FOOD ALLERGY IN HUMAN-IMMUNODEFICIENCY-VIRUS (HIV) INFECTION

Background: Gastrointestinal complaints and pruritic skin conditions a re common in patients infected with human immunodeficiency virus (HIV) . Because atopic disorders such as drug allergy, asthma, and allergic rhinitis are apparently increased, we hypothesized that food allergy m ay also be more common in patients with HIV. Objective: The purpose of this study was to estimate the prevalence of food allergy in patients infected with HIV. Methods: Consecutive patients visiting our outpati ent adult HIV clinic were screened for possible food allergy by use of a questionnaire. One hundred seventy-six patients responded. Sixty-tw o of these patients reported symptoms compatible with a possible food allergy. Followup of the 62 subjects was possible in 40. Thirty-one pa tients were skin tested for foods thought to produce reactions. Result s: Three patients (1.7%) described previous anaphylactic responses to specific foods and were therefore not skin tested or challenged orally . Six patients (3.4%) described very strong histories of food allergy but either refused or were too ill for testing. Twenty-nine of the 31 patients had negative skin tests. One of the two patients with a posit ive skin test to a suspected food also had a positive double-blind, pl acebo-controlled food challenge (DBPCFC). There was no correlation bet ween CD4 cell count and likelihood of food allergy. Based on a strong history alone, the maximal estimated prevalence of food allergy in thi s group was 5.7% (10 of 176). By using the more strict criterion of po sitive DBPCFC, the prevalence of food allergy in this patient populati on was 0.57% (1 of 176). Conclusion: These results suggest that food a llergy is an uncommon disease in patients with HIV infection with an e stimated prevalence similar to that found in the general adult populat ion. Our data do not suggest an obvious direct correlation between HIV infection and food allergy.