Traub A, Margulis S B, Stricker R B
Sexually Transmitted Disease Unit, Irmandade da Santa Casa de Misericordia, Porto Alegre, Brazil.
Dermatology. 1997;195(4):369-73. doi: 10.1159/000245990.
Despite the rapid spread of human immunodeficiency virus (HIV) in the developing countries of Africa, Asia and Latin America, accessible and affordable antiretroviral therapies have not been developed. Dinitrochlorobenzene (DNCB) is an inexpensive contact sensitizing agent that stimulates cell-mediated immunity when applied to the skin. We have examined the clinical and immunologic effects of topical DNCB therapy in a cohort of indigent patients with HIV disease from Brazil.
Thirty-five HIV-infected subjects were divided into a control group that refused DNCB therapy (6 patients) and a treatment group that applied topical DNCB on a weekly basis throughout the study (29 patients). Subjects were monitored for adverse clinical events, progression to AIDS and changes in body weight. CD4 and CD8 T-cell counts were also monitored in both groups.
Control and treated patients were evenly matched in terms of age, initial clinical status and prior adverse clinical events. The mean follow-up was 19.7 months for the control group and 17.8 months for the DNCB group. Control patients had significantly more adverse clinical events and progression to AIDS during the study than the treatment group (p = 0.002 and p = 0.013, respectively). There were no deaths in either group. Control patient weights decreased over the study period while DNCB patient weights increased (p < 0.001). CD4 and CD8 T-cell counts decreased significantly in the control group and increased in the DNCB group (p < 0.001 and p = 0.031, respectively). DNCB therapy was well tolerated.
Topical DNCB therapy affords a rational, effective and inexpensive treatment approach for HIV disease. DNCB should benefit patients in developing nations with limited access to health care.
尽管人类免疫缺陷病毒（HIV）在非洲、亚洲和拉丁美洲的发展中国家迅速传播，但尚未开发出可及且负担得起的抗逆转录病毒疗法。二硝基氯苯（DNCB）是一种廉价的接触致敏剂，应用于皮肤时可刺激细胞介导的免疫。我们研究了局部DNCB疗法对一组来自巴西的贫困HIV疾病患者的临床和免疫效果。
35名HIV感染受试者被分为拒绝DNCB治疗的对照组（6名患者）和在整个研究过程中每周应用局部DNCB的治疗组（29名患者）。对受试者进行不良临床事件、进展为艾滋病以及体重变化的监测。两组还监测了CD4和CD8 T细胞计数。
对照组和治疗组在年龄、初始临床状态和既往不良临床事件方面匹配良好。对照组的平均随访时间为19.7个月，DNCB组为17.8个月。在研究期间，对照组患者的不良临床事件和进展为艾滋病的情况明显多于治疗组（分别为p = 0.002和p = 0.013）。两组均无死亡病例。在研究期间，对照组患者体重下降，而DNCB组患者体重增加（p < 0.001）。对照组CD4和CD8 T细胞计数显著下降，DNCB组则升高（分别为p < 0.001和p = 0.031）。DNCB疗法耐受性良好。
局部DNCB疗法为HIV疾病提供了一种合理、有效且廉价的治疗方法。DNCB应使医疗保健机会有限的发展中国家的患者受益。
