INVITRO AND INVIVO MEASUREMENT OF CELL-MEDIATED-IMMUNITY IN PATIENTS WITH HIV-1 INFECTION

We studied the usefulness of the in vitro lymphoproliferation assay and the in vivo skin test in HIV-1-infected patients by using Clostridium tetani and tuberculin as testing antigens. Moreover, the relationship between data obtained from both assays was studied. In 56 HIV-infected patients not receiving antiretroviral therapy CD4+ cell counting was performed. In addition, in vitro (lymphocyte proliferation assay) and in vivo (delayed type hypersensitivity skin test) measuring of the immune status was done using C. tetani and tuberculin as testing antigens. When using C. tetani a significant correlation between the results of both tests and the CD4+ cell count was found. In contrast to earlier reports from African countries, in vivo skin testing using tuberculin did not yield clinically significant information on the degree of immunodeficiency. We explain our findings by the fact that health care policy in The Netherlands encompasses vaccination with C. tetani, which enables the application of C. tetani as testing antigen for measuring immune function both in vitro and in vivo.