Predictors of atopy in HIV-infected patients

Background: Some studies have reported an increase of atopy in HIV-infected (HIV+) patients, but the cause still remains unclear. Objective: To determine the prevalence of atopy in HIV+ patients and to inv estigate its predictors. Methods: Seventy-four HIV+ hospitalized patients (46 of them with AIDS) wer e studied prospectively for the presence of atopy, based on immediate hyper sensitivity to common allergens by prick test. Serum immunoglobulins, speci fic IgE, lymphocyte subsets, and the expression of low affinity IgE recepto r (CD23) on B cells were determined. Results: Thirty-one percent of patients presented IgE values greater than 1 50 ku/L (39% of patients without AIDS and 26% of AIDS patients; P = .23) an d 47% showed an increase (greater than or equal to 2%) in the percentage of CD23 + B cells. Non-AIDS patients had higher IgE values than AIDS patients (346 +/- 605 versus 175 +/- 276; P = .16). Atopy prevalence was higher in non-AIDS than in AIDS patients (28% versus 11%; P = .06). Specific IgE agre ed with positive prick test in 58% of cases. Multivariate analysis showed t hat a personal history suggestive of allergic disease and IgE > 150 ku/L we re predictors of atopy, while gender, risk group, CD4+ T cells, CD23 expres sion on B cells, and AIDS were not associated. Conclusions: HIV+ patients present a higher prevalence of atopy in early st ages of HIV infection than general population. Since allergic reactions cou ld accelerate HIV-infection by increasing type 2 cytokines, it is important to evaluate the atopic state in HIV+ patients with IgE > 150 ku/L or with suggestive allergic history in order to prevent it.