Background: Delayed-type hypersensitivity (DTH) testing, an in vivo assessment of cell-mediated immunity, is a\r\npredictor of HIV disease progression beyond CD4 cell count. We investigated whether preserved DTH\r\nresponsiveness was characteristic of HIV controllers compared to non-controllers and individuals on suppressive\r\nHAART.\r\nFindings: DTH testing consisted of = 3 recall antigens applied approximately every 6 months. DTH responses were\r\nclassified by the number of positive skin tests: anergic (0), partial anergic (1), or non-anergic (= 2). HIV controllers\r\nwere compared to treatment na�¯ve non-controllers (n = 3822) and a subgroup of non-controllers with VL < 400\r\ncopies/mL on their initial HAART regimen (n = 491). The proportion of non-anergic results at first DTH testing was\r\nsimilar for HIV controllers compared to non-controllers (81.9% vs. 77.6%; P = 0.22), but tended to be greater in HIV\r\ncontrollers compared to the HAART subgroup (81.9% vs. 74.5%; P = 0.07). Complete anergy was observed in 14\r\n(10.1%) HIV controllers with CD4 counts = 400 cells/uL. For longitudinal testing, the average percentage of nonanergic\r\nDTH determinations per participant was higher in HIV controllers compared to non-controllers (81.2 �±\r\n31.9% vs. 70.7 �± 36.8%; P = 0.0002), however this difference was eliminated with stratification by CD4 count: 200-\r\n399 (83.4 �± 35.6% vs. 71.9 �± 40.9%; P = 0.15) and > 400 cells/uL (81.2 �± 31.5% vs. 80.4 �± 32.7%; P = 0.76).\r\nConclusions: Spontaneous virologic control was not associated with DTH responsiveness, and several HIV\r\ncontrollers were anergic despite having elevated CD4 counts. These findings suggest that cellular immunity\r\nassessed by DTH is not a principal factor contributing to spontaneous virologic suppression in HIV controllers
Loading....