Gordin F M, Hartigan P M, Klimas N G, Zolla-Pazner S B, Simberkoff M S, Hamilton J D
Division of Infectious Diseases, VA Medical Center, Washington, DC 20422.
J Infect Dis. 1994 Apr;169(4):893-7. doi: 10.1093/infdis/169.4.893.
Delayed-type hypersensitivity (DTH) testing was evaluated as a predictor of human immunodeficiency virus (HIV) disease progression in 336 symptomatic patients with baseline CD4 cell counts of 200-500/mm3 who were participating in a randomized trial of early versus late therapy with zidovudine. Patients with a response of > 2 mm to any of seven antigens were categorized as reactive; those without were anergic. Anergic patients were significantly more likely than reactive patients to have HIV disease progression as evidenced by decrease in CD4 cell count (52% vs. 27%), development of AIDS (33% vs. 17%), or death (18% vs. 9%) (P < or = .02), irrespective of time of zidovudine initiation. By multivariate analysis, DTH results were an independent predictor of HIV progression separate from CD4 cell count, p24 antigen positivity, or level of beta 2-microglobulin. DTH skin tests are an independent predictor of HIV disease progression and may be of value in the evaluation of a patient's immune status.
在一项关于齐多夫定早期与晚期治疗的随机试验中，对336例基线CD4细胞计数为200 - 500/mm³的有症状患者进行了迟发型超敏反应（DTH）检测，以评估其作为人类免疫缺陷病毒（HIV）疾病进展预测指标的价值。对七种抗原中任何一种反应大于2 mm的患者被归类为反应性；无反应者为无反应性。无反应性患者比反应性患者更有可能出现HIV疾病进展，表现为CD4细胞计数下降（52%对27%）、发展为艾滋病（33%对17%）或死亡（18%对9%）（P≤0.02），无论齐多夫定开始使用的时间如何。通过多变量分析，DTH结果是HIV进展的独立预测指标，独立于CD4细胞计数、p24抗原阳性或β2-微球蛋白水平。DTH皮肤试验是HIV疾病进展的独立预测指标，可能在评估患者免疫状态方面具有价值。
