COMPARISON OF 2 METHODS FOR THE ASSESSMENT OF DELAYED-TYPE HYPERSENSITIVITY SKIN-RESPONSES IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

We compared two techniques for detecting delayed-type hypersensitivity (DTH) skin responses in 359 patients infected with human immunodefici ency virus (HIV) (mean CD4(+) lymphocyte count, 387/mu L). DTH respons es were assessed with use of two antigenic panels administered simulta neously: tuberculin purified protein derivative (PPD) plus three contr ol antigens (Candida albicans, mumps antigen, and tetanus toroid) admi nistered by the Mantoux method and by a multiple-puncture device deliv ering seven antigens percutaneously (MULTITEST CMI; Institut Merieux, Lyon, France). Eighty-three patients (23%) were anergic, 216 (60%) rea cted to both panels, 55 (15%) did not react to MULTITEST CMI but did r eact to the antigens administered by Mantoux method, and only five (1% ) reacted to MULTITEST CMI without reacting to antigens administered b y the Mantoux method (P <.001, McNemar's test). Each of the three poss ible combinations of PPD plus two control antigens administered by the Mantoux method were also superior to MULTITEST CMI for classifying pa tients as nonanergic (P <.001, McNemar's test). We conclude that the a pplication of antigens by the Mantoux method is more efficient than MU LTITEST CMI for detecting DTH skin responses in HIV-infected patients.