THE VALUE OF THE LYMPHOCYTE-PROLIFERATION TEST WITH PHYTOHEMAGGLUTININ IN THE IMMUNE EVALUATION OF BRAZILIAN HIV-INFECTED PATIENTS

We evaluated phytohemagglutinin (PHA) lymphocyte proliferation and del ayed-type hypersensitivity tests in 130 Brazilian HIV-infected patient s with the objective of assessing the value of these tests in staging HIV infection. Patients were divided into three groups according to th eir CD4+ cell counts (cells/ mm(3)): <200 (n = 28); 200 to 499 (n = 50 ); and greater than or equal to 500 (n = 52). An additional 114 indivi duals, who had come to the same institution for elective surgeries, we re enrolled as controls. Results showed a significant decrease in PHA responses when CD4+ cell counts fell below 500 cells/mm(3). This decre ase was, however, indistinguishable from that of patients with <200 ce lls/mm(3). In contrast, skin test anergy to common antigenic preparati ons was only evident in the group of patients with less than 200 CD4cells/mm(3). Decreases in PHA responses and in CD4+ cell counts were s ignificantly correlated. Since the introduction of antiretroviral ther apy is recommended when CD4+ cell counts are below 500 cells/mm(3), th e PHA proliferation test, in our conditions, could be useful as an add itional parameter to initiate antiretroviral therapy. Further prospect ive studies are needed to establish the value of this test in HIV-infe cted patients.