USE OF THE 2,3-DIACYL-TREHALOSE AND THE PURIFIED PROTEIN DERIVATIVE IN THE SERODIAGNOSIS OF TUBERCULOSIS IN AIDS

The effect of the human immunodeficiency vines (HIV) infection on Ige production against purified protein derivative (PPD) and 2,3-diacil-tr ehalose (SL-IV) was investigated by an enzyme-linked immunosorbent ass ay (ELISA) test. Comparison between the antigens showed that immunocom petent patients produce preferentially antibodies to SL-IV than to PPD (73.3% versus 63.3%). Combination of these results showed an increase of the sensitivity to 80%, which decreased over the spectrum of immun odepression caused by HIV. In the tuberculous HIV seropositive group t he sensitivities of SL-IV and PPD were 36.4% versus 40% and 0% versus 22.2% in the tuberculosis/acquired immunodeficiency syndrome (TB/AIDS) group. Combination of these results gave respectively 54.5% and 20%, showing that serological tests have limited value for diagnosis of tub erculosis in HIV infected patients. High antibody levels were observed in HIV seropositive asymptomatic group, but only two individuals were positive for both antigens. In the follow up, one of them developed t uberculous lymphadenitis, indicating that further work is needed to ac cess the value of serological tests in predicting tuberculosis in HIV infected individuals.