title: Association between tuberculin skin test reactivity, the memory CD4 cell subset, and circulating FoxP3-expressing cells in HIV-infected persons.
abstract: BACKGROUND
  Lack of reactivity to the tuberculin skin test (TST) is widely observed in individuals with advanced human immunodeficiency virus type 1 (HIV-1) infection.
  
  
  METHODS
  Biopsy specimens from the TST reaction site and from skin not infiltrated with purified protein derivative were obtained from 15 HIV-1-infected and 23 uninfected persons who did not have active tuberculosis and who were from a community in which the incidence of tuberculosis was very high. Histologic sections (size, 8 mum) were immunohistochemically stained for CD4, CD8, CD28, CD45RA, CD45RO, CD62L, CD1a, human leukocyte antigen (HLA)-DR, granulysin, interferon-gamma, and FoxP3 and were analyzed by single-cell in situ digital imaging. Peripheral blood mononuclear cells were analyzed using a fluorescence-activated cell sorter.
  
  
  RESULTS
  Biopsy specimens obtained from TST-reactive skin of HIV-1-infected persons demonstrated fewer CD4(+) T cells at the TST site (P = .36) but more HLA-DR(+) T cells (P = .037) than did such biopsy specimens obtained from HIV-1-uninfected persons. Among HIV-1-infected persons, the total number of cells (P = .008) and numbers of CD45RO(+) memory T cells (P = .003) were significantly higher in TST-reactive persons than in TST-unreactive persons. For HIV-1-infected persons, TST induration was inversely correlated with the numbers of FoxP3(+) T cells in the blood (P = .026) but was unrelated to the number of circulating CD4(+) T cells.
  
  
  CONCLUSIONS
  For HIV-1 infected persons, the TST depends on memory T cells and is more strongly associated with the numbers of circulating FoxP3(+)CD4(+) T cells than with the total number of CD4(+) T cells.
authors.affiliation: Division of Clinical Infectious Diseases, Medical Clinic, Research Center Borstel, Borstel, Germany.
authors.forename: Heike
authors.initials: H
authors.lastname: Sarrazin
authors.forename: Katalin Andrea
authors.initials: KA
authors.lastname: Wilkinson
authors.forename: Jan
authors.initials: J
authors.lastname: Andersson
authors.forename: Molebogeng Xheeda
authors.initials: MX
authors.lastname: Rangaka
authors.forename: Lena
authors.initials: L
authors.lastname: Radler
authors.forename: Kerryn
authors.initials: K
authors.lastname: van Veen
authors.forename: Christoph
authors.initials: C
authors.lastname: Lange
authors.forename: Robert John
authors.initials: RJ
authors.lastname: Wilkinson
mesh_terms: D000328:Adult; D015496:CD4-Positive T-Lymphocytes / Q000145:classification / Q000276:immunology / Q000502:physiology*; D005260:Female; D051858:Forkhead Transcription Factors / Q000235:genetics / Q000378:metabolism*; D015658:HIV Infections / Q000150:complications / Q000276:immunology*; D006801:Humans; D007156:Immunologic Memory; D016130:Immunophenotyping; D008297:Male; D012867:Skin / Q000166:cytology / Q000276:immunology; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis
chemical_list: C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors