INVITRO AND INVIVO MEASUREMENT OF CELL-MEDIATED-IMMUNITY IN PATIENTS WITH HIV-1 INFECTION

We studied the usefulness of the in vitro lymphoproliferation assay an d the in vivo skin test in HIV-1-infected patients by using Clostridiu m tetani and tuberculin as testing antigens. Moreover, the relationshi p between data obtained from both assays was studied. In 56 HIV-infect ed patients not receiving antiretroviral therapy CD4+ cell counting wa s performed. In addition, in vitro (lymphocyte proliferation assay) an d in vivo (delayed type hypersensitivity skin test) measuring of the i mmune status was done using C. tetani and tuberculin as testing antige ns. When using C. tetani a significant correlation between the results of both tests and the CD4+ cell count was found. In contrast to earli er reports from African countries, in vivo skin testing using tubercul in did not yield clinically significant information on the degree of i mmunodeficiency. We explain our findings by the fact that health care policy in The Netherlands encompasses vaccination with C. tetani, whic h enables the application of C. tetani as testing antigen for measurin g immune function both in vitro and in vivo.