The prevalence of anergy in human immunodeficiency virus-infected adolescents and the association of delayed-type hypersensitivity with subject characteristics

Purpose: To examine the prevalence of anergy in HIV-infected adolescents an d factors associated with its occurrence. Methods: Anergy was defined as less than 2mm induration to each of three in tradermally applied antigens (Candida albicans, tetanus toroid, and mumps) between 24 and 96 hours in a population of HIV-infected adolescents aged 12 -18 at entry in a national multicenter study of HIV disease progression. CD 4(+) T-cell counts and plasma HIV-1 RNA were measured in quality controlled laboratories. Factors associated with the probability of anergy were exami ned with contingency table comparisons, tree-structured classification, and logistic regression analyses. Results: Overall prevalence of anergy in this clinic-based population of 16 7 was 11% [7% in males and 12% in females (p = 0.57)]. The sole significant predictor of anergy was decreased CD4(+) T-cell count (p = 0.005). Conclusion: The prevalence of anergy is low in this HIV-infected population compared to older infected cohorts. The occurrence of differential rates o f anergy in particular age and sex groupings that may be related to intrins ic immunologic differences requires further study. (C) Society for Adolesce nt Medicine, 2000.