Delayed-type hypersensitivity skin testing in human immunodeficiency virus-infected pediatric patients

Area of Science:

• Immunology
• Pediatric Infectious Diseases
• Cellular Immunity

Background:

• Pediatric human immunodeficiency virus (HIV) infection can impact immune function.
• Delayed-type hypersensitivity (DTH) is a measure of cell-mediated immunity.
• Assessing DTH responses in HIV-infected children is crucial for understanding immune status.

Purpose of the Study:

• To determine if HIV-infected children can elicit DTH skin responses to recall antigens.
• To investigate the correlation between DTH responses and clinical/immunologic parameters in pediatric HIV.
• To compare DTH responsiveness in HIV-infected children versus uninfected controls.

Main Methods:

• Prospective evaluation of DTH skin test responses in HIV-infected children and uninfected controls.
• Yearly testing using recall antigens including Candida albicans, mumps virus, Trichophyton, purified protein derivative of tuberculin, and tetanus toxoid.
• Clinical staging (CDC classification) and T-cell subset analysis (CD4+ percentages) performed concurrently.

Main Results:

• HIV-infected children generally showed fewer and smaller DTH responses compared to uninfected children.
• Age-adjusted analysis revealed minimal differences in DTH responsiveness between groups.
• Anergy (lack of DTH response) was significantly associated with symptomatic HIV disease, advanced clinical/immunologic status, and low CD4+ percentages.

Conclusions:

• HIV-infected children retain the capacity for antigen-specific cell-mediated immune responses.
• Diminished DTH responsiveness serves as a reliable indicator of HIV disease progression in children.
• DTH testing can be a valuable tool in monitoring immune status in pediatric HIV patients.