Evaluation of delayed-type hypersensitivity (anergy) skin tests in HIV-infected children

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Objectives: The objectives of this study were to compare utility of different antigens for anergy testing in HlVnnfected children and to seek correlates of anergy by comparing percent of anergic HIV-infected children at various clinical disease stages and degrees of immunosuppression. Methods: HIV-infected children 9 mos. of age or older had anergy testing placed simuftaneous with tuberculin skin testing. Children 9-11 mos. were tested with Candida (: 100 dilution) and tetanus toxokJ (1:10 di'uton) and children older than 12 mos, with prior mumps vaccination received testing with tetanus toxoid (1:10) and mumps skin test antigen (MSTA). Results were recorded as longest measured width of induration plus longest measured length of induration divided by 2, Patients (pts.) were considered anergic if both tests reacted <2 mm. Percent Anergy. By Clinical & Immunoiogical Disease Stage ABC Total33%( 3) 33%( 3) N/A (0) 33% (6) 2 0%( 7) 14%( 7) N/A (0) 7%( 14) 3 0%( I) 27%(l|) 7196(7) 42%(I9) Total 9%( 11 ) 24%(21} 71 %(7) 28%(39) ( ) No. of pts. tested in that disease category. Results: Fifty-four tests were placed in 50 pts., 39 of which were évaluable (S never returned. 6 were placed or read unreliably). Of these 39 pts., 11 (28%) were anergic 72% responded to one or more antigens. Percent of anergic pts. at varjous disease stages and degree of immunosuppression (based on the Centers for Disease Controls 1994 Classification for Children) is presented in the table. Candida and tetanus antigens coukj not be compared as only one évaluable pt received this combination and was anergic. Of 28 non-anergic pts. 23 responded more to MSTA than to tetanus, 16 of which would have been anergic if only tetanus had been used.The remaining 5 responded more to tetanus than MSTA, only one of which was anergic by MSTA. Conclusions: The majoty of our HlV-infected pts., even with severe immunosuppression. were not anergic. Only category C3 was associated with a majority of anergic pts.Tetar.us toxoid 1:10 alone signrfcantly overestimates anergy and used together adds little to MSTA.

Original languageEnglish (US)
Pages (from-to)368
Number of pages1
JournalPediatric AIDS and HIV Infection
Issue number5
StatePublished - 1996
Externally publishedYes

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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