Delayed-Type Hypersensitivity Testing in Tanzanian Adults with HIV Infection

Abstract

Delayed-type hypersensitivity (DTH) testing and total lymphocyte counts as measures of cell-mediated immune function were assessed for medical patients in Dar es Salaam, Tanzania. DTH testing was performed with the Multitest CMI device which simultaneously administers seven antigens. Of 201 patients completing DTH testing, 90 were HIV seropositive. Anergy occurred more frequently among HIV-seropositive patients (39 of 90) as compared with HIV-seronegative patients (17 of 111). DTH skin test reactivity, measured by anergy, the number of positive antigens, and the combined DTH response induration, was significantly related to the clinical stage of HIV disease. Median total lymphocyte counts were significantly lower in HIV-seropositive patients than in HIV-seronegative patients (1,130 vs. 1,680 lymphocytes x 10(6)/L). Total lymphocyte counts decreased with increasing severity of HIV disease. In multivariable analysis, the number of positive antigens in DTH testing and lymphopenia significantly predicted HIV infection. The findings suggest that DTH testing and total lymphocyte counts may be useful, inexpensive tests of immune function in African patients with HIV disease.

Antimutagenic activity of flavonoids from the heartwood of Rhus verniciflua

“…The stem bark of Rhus verniciflua contains a high level of urushiols, which are polymerized formation of a lacquer film by the radical-chain reaction (Hirota et al, 1998). The exudate was previously found to have anti-AIDS, a strong antioxidant and immune-enhancing activities (Miller et al, 1996). However, its therapeutic use is undermined by the strong shown by some of the population in East Asia, especially to western.…”

Anergy Skin Testing and Preventive Therapy for HIV-Infected Persons: Revised Recommendations

“…Lack of response to one or more control antigens, however, does not always mean inability to respond to PPD. In populations in which the prevalence of tuberculin reactivity is high, the percentage of persons who react to PPD may be higher than the percentage reacting to several other antigens (28,29 ). Even in populations in which the prevalence of PPD positivity is low, some persons respond to PPD testing despite lack of response to a companion antigen (19 ).…”

“…The following CDC staff members prepared this report: [27][28][29][30][31][32][33] for the use of anergy skin testing in conjunction with purified protein derivative (PPD)-tuberculin skin testing of persons infected with human immunodeficiency virus (HIV). In February 1997, CDC convened a meeting of consultants to discuss current information regarding anergy skin testing, PPD skin testing, and tuberculosis (TB) preventive therapy for HIV-infected persons.…”

Association of cutaneous anergy with human papillomavirus and cervical neoplasia in HIV-seropositive and seronegative women

“…In the past, anergy testing was used in screening for tuberculosis. Although anergy testing is no longer recommended in routine clinical use, largely because of its limited reproducibility and other factors [12], it does provide information about the capacity of HIV-infected patients to mount an effective local immune response [13][14][15][16][17][18][19][20][21][22][23][24][25]. We have previously found that anergy status before the initiation of HAART independently predicts post-HAART morbidity and death [26,27], even after controlling for CD4 T-cell count, HIV-RNA level, and other factors.…”