Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
Stability of cutaneous anergy in women with or at risk for HIV infection. HIV Epidemiology Research Study Group.
J Acquir Immune Defic Syndr Hum Retrovirol. 1999 Mar 1;20(3):238-44. Unique Identifier : AIDSLINE MED/99174789 Klein RS; Sobel J; Flanigan T; Smith D; Margolick JB; Department of Medicine, Montefiore Medical Center and Albert; Einstein College of Medicine, Bronx, New York 10467, USA.
Abstract:
OBJECTIVE: To study the stability of cutaneous anergy in women with or at risk for HIV infection. DESIGN: Prospective multicenter cohort study METHODS: Interviews, CD4+ lymphocyte counts, and intradermal skin testing with mumps, Candida, and tetanus toxoid antigens were performed on two occasions at a median interval of 74 weeks in 436 HIV-seropositive and 252 seronegative at-risk women; only 10 (2%) HIV-seropositive women were taking highly active antiretroviral therapy at the time of delayed-type hypersensitivity (DTH) testing. Anergy was defined as induration <2 mm to all three antigens. RESULTS: Skin test reactivity at repeat testing was seen in 202 of 233 (87%) HIV-seronegative women who were not anergic at baseline, compared with 10 (53%) of 19 seronegative women who were anergic at baseline (relative risk [RR], 1.7; 95% confidence interval [CI], 1.07-2.5). Anergy at retesting was seen in 108 of 169 (64%) HIV-seropositive women who were previously anergic, compared with 77 of 267 (29%) who were not previously anergic (RR, 2.2; 95% CI, 1.8-2.8). Among initially anergic seropositive women, CD4+ lymphocyte counts were lower at both initial and follow-up testing in those who remained anergic than in those who reacted at follow-up (p < .001). The relative risks for anergy at retesting of initially anergic seropositive women, compared with initially reactive seropositive women, were related to CD4+ level; 2.5 (95% CI, 1.4-4.3) for CD4+ counts < 200 cells/mm3, 2.0 (95% CI, 1.5-1.7) for CD4+ counts 200-500 cells/mm3, and 1.6 (95% CI, 0.9-2.8) for CD4+ counts >500 cells/mm3. CONCLUSIONS: Although anergic HIV-seropositive women may become reactive, cutaneous anergy predicts a higher likelihood of anergy at retesting as well as lower CD4+ counts. Stability of anergy is greatest in HIV-seropositive women with low CD4+ counts.
Keywords: JOURNAL ARTICLE MULTICENTER STUDY Clonal Anergy/*IMMUNOLOGY CD4 Lymphocyte Count Epidemiologic Studies Female Human Hypersensitivity, Delayed/*IMMUNOLOGY HIV Infections/*IMMUNOLOGY Intradermal Tests Prospective Studies Risk Factors Support, U.S. Gov't, P.H.S. 990630
A9960979
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Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.
