PILOT-STUDY OF TOPICAL DINITROCHLOROBENZENE (DNCB) IN HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

Dendritic cells, the primary antigen presenting cells of the human imm une system, are heavily infected with human immunodeficiency virus (HI V) in patients with the acquired immunodeficiency syndrome (AIDS). Din itrochlorobenzene (DNCB) is a contact sensitizing agent that acts as a potent immune modulator of dendritic cells. In this pilot study, we e xamined the safety and efficacy of topical DNCB application in patient s with early HIV disease. Topical DNCB was well tolerated by these pat ients, with an adverse reaction rate of 10%. CD4+ T-cell counts remain ed stable with repeated DNCB use. In contrast, CD8+ T-cell counts and natural killer cells increased significantly following DNCB sensitizat ion. This increase in CD8+ T-cell and natural killer cell subsets was accompanied by a decrease in HIV replication, as measured by serum HIV RNA levels. Based on this pilot study, we conclude that topical DNCB is safe in early HIV disease and may decrease viral load via a systemi c effect on dendritic cells, CD8+ T-cells and natural killer cells. Th ese results require confirmation in larger controlled trials.