Delayed-type hypersensitivity skin tests are an independent predictor of human immunodeficiency virus disease progression. Department of Veterans Affairs Cooperative Study Group.
Delayed-type hypersensitivity (DTH) testing was evaluated as a predictor of human immunodeficiency virus (HIV) disease progression in 336 symptomatic patients with baseline CD4 cell counts of 200-500/mm3 who were participating in a randomized trial of early versus late therapy with zidovudine. Patients with a response of > 2 mm to any of seven antigens were categorized as reactive; those without were anergic. Anergic patients were significantly more likely than reactive patients to have HIV disease progression as evidenced by decrease in CD4 cell count (52% vs. 27%), development of AIDS (33% vs. 17%), or death (18% vs. 9%) (P < or = .02), irrespective of time of zidovudine initiation. By multivariate analysis, DTH results were an independent predictor of HIV progression separate from CD4 cell count, p24 antigen positivity, or level of beta 2-microglobulin. DTH skin tests are an independent predictor of HIV disease progression and may be of value in the evaluation of a patient's immune status.
Gordin
F M
FM
Division of Infectious Diseases, VA Medical Center, Washington, DC 20422.
Hartigan
P M
PM
Klimas
N G
NG
Zolla-Pazner
S B
SB
Simberkoff
M S
MS
Hamilton
J D
JD
D000163:Acquired Immunodeficiency Syndrome / Q000209:etiology; D000328:Adult; D000367:Age Factors; D015496:CD4-Positive T-Lymphocytes; D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000209:etiology / Q000276:immunology* / Q000401:mortality; D006801:Humans; D006968:Hypersensitivity, Delayed; D007958:Leukocyte Count; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012882:Skin Tests; D015996:Survival Rate; D016896:Treatment Outcome; D015215:Zidovudine / Q000627:therapeutic use; D001613:beta 2-Microglobulin / Q000032:analysis
D001613:beta 2-Microglobulin; D015215:Zidovudine