OBJECTIVE MEASURES OF ALLERGIC DISEASE IN CHILDREN WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Background: Available information suggests that IgE levels are elevate d in adults infected with human immunodeficiency virus (HIV), and that increased IgE levels correlate with allergic disease, with decreased CD4 counts, and with a poor prognosis. Data with respect to these fact ors in children are scant. Objective: We investigated whether serum Ig E levels are elevated in children with HIV and, if so, whether the ser um IgE level correlates with the degree of immunodeficiency and/or obj ective indicators of allergic disease. Methods: Serum IgE levels, CD4 counts, absolute eosinophil counts, and immediate hypersensitivity ski n test (IHST) results were collected from 43 children with symptomatic HIV infection (mean age 7.2 years). Associations between serum IgE le vels, CD4 counts, and eosinophil counts were investigated by multiple stepwise linear regression analysis. Data were stratified according to IHST positivity, and analysis of variance was used to compare mean va lues for age, CD4 counts, IgE levels, and eosinophil counts between th e two groups. Results: Serum IgE values were elevated more than 2 SDs above control age-matched mean values in 17 of 43 patients (40%). IHST results were positive in 12 of 43 patients (28%). CD4 counts were les s than 200/mm(3) in 17 of 43 patients (40%). Stepwise linear regressio n failed to demonstrate any correlation between serum IgE levels and e ither CD? or eosinophil counts. With data divided into two groups acco rding to MST results (positive vs negative), analysis of variance fail ed to reveal significant differences between means for patient age, CD 4 counts, IgE levels, or eosinophil counts. Conclusions: Our findings confirm that serum IgE levels are increased in children infected with HIV,just as in adults. However, an elevated serum IgE level did not co rrelate with allergic disease as measured by IHST results and eosinoph il counts, nor with the degree of immune dysfunction as approximated b y CD4 counts. The mechanism and significance of elevated serum IgE lev els remain unclear in children with HIV, and warrant further investiga tion.