Journal
JOURNAL OF INFECTIOUS DISEASES
Volume 188, Issue 12, Pages 1794-1803Publisher
OXFORD UNIV PRESS INC
DOI: 10.1086/379900
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Funding
- NCRR NIH HHS [5M01 RR00044, RR00046, RR00052, RR00051] Funding Source: Medline
- NIAID NIH HHS [5U01 AI39156-06, 5U01 AI32782, U01 AI38855, 5U01 AI27673-140, 5U01 AI27666, 5U01 AI39156-04, U01 AI27665, AI2760-17, AI27660, AI27664, AI27668, AI32770, 1 U01 AI46370-03, AI258799, AI38858, UO1 AI27659, AI25868, AI50410, AI25924, P30 AI27742, 5U01 AI39156-03, 5U01 AI39156-05, U01 AI25915, U01 AI27658] Funding Source: Medline
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Immune function was observed for 144 weeks in 643 human immunodeficiency virus (HIV)-infected subjects who (1) had nadir CD4(+) cell counts of <50 cells/mm(3), followed by a sustained increase to >= 100 cells/mm(3) after the initiation of HAART, and (2) were enrolled in a randomized trial of continued azithromycin prophylaxis versus withdrawal for prevention of Mycobacterium avium complex disease. The median CD4(+) cell count was 226 cells/mm(3) at entry and 358 cells/mm(3) at week 144. Anergy (80.2% of patients) and lack of lymphoproliferative response to tetanus toxoid (TT; 73%) after immunization and impaired antibody responses after receipt of hepatitis A (54%) and TT (86%) vaccines were considered to be evidence of impaired immune reconstitution. Receipt of azithromycin did not have an effect on CD4(+) cell count but was associated with higher rates of delayed-type hypersensitivity responses to TT (25% of subjects who received azithromycin vs. 15% of those who did not; P =.009) and mumps skin test antigen (29% vs. 17%; P =.001). Although the subjects had only partial responses to immune function testing, the rate of opportunistic infections was very low, and none of the tests was predictive of risk.
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