REPLY
Delayed-Type Hypersensitivity and AIDS
MAJ Stephen P. Blatt, MC, USAF, and
MAJ Craig W. Hendrix, MC, USAF
15 February 1994 | Volume 120 Issue 4 | Pages 343-344
IN RESPONSE:
Drs. Stricker and Elswood suggest the possible use of topical 2,4-dinitrochlorobenzene to induce allergic contact dermatitis in patients infected with HIV and thereby to modulate the cellular immune response against the virus [1]. Although some evidence suggests that dinitrochlorobenzene may preferentially stimulate a Th1-like cytokine profile in mice [2], no data exist to support such a mechanism in humans. On the contrary, we are concerned about the induction of nonspecific immunologic stimulation in patients infected with HIV because of the overwhelming evidence that immunologic activation is associated with a worsened prognosis in such patients [3]. Nonspecific T-cell activation may accelerate the course of HIV infection through several mechanisms, including the induction of programmed cell death (apoptosis) and up-regulation of HIV expression [4, 5]. Until more detailed immunologic studies of dinitrochlorobenzene in humans are available, we suggest caution in interpreting uncontrolled, anecdotal case series reports describing this chemical allergen as a treatment for HIV infection.
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Author and Article Information
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USAF Medical Center; Lackland Air Force Base; Lackland, TX 78236-5300
Disclaimer: The views expressed in this letter are those of the authors and do not reflect the official policy of the Department of Defense or other Departments of the U.S. Government.
1. Stricker RB, Elswood BF. Topical dinitrochlorobenzene in HIV disease. J Am Acad Dermatol. 1993; 28:796-7.
2. Dearman RJ, Kimber I. Differential stimulation of immune function by respiratory and contact chemical allergens. Immunology. 1991; 72: 563-70.
3. Fahey JL, Taylor JM, Detels R, Hofmann B, Melmed R, Nishanian P, et al. The prognostic value of cellular and serologic markers in infection with human immunodeficiency virus type I. N Engl J Med. 1990; 322:166-72.
4. Groux H, Torpier G, Monte D, Mouton Y, Capron A, Aneisen JC. Activation-induced death by apoptosis in CD4+ T-cells from human immunodeficiency virus-infected asymptomatic individuals. J Exp Med. 1992; 175:331-40.
5. Pantaleo G, Craziosi C, Fauci AS. The immunopathogenesis of human immunodeficiency virus infection. N Engl J Med. 1993; 328:327-35.
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