DELAYED-TYPE HYPERSENSITIVITY SKIN-TESTS ARE AN INDEPENDENT PREDICTOROF HUMAN-IMMUNODEFICIENCY-VIRUS DISEASE PROGRESSION

Delayed-type hypersensitivity (DTH) testing was evaluated as a predict or of human immunodeficiency virus (HIV) disease progression in 336 sy mptomatic patients with baseline CD4 cell counts of 200-500/mm(3) who were participating in a randomized trial of early versus late therapy with zidovudine. Patients with a response of > 2 mm to any of seven an tigens were categorized as reactive; those without were anergic. Anerg ic patients were significantly more likely than reactive patients to h ave HIV disease progression as evidenced by decrease in CD4 cell count (52% vs. 27%), development of AIDS (33% vs. 17%), or death (18% vs. 9 %) (P less than or equal to .02), irrespective of time of zidovudine i nitiation. By multivariate analysis, DTH results were an independent p redictor of HIV progression separate from CD4 cell count, p24 antigen positivity, or level of beta(2)-microglobulin. DTH skin tests are an i ndependent predictor of HIV disease progression and may be of value in the evaluation of a patient's immune status.