Dar es Salaam, Tanzania.
- To determine if these measures correlate with HIV disease severity.
- To identify if DTH testing and lymphocyte counts can predict HIV infection.
Main Methods:
- A cohort of 201 medical patients in Dar es Salaam underwent DTH testing using the Multitest CMI device, assessing reactivity to seven antigens.
- Total lymphocyte counts were measured for all participants.
- Patients were categorized as HIV-seropositive (n=90) or HIV-seronegative (n=111), and HIV disease stage was assessed.
Main Results:
- Anergy (lack of DTH reaction) was significantly more prevalent in HIV-seropositive patients (43.3%) compared to HIV-seronegative patients (15.3%).
- DTH reactivity, including the number of positive antigens and induration size, correlated significantly with HIV clinical stage.
- Median total lymphocyte counts were lower in HIV-seropositive patients (1,130 cells/µL) versus HIV-seronegative patients (1,680 cells/µL), decreasing with disease severity.
- Multivariable analysis indicated that the number of positive DTH antigens and lymphopenia were significant predictors of HIV infection.
Conclusions:
- DTH testing and total lymphocyte counts are valuable and cost-effective tools for evaluating immune function in African patients with HIV.
- These tests can aid in diagnosing HIV infection and monitoring disease progression in resource-limited settings.
- The findings support the integration of DTH testing and lymphocyte counts into routine patient care for HIV management in Tanzania.