DTH Responsiveness of HIV-Infected Thai Adults

ARTHUR E. BROWN, M.D.l, SORACHAI NITAYAPHAN, M.D.l, SUCHITRA SUKWIT, M.S. (Public Health)l, SOMBAT LEELASUPASRI, M.D.2, LAURI MARKOWITZ, M.D),4,5, PATRICIA MORGAN, M.Sc., PA-c1,4, SUCHADA CHINA WORAPONG, B.Sc., R.N.l, DEBORAH BIRX, M.D.3

Affiliation : Department of Defense. Support for this study was provided by the U.S. Army Medical Research and Materiel Command

AbstractA study was carried out in Thailand to determine the frequency of reactivity to delayed- type hypersensitivity (DTH) skin tests used for the staging of HIV patients in the United States. A four-antigen panel which included tetanus toxoid (1: 10), Candida ( 1: 10), mumps and Tricho- phyton antigens was assessed in 221 adult subjects from across the full immunological spectrum of HIV disease. Complete anergy was found in 38 per cent of 73 subjects with CD4 counts of 0-200 cells/ml and in 6 per cent of 78 subjects with 201-400 cells/mi. Partial anergy (response to I of 4 antigens) was found in 26 per cent of the 0-200 cell/ml group and decreased progres- sively with increasing CD4 cell count. Results suggested that a 3-member recall antigen panel would provide nearly all the clinically useful information gained by the more standard 4-member panel. In conclusion, DTH skin testing was confirmed to provide a method of assessing the inte- grity of cellular immune function of HIV-infected Thai adults which correlated with disease progression.

Keywords : HIV-1, Skin Testing, Cutaneous Delayed-type Hypersensitivity

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