Human Immunodeficiency Virus Infected Participants Research Articles

Evaluation of Serum Cytokines Biomakers in HIV-Infected Subjects Before and After Commencement of Haart in Federal Teaching Hospital Gombe

The Human Immunodeficiency Virus (HIV) infection causes the acquired immunodeficiency syndrome (AIDS), which is a systemic disorder characterized by severe impairment and progressive damage of both cellular and humoral immune responses. The aim of this study is to evaluate the effect of long administration of HAART on haematological indices, immunological biomarkers, Biochemical and some cytokines in HIV infected subjects   at federal teaching hospital Gombe.  This is a cross sectional study carried out from May to December 2021 on 132 HIV infected adults. The design entails collecting pre and post blood sample after treatment with highly anti-retroviral treatment (HAART) for more than six months. Out of the 132 subjects studied, 66 were HIV sero-positive and these were the test group, while the remaining 66 were HIV Sero-negative drawn from client visiting blood bank of FTH Gombe to make voluntary donation and HIV Testing Unit (HTS) for Marital and Medical Certificate of Fitness Screening and served as control group. All the subjects were between the ages of 15 - 65 years and are aged matched with the control group. Demographic data was collected using structured questionnaire.  The protocol entails collecting 9mls of venous blood from those who were seropositive for HIV 1 &2 before commencement of HAART. This sample is designed pre- treatment sample and these individuals were followed up for 6 months and a second sample collection was done some were lost to follow up and so the attrition was compensated by also collecting blood samples from other HIV individual who had been on HAART for several years. 4ml was dispensed into EDTA bottle for Full blood count using ELIZA analyzer. P<0.05 was considered as significant.The result of the analysis indicated that the mean±se of Interleukines-2 (IL-2) (pg/ml) and Interleukines -6 (IL-6) (pg/ml) parameters for the control group are 65.43 ± 3.37and 34.74 ± 1.20 respectively. The mean±se of the treatment naïve for IL-2 and IL-6 are 101.61 ± 16.47 and 14.63 ± 1.65 respectively. Also, the mean±se of the treatment/HAART for Interleukines-2 (IL-2) (pg/ml) and Interleukines -6 (IL-6) (pg/ml) are 67.43 ± 1.40 and 10.80 ± 0.45 respectively. The IL-2 significantly higher among treatment Naïve HIV infected participants when compared with treatment and control group with (p-value < 0.05). The result is also shown in table 2.0 Above.From this work it is clear that all the cases in this regard, confirm the fact that Long-term HAART remarkably drops the viral load and inflammation in HIV positive  subjects and shows  that  a  low-level  inflammation  continues  which probably leads to  chronic inflammatory  state, morbidity  and mortality in this group of subjects among HIV positive patients in this part of Northern Nigeria despite the reported side effects

The Effect of HBV/HCV in Response to HAART in HIV Patients after 12 Months in Kumba Health District in the South West Region of Cameroon.

Hepatitis B (HBV) and C (HCV) are two among the numerous forms of infections whose clinical degeneration, morbidity–mortality and low immune responsiveness in people living with human immunodeficiency virus (HIV) are highly evident. Co-infection of HIV with HBV and HCV has been associated with reduced survival, increased risk of progression to liver diseases and increased risk of hepatotoxicity associated with antiretroviral therapy (ARV). We carried out biochemical, immunological, virological and clinical analysis of hepatitis B and C positive HIV patients as well as some HIV positive individuals receiving antiretroviral therapy in Kumba Health District to evaluate the immune response to the ARV therapy and identified risk factors associated with the treatment outcomes. A total of 52 HIV patients, 36 HIV/HBV and 12 HIV/HCV patients were involved in this study. We performed CD4 counts, viral load test, analyzed ALAT/ASAT, albumin, bilirubin, and creatinine and measured the weights of HIV patients, HIV/HBV and HIV/HCV enrolled for not more than one year in Kumba Health District. The results were analyzed to evaluate the immune response and possible risk factors associated with the treatment outcomes. The mean increase in weight in participants of all groups over 12 months (17.12 kg) was greater than the mean increase in CD4 (8.92 cell/mm3). However, the mean decrease in viral loads over a 12 months was also very high (1035.17 copies/mL). There was a significant change in the mean values from baseline for all the three variables (p < 0.0001). HIV disease outcomes following HAART (high active antiretroviral therapy) do not appear to be adversely affected by HBV or HCV co-infection, except for slightly poorer CD4 count responses in HIV/HCV co-infected patients. Concerning the renal and liver functions, all the biomarkers witnessed a decrease in patients of all groups in response to HAART over time, with a more rapid decrease in mono-infected patients as compared with those co-infected with HBV but the case was contrary for those co-infected with HCV. Co-infection with HBV or HCV was relatively common among HIV infected participants in Kumba Health District. There were differences in response to HAART between the mono-infected compared with the co-infected, taking into consideration the weight, CD4 count, and viral load. In addition, there was also a variation in the different biomarkers of liver and renal function between mono-infected and co-infected patients.

Factors Affecting the Prevalence of Skin Disorders among Human Immunodeficiency Virus (HIV) Infected Children in Aminu Kano Teaching Hospital (AKTH) Kano, Nigeria

Introduction: Among HIV infected children, skin disorders are vital as they give a clue to diagnosis of the HIV disease. Various factors are associated with occurrence of skin disorders among HIV infected children. Objectives: To determine the factors associated with prevalence of skin disorders among HIV infected children in Aminu Kano Teaching Hospital (AKTH) Kano, Nigeria. Materials and Methods: It was a cross-sectional study conducted to determine the factors affecting skin disorders among HIV infected children attending Paediatric Infectious Disease Clinic of Aminu Kano Teaching Hospital, Kano, Nigeria. A total of 223 HIV infected participants aged 6weeks to14 years were recruited for this study. Chi-square test or Fishers exact test where necessary were used to determine the difference between proportions of categorical variables and level of significance was set at 0.05. Multivariate analysis was used to further analyse significant relationships from the univariate analysis. The confidence level was set at 95% and a p-value less than 0.05 was considered statistically significant Results: There were 110 (49.3%) males and 113 females (50.7%). The male to female ratio was found to be 1:1.1. Seventy-eight percent (78%) of the children had skin disorder. A multivariate analysis showed that only age, social class and immune status were significantly associated with the occurrence of skin disorders. Conclusion: Among the HIV infected children, age, socioeconomic class and immune status were the factors found to determine the Prevalence of skin disorders.

Prevalence and Pattern of Skin Disorders among Human Immuno Deficiency Virus (HIV) Infected Children in Aminu Kano Teaching Hospital (AKTH) Kano, Nigeria

Introduction: In HIV infected children, skin disorders are important as they serve as clue to diagnosis of the HIV disease. The Skin is one of the early systems affected by HIV/AIDS, which can affect almost all organs and systems in the body. Prevalence of skin disorders among HIV infected children is up to 90% in some studies. Objective: To determine the prevalence of skin disorders among HIV infected children attending paediatric infectious disease clinic in Aminu Kano Teaching Hospital Kano, Nigeria. Materials and Methods: A cross-sectional study was conducted to determine the prevalence of skin manifestations among HIV infected children attending paediatric infectious disease clinic of Aminu Kano Teaching Hospital, Kano, Nigeria. A total of 223 HIV infected participants aged 6weeks to14 years were recruited for this study. Results: The prevalence of skin disorders among HIV infected children was 78.0%. The leading categories were infections and infestations accounting for 55.1% then inflammatory skin disorders (20.6%) Dermatophytoses were the commonest specific skin disorders observed. Conclusion: Therefore, the prevalence of skin disorder among HIV infected children in Aminu Kano Teaching Hospital is high (78%). Infections and infestations were the commonest category found followed by inflammatory skin disorders.

Utility of the monocyte to lymphocyte ratio in diagnosing latent tuberculosis among HIV-infected individuals with a negative tuberculosis symptom screen.

Latent Tuberculosis Infection (LTBI) remains a major driver of the TB epidemic, and individuals with Human Immuno-deficiency Virus (HIV) are particularly at a heightened risk of developing LTBI. However, LTBI screening among HIV-infected individuals in resource limited setting is largely based on a negative symptom screen, which has low specificity. In a cross sectional diagnostic study, 115 HIV infected participants with a negative symptom screen will be consented and enrolled. They will be requested to donate 5 ml of blood for complete blood count (CBC) and interferon gamma release assay (IGRA) testing. In a nested prospective study, the 115 participants will be initiated on Tuberculosis Preventive Therapy and the CBC testing repeated after 3 months. In the analysis of study finding, the monocyte to lymphocyte ratio (MLR) will be derived from the dividend of the absolute monocyte and lymphocyte counts. The optimal MLR positivity cut-off for elevated or normal MLR will be the highest value of Youden's index, J (sensitivity + specificity-1). The MLR will be cross tabulated with the IGRA status to determine the sensitivity, specificity, negative and positive predictive values of the MLR. The area under the receiver operating characteristic (ROC) curve will be determined to give the overall diagnostic accuracy of MLR. The baseline and 3 month CBC will be used to determine the change in MLR, and a random effect logistic regression will be used to determine factors associated with the change in the MLR. If positive results are realized from this study, the MLR could become an inexpensive alternative biomarker with potential to improve the specificity of the negative symptom screen in identifying individuals that should be targeted for TB preventive therapy.

Prevalence of insulin resistance among patients attending the HIV clinic in a Nigerian tertiary hospital

BackgroundInsulin Resistance(IR) is increasing in Africans as well as among the Human Immunodeficiency Virus(HIV) infected population for several reasons which include the viral infection itself and the use of Highly active antiretroviral therapy (HAART). This present study assessed the prevalence of IR among HIV infected population and the imminent effect of the disease and therapy on patients. MethodsThis cross sectional study was conducted in Lagos among 266 HIV infected participants and 130 HIV Negative controls aged 18–80 years. Questionnaires were administered and fasting venous blood samples collected for plasma glucose and insulin. Homeostatic Model Assessment (HOMA-IR) and Quantitative Insulin Check Index (QUICKI) indices were used to establish Insulin Resistance using a cut off of >2 and <0.339 respectively. ResultsInsulin resistance was prevalent in 24.1% of HIV-infected participants based on a HOMA-IR and 21.1% using QUICKI compared to 8.5% and 4.6% in the HIV uninfected controls (p<0.001). A prevalence of 25.8% was found among the HAART exposed group compared to 10% among the HAART naïve group (p=0.056) using HOMA-IR while QUICKI results showed 22.5% and 10% respectively (p=0.115). ConclusionThis study established a significantly high prevalence of IR among HIV infected patients and a higher but non-significant prevalence among the HAART exposed group. Close monitoring of patients is recommended to reduce the risk of developing Diabetes Mellitus. Further research work is needed to identify ways of lowering the prevalence of IR in HIV infected persons.

Evaluating the use of procalcitonin in an asymptomatic, HIV-infected antiretroviral therapy-naïve, South African cohort.

The chronic stage of human immunodeficiency virus (HIV) infection, although clinically asymptomatic, is characterized by activation of the immune system and persistent inflammation. Procalcitonin (PCT) has been studied in HIV infection as a marker of bacterial infection. Our aim was to assess the effect of persistent immune activation on PCT levels in asymptomatic treatment naïve HIV infected subjects. This was a cross-sectional study of 68 asymptomatic antiretroviral therapy-naive HIV infected participants and 42 uninfected controls. Stored serum samples were used to measure: PCT, interleukin-6 (IL-6), lipopolysaccharide binding protein (LBP), high sensitivity C-reactive protein (hsCRP), immunoglobulin G (IgG) and albumin. PCT was correlated with markers of: disease progression (CD4 count and viral load), immune activation (CD 38 on CD8+ T cells, IgG and LBP), inflammation (IL-6, hsCRP and albumin). IL-6, IgG and CD8/38 were all significantly increased while albumin and CD4 counts were significantly lower in the HIV infected group. PCT levels were not significantly different between the two groups. There was no significant difference in LBP and hsCRP; however, their levels were increased in both groups. PCT correlated only with LBP (p=0.0001). IL-6 and LBP correlated positively with hsCRP and IgG. Albumin correlated inversely with IL-6 and viral load. Only IgG and CD8/38 correlated inversely with CD4 counts. We demonstrated the activation of the innate (raised LBP), humoral (raised IgG) and cellular immune systems (increased CD8/38 T cells). Despite a state of persistent inflammation, PCT levels are not elevated in asymptomatic untreated HIV infection.

Syphilis among people with HIV infection in southern Ethiopia: sero-prevalence and risk factors.

BackgroundSyphilis facilitates both HIV (human immunodeficiency virus) transmission and acquisition, reflecting the complex interplay between the two infections. Scarce information exists regarding syphilis epidemiology in Ethiopian context. Thus, this study determined the sero-prevalence of syphilis and associated risk factors in people with HIV infection.MethodsA cross-sectional study was conducted at Hawassa Referral Hospital, southern Ethiopia from January to May, 2014. A consecutive 993 HIV–infected participants were studied; but individuals under 15 years of age or treated for syphilis or those with a CD4+ T–cell count below 50 cells/μl were excluded. Structured questionnaires were used to collect data on socio-demography and potential risk factors for syphilis. Moreover, blood samples were collected from all participants and screened for syphilis using rapid plasma reagin (RPR) test, and those found sero-positive were confirmed using treponema pallidum haemagglutination assay (TPHA).ResultsThe sero-prevalence of syphilis was found to be 7.3% (95% CI 5.7– 9%). The rate of infection was significantly higher among participants who were ART (antiretroviral therapy) naive (odds ratio (OR) = 2.2; 95% CI 1.22 – 4.1), men (OR = 2.2; 95% CI 1.22 – 3.87), older than 50 years of age (OR = 3.9; 95% CI 1.45 – 6.94), had only primary school level education (OR = 7.8; 95% CI 2.63 – 23.2) and had a history of blood transfusion (OR = 3.9; 95% CI 1.5 – 10.4).ConclusionThe high prevalence of syphilis among HIV-infected population warrants integrating syphilis screening with HIV care to limit the clinical consequences of untreated syphilis as well as its adverse impact on HIV transmission.

Human immunodeficiency virus, hepatitis C, and inflammatory biomarkers in individuals with alcohol problems: a cross-sectional study

BackgroundAssessing whether hepatitis C (HCV) co-infection with human immunodeficiency virus (HIV) is associated with increased inflammation is complex. The liver, integral to inflammatory biomarker synthesis, is compromised by HCV and alcohol abuse. Using single liver-synthesized biomarkers (e.g. C-reactive protein) to represent inflammation may not be appropriate in HIV/HCV co-infection. We hypothesized that 1) detectable HIV/HCV RNA was independently associated with increased inflammation; 2) a composite inflammation measure describes inflammation differently from single inflammatory biomarkers.MethodsWe compared inflammation by HIV/HCV group in a cohort of 361 HIV infected participants from the HIV-Longitudinal Interrelationships of Viruses and Ethanol study. Inflammatory biomarkers >75th percentile were considered elevated. Associations between HIV/HCV group and elevated biomarkers were analyzed as a composite measure (inflammatory burden) or individually. We defined inflammatory burden as number of concurrently elevated biomarkers. Biomarkers included interleukin-6 (IL-6), C-reactive protein (CRP), cystatin C, serum amyloid-A (SAA), tumor necrosis factor-alpha (TNF-α), interleukin-10 (IL-10). Covariates: alcohol, liver fibrosis, comorbidities, CD4 count, antiretroviral therapy, substance use.ResultsDetectable HIV and HCV RNA (OR = 2.49; 95% CI = 1.05–5.89) and detectable HCV RNA alone (2.95; 1.08–8.01) were independently associated with increased odds of having a greater inflammatory burden compared to undetectable viremia. Elevated IL-10 (7.79; 1.90–31.97) and TNF-α (7.70; 1.42–41.83) were independently associated with detectable HIV and HCV RNA. Elevated IL-10 was also associated with detectable HCV RNA alone (5.51; 1.17, 25.84).ConclusionsDetectable HIV and HCV replication versus undetectable replication was associated with inflammatory burden and certain inflammatory biomarkers independently of alcohol consumption, liver fibrosis and other comorbidities.

Improvement in Immunological Parameters in Patients Receiving Highly Active Anti-Retroviral Therapy in Nepal

Highly active anti-retroviral therapy (HAART) has been freely available in Nepal since 2004. In the present longitudinal study, we followed two distinct cohorts of human immunodeficiency virus-infected participants, those receiving HAART and those under assessment of eligibility for HAART, during the period 2005-2007 in Kathmandu, Nepal. The median change in CD4+ T-cell count among participants receiving HAART after 12 months of the initiation of therapy was +118 T cells/μl (95% confidence interval [CI], +91 to +145 T cells/μl) and that among participants under assessment of eligibility for HAART was -74 T cells/μl (95% CI, -103 to -44 cells/μl). However, the median CD8+ T-cell count after 12 months remained stable in both the cohorts (P > 0.05). The CD4+/CD8+ T-cell ratio increased from 0.16 to 0.26 after 12 months of therapy (P < 0.001). The multivariate regression model revealed that participants >30 years of age, and injection drug users had significantly lower increases in the CD4+ T-cell count in response to therapy. We observed a high proportion of loss to follow-up after 12 months of therapy; however, the associated factors were unknown. In conclusion, we observed a significant improvement in the CD4+ T-cell count in participants receiving HAART; however, the CD4+/CD8+ T-cell ratio remained <0.5 after 12 months of treatment.

Biomarkers and Electrocardiographic Evidence of Myocardial Ischemia in Patients With Human Immunodeficiency Virus Infection

We assessed the relation of inflammatory and coagulation biomarkers with electrocardiographic (ECG) evidence of myocardial ischemia. High-sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), and D-dimer levels were measured at study entry for 3,085 human immunodeficiency virus-infected participants (mean age 44 years; 26.4% women; 24.6% black) in the Strategies for Management of Antiretroviral Therapy trial. Logistic regression models were used to examine the associations of these biomarkers with prevalent and incident myocardial ischemia. The latter analyses were performed for 1,411 participants who were randomly assigned to receive continuous antiretroviral therapy during follow-up to suppress the human immunodeficiency virus viral load and had ≥1 ECG reading during the follow-up period. The median hsCRP, IL-6, and D-dimer level was 1.65 μg/ml (interquartile range 0.69 to 4.11), 1.60 pg/ml (interquartile range 1.00 to 2.75), and 0.18 μg/ml (interquartile range 0.11 to 0.32), respectively. At baseline, the prevalence of major or minor Q-QS or ST-T ECG abnormalities was 18.6%. The biomarker levels were associated with prevalent major or minor ischemic abnormalities on the univariate analyses; however, adjustment for traditional risk factors attenuated these associations. The adjusted odds ratio for major or minor ischemic abnormalities and 95% confidence intervals for the greatest versus lowest quartiles was 1.3 (95% confidence interval 0.9 to 1.7) for hsCRP, 1.0 (95% confidence interval 0.7 to 1.3) for IL-6, and 1.1 (95% confidence interval 0.9 to 1.5) for D-dimer. During a median follow-up of 2.3 years, new definite or probable ischemic ECG abnormalities developed in 11.7% of participants receiving continuous antiretroviral therapy. Biomarker levels were not associated with incident abnormalities on unadjusted or adjusted analyses. In conclusion, higher levels of hsCRP, IL-6, and D-dimer were not associated with ischemic ECG abnormalities. Elevated biomarker levels and ECG abnormalities indicating myocardial ischemia might reflect different risk pathways for cardiovascular disease.

The Impact of Depressive Symptoms on Neuropsychological Performance Tests in HIV-Infected Individuals: A Study of the Hawaii Aging with HIV Cohort

BACKGROUND: The frequency of neurocognitive impairment (NCI) in human immunodeficiency virus (HIV)-infected individuals remains high despite the availability of potent antiretroviral therapy (ART). The concurrence of depression among HIV-infected patients with NCI is common, especially among older individuals. Depression has been implicated as a risk factor for impaired neuropsychological performance (NP). This study explored the relationship between depressive symptoms and NP testing in HIV-infected individuals. METHODS: A cross-sectional analysis was performed within the Hawaii Aging with HIV Cohort, a large prospective study of cognition of older (50 or more years old) compared to younger (20 to 39 years old) HIV-infected individuals. RESULTS: Two hundred and eighty-five HIV infected participants (157 older and 128 younger) were administered a battery of NP tests to measure performance in major cognitive domains. Depressive symptoms were measured using the Beck Depression Inventory (BDI). The rates of depressive symptoms and neuropsychological impairment were similar in older and younger groups. Multivariate analyses revealed depressive symptoms were associated with NP test impairment in the younger group. In the older group, depressive symptoms were not associated with NP. CONCLUSION: This study suggests that depressive symptoms are associated with NP test impairment in younger HIV-infected individuals, but not in older individuals.

Evaluation of immunoglobulin classes (IgA, IgG and IgM) levels and complement fixation activity in HIV infected subjects

The study was designed to evaluate the immunoglobulin A, G and M levels and complement fixation activity in HIV infected participants, who were not administered antiretroviral therapy (ART). Eighty (80) HIV infected participants, aged between 15 – 55 years (38 ±10 years), were recruited for the study. Forty five (45) of the participants were classified as symptomatic HIV (stage ii), while the remaining 35 were classified asasymptomatic HIV (stage i). Similarly, 40 seronegative participants served as control. Blood samples were collected from the participants for the determination of HIV status by immunochromatography, HIV confirmation by Western blot, determination of immunoglobulin levels by immunoturbidimetry, and complement activity by complement fixation test. The IgG and IgA were significantly increased in symptomatic HIV infection compared with asymptomatic HIV infection (p0.05). The complement fixation activities decreased in HIV infected patients compared with the values in HIV seronegatives. The increase in IgA concentration with HIV infected participants may suggest existence of mucosal infections, while theincrease in IgG concentration in HIV infected participants may suggest evidence of increased opportunistic infection requiring IgG response. The low level of complement activity in HIV infected participants maypredispose individuals with HIV infection to disease commonly controlled through immunological activity of the complement. Keywords: Human Immunodeficiency Virus (HIV), immunoglobulins (IgA, IgG and IgM), complements.

Oral cyclosporin A inhibits CD4 T cell P-glycoprotein activity in HIV-infected adults initiating treatment with nucleoside reverse transcriptase inhibitors

P-glycoprotein limits the tissue penetration of many antiretroviral drugs. The aim of our study was to characterize the effects of the P-glycoprotein substrate cyclosporin A on T cell P-glycoprotein activity in human immunodeficiency virus-infected participants in the AIDS Clinical Trials Group study A5138. We studied P-glycoprotein activity on CD4 and CD8 T cells in 16 participants randomized to receive oral cyclosporin A (n=9) or not (n=7) during initiation antiretroviral therapy (ART) that did not include protease or non-nucleoside reverse transcriptase inhibitors. CD4 T cell P-glycoprotein activity decreased by a median of 8 percentage points with cyclosporin A/ART (difference between cyclosporin A/ART vs. ART only, P= 0.001). Plasma trough cyclosporin A concentrations correlated with the change in P-glycoprotein activity in several T cell subsets. Oral cyclosporin A can inhibit peripheral blood CD4 T cell P-glycoprotein activity. Targeted P-glycoprotein inhibition may enhance the delivery of ART to T cells.

Methamphetamine and Young Men Who Have Sex With Men

To examine patterns, consequences, and correlates of methamphetamine use among adolescent and young adult men who have sex with men (YMSM). Descriptive, bivariate, and hierarchical regression analyses of cross-sectional data. Howard Brown Health Center, a community-based facility in Chicago, Ill, from August 2004 to September 2005. Three hundred ten YMSM who completed an anonymous, computer-assisted survey. Methamphetamine use in the past year. Participants ranged in age from 16 to 24 years (mean age, 20.3 years); 30% were white and 70% were of other race/ethnicity (African American, 33%; Hispanic, 26%; Asian or Pacific Islander, 3%; and other, 8%). Participants reported many high-risk sexual and substance use behaviors. Thirteen percent used methamphetamine in the past year. Methamphetamine use was more common among human immunodeficiency virus-infected participants (odds ratio, 2.8; 95% confidence interval, 1.3-5.3) and varied by age and race/ethnicity; substantially higher prevalence was reported by older and non-African American YMSM (P<.001). Compared with other illicit substance users, methamphetamine users reported more memory difficulties, impairments in daily activities, and unintended risky sex resulting from substance use (all P<.01). Hierarchical regression identified sexual risk (unprotected intercourse and multiple partners), sexualized social context (eg, Internet sex, sex in a bathhouse or sex club, sex with older partners, and commercial sex), lower self-esteem, and psychological distress as correlated with methamphetamine use among participants (P<.05). A substantial percentage of YMSM in this sample used methamphetamine. Methamphetamine use is a public health problem with significant implications for the health and well-being of YMSM. Methamphetamine use was associated with human immunodeficiency virus-related risk, and patterns of use were predicted by demographic data, sexualized social contexts, and psychological variables.

In vivo delayed-type hypersensitivity skin test anergy in human immunodeficiency virus type 1 infection is associated with T cell nonresponsiveness in vitro.

In a cross-sectional study, the prevalence of delayed-type hypersensitivity skin test anergy (DTHA) was examined in 136 asymptomatic human immunodeficiency virus-infected participants in relation to immunologic and virologic parameters. DTHA was assessed with a multitest cell-mediated immunity skin test. Of the 136 participants, with a mean CD4 T cell count of 335 x 10(6)/L, 25 were anergic (18.4%). In the stepwise forward multivariate logistic regression models, after adjustment for CD4 T cell counts, depending on whether it was analyzed continuously or after dichotomization (20th percentile), both T cell reactivity to CD2 plus CD28 antibodies or to CD3 antibodies were the most predictive markers of DTHA (odds ratio, 0.80; 95% confidence interval, 0.67-0.94; and odds ratio, 2.97; 95% confidence interval, 1.1-8.3, respectively). This study shows a strong correlation between the decreased T cell responses in vitro and DTHA. Therefore, next to DTHA testing, T cell function assays may be useful to test immune reconstitution observed during antiretroviral treatment.