Allergen immunotherapy in HIV patients with severe allergic rhinitis

Abstract

Allergen Immunotherapy in HIV Patients with Severe Allergic Rhinitis A. Kohli I, M. Lee-Wong2; 1Section of Allergy and Clinical Immunology, Yale-New Haven Hospital, Yale University School of Medicine, New Haven, CT, 2Division of Clinical Immunology and Allergy, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, NY. RATIONALE: We conducted a pilot study to investigate whether allergen immunotherapy (AIT) is safe and effective for severe allergic rhinitis in HIV positive patients. METHODS: Six HIV positive patients with severe allergic rhinitis were referred to the Allergy and Immunology Clinic by their Infectious Disease specialists. All patients enrolled met the inclusion criteria of severe allergic rhinitis with CD4 count >200/mm 3 and absence of history of opportunistic infection. Patients were administered skin prick testing and/or RAST testing with subsequent AIT to culprit allergens. CD4 count, viral load, and three separate allergic rhinitis symptom scores based on Lebel et al, Norman et al, and Holm et al were recorded. RESULTS: There was a mean decrease in Lebel Score of 3.6 + SD 1.5, mean reduction in Norman Score of 4.6 -+ SD 1.5, and mean decline in Holm Score of 5 -+ SD 1.6 with AIT over a period of three to twelve months. CD4 count and viral load remained stable, except in one patient who self-discontinued anti-retroviral medication. CONCLUSIONS: We observed diminished allergic rhinitis symptoms with AIT in HIV positive patients. There was no change in CD4 count or viral load, except for one patient who discontinued anti-retroviral therapy. AIT may be safe and effective in selected HIV positive patients for the treatment of severe allergic rhinitis. Funding: Beth Israel Medical Center