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Zidovudine-induced restoration of cell-mediated immunity to mycobacteria in immunodeficient HIV-infected patients

French, M.A.H., Mallal, S. and Dawkins, R.L. (1992) Zidovudine-induced restoration of cell-mediated immunity to mycobacteria in immunodeficient HIV-infected patients. AIDS, 6 (11). pp. 1293-1297.

Link to Published Version: http://journals.lww.com/aidsonline/Abstract/1992/1...
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Abstract

Objective: To describe a localized form of Mycobacterium avium intracellulare (MAI) infection occurring concurrently with the restoration of cutaneous delayed-type hypersensitivity (DTH) responses to mycobacterial antigens after commencement of ziclovudine therapy in immunodeficient HIV-infected patients.

Patients: The first 108 Western Australian patients with a CD4+ T-cell count of <200 $$ 106/1 and/or symptomatic disease to be given zidovudine (ZDV), of whom 72 had adequate DTH data.

Methods: DTH responses to seven antigens were measured by the 'Multitest' method before and on at least two occasions during the 6 months after commencing ZDV. All patients were reviewed at regular intervals and clinical events recorded.

Results: Of the 64 patients who were anergic to tuberculin before commencing ZDV, 27 (42%) developed a DTH response to tuberculin after ZDV. Four of the nine patients with a 'Multitest' tuberculin response of >=8mm and one patient who developed a positive Mantoux test to M. avium purified protein derivative developed an illness characterized by localized MAI infection, lymphadenopathy and/or severe fevers after 1-2 weeks.

Conclusion: The development of localized MAI infection and/or fevers shortly after commencing ZDV in immunodeficient HIV-infected patients may reflect restoration of cellular immunity to mycobacterial antigens in some patients rather than early failure of therapy or hypersensitivity to ZDV.

Item Type: Journal Article
Publisher: Lippincott Williams & Wilkins Ltd.
Copyright: (C) 1992 Lippincott-Raven Publishers
URI: http://researchrepository.murdoch.edu.au/id/eprint/14973
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