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.
Rogers
A S
AS
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
Ellenberg
J H
JH
Douglas
S D
SD
Henry-Reid
L
L
Peralta
L
L
Wilson
C M
CM
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