DELAYED-TYPE HYPERSENSITIVITY TESTING IN TANZANIAN ADULTS WITH HIV-INFECTION

Delayed-type hypersensitivity (DTH) testing and total lymphocyte count s as measures of cell-mediated immune function were assessed for medic al patients in Dar es Salaam, Tanzania. DTH testing was performed with the Multitest CMI device which simultaneously administers seven antig ens. Of 201 patients completing DTH testing, 90 were HIV seropositive. Anergy occurred more frequently among HIV-seropositive patients (39 o f 90) as compared with HIV-seronegative patients (17 of 111). DTH skin test reactivity, measured by anergy, the number of positive antigens, and the combined DTH response induration, was significantly related t o the clinical stage of HIV disease. Median total lymphocyte counts we re significantly lower in HIV-seropositive patients than in HIV-serone gative patients (1,130 vs. 1,680 lymphocytes x 10(6)/L). Total lymphoc yte counts decreased with increasing severity of HIV disease. In multi variable analysis, the number of positive antigens in DTH testing and lymphopenia significantly predicted HIV infection. The findings sugges t that DTH testing and total lymphocyte counts may be useful, inexpens ive tests of immune function in African patients with HIV disease.