Performance of antigens used in detecting delayed-type hypersensitivity in adolescents infected with the human immunodeficiency virus.
We examined the performance of delayed-type hypersensitivity (DTH) antigens employing a new Candida albicans product in a human immunodeficiency virus (HIV)-infected and nonanergic adolescent population. Diameters of induration (in millimeters) for three intradermally applied antigens (C. albicans, tetanus toxoid, and mumps) were compared in a population of HIV-infected 12 to 18 year olds at study entry in a national multicenter study of HIV disease progression. CD4+ T-cell counts were measured in quality-controlled laboratories. The influence of past immunization, gender, and clinical status on antigen reactivity was evaluated with contingency table comparisons and relative risk estimation. Nearly one-half of the 123 eligible subjects were untreated, and almost three-quarters were early in HIV disease by clinical indicators. There was no statistically significant difference in reactivity by past immunization status. Candida antigen (CASTA; Greer Laboratories) evoked DTH response in a significantly higher number of males and females at every level of induration (largest P value, 0.049 for male comparisons; all P values, <0.001 for females) and in subjects with early and intermediate HIV disease at every level of induration (all P values, <0.0001) than either tetanus or mumps antigens. No two-antigen combination was as useful as all three antigens across either gender or clinical categories, although candida and tetanus was the most useful two-antigen combination at indurations of <3 mm. The superior performance of a new C. albicans antigen may extend the utility of DTH assessment in monitoring immune function.
Pediatric, Adolescent, and Maternal AIDS Branch, National Institute of Child Health and Human Development, 6100 Executive Blvd., Room 4B11 MSC 7510, Bethesda, MD 20892-7510. ar44n@nih.gov
A S
AS
Rogers
J H
JH
Ellenberg
S D
SD
Douglas
L
L
Henry-Reid
L
L
Peralta
C M
CM
Wilson
D000293:Adolescent; D000328:Adult; D000946:Antigens, Fungal / Q000276:immunology; D018791:CD4 Lymphocyte Count; D002176:Candida albicans / Q000276:immunology; D002648:Child; D000939:Epitopes / Q000276:immunology*; D005260:Female; D015488:HIV Antigens / Q000276:immunology*; D015658:HIV Infections / Q000175:diagnosis* / Q000276:immunology*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology* / Q000821:virology; D008297:Male; D009109:Mumps virus / Q000276:immunology; D012737:Sex Factors; D013745:Tetanus Toxoid / Q000276:immunology
D000946:Antigens, Fungal; D000939:Epitopes; D015488:HIV Antigens; D013745:Tetanus Toxoid