Results

The clinica lcharacteristics of the study subjects are shown in Table 1.Twenty homosexual men were enrolled in the study.Sixteen were asymptomatic，while four had lymphadenopathy.Nine patients were on a stable dose of AZT，while eleven patients were on no medication.One subject was on a stable dose of ddI and one was on a stable dose of ddC in addition to AZT.CD4+T-cell counts ranged from 170/μl to 560/μl prior to entry into the study.

Table 1　Clinical characteristics of study subjects

All patients underwent DNCB sensitization，and all were sensitized by the 10%solution.Two subjects experienced significant reactions to the initial DNCB application despite negative patch tests.These reactions included burning，itching and erythema at the application site（see Figure 1）.The reactions subsided within 48 h with local care（moisturizing lotion or cream）.No subject had a systemic adverse reaction to the DNCB，although most subjects experienced some initial discomfort at the application site.Each subject experienced a‘reflare’within 3—6 weeks after initiation of the 2%DNCB applications.

Figure 1　Pronounced contact dermatitis induced by topical DNCB application

Sixteen subjects were followed for 3—20 months after DNCB sensitization.The mean follow-up was seven months.None of the subjects had progression of HIV disease during this time.One patient withdrew from the study because of the‘cosmetic effects’of DNCB application.Another patient discontinued DNCB use because of discouragement by his private physician.These subjects were followed for six months after discontinuing DNCB.Neither subject was on AZT.

Results of lymphocyte subset analysis in the 16 patients are shown in Table 2.The mean CD4+T-cell count prior to DNCB use was 347 cells/μl.Following DNCB sensitization，the mean CD4+T-cell count remained stable at 343 cells/μl（P=N.S.）.Subjects on AZT had a slight increase in CD4+T-cells，while subjects not on AZT had a slight decrease.These differences were not significant，however.In contrast to the CD4+T-cell counts，CD8+T-cell counts showed a significant increase following DNCB sensitization，from a mean of 904 cells/μl to a mean of 1，068 cells/μl（P=0.006）.This increase was seen in patients regardless of AZT treatment（see Table 2）.The increase in CD8+T-cells persisted for at least six months during continuous DNCB use（data not shown）.Analysis of the cytotoxic T-cell subset（CD8+CD57+）showed no change with DNCB sensitization（see Table 2）.In contrast，the natural killer cell subset（CD56+）increased significantly with DNCB use，from a mean of 95 cells/μl to a mean of 119 cells/μl（P=0.037）.This increase was independent of AZT treatment（data not shown）.(https://www.daowen.com)

Table 2　Effect of topical DNCB application on lymphocyte subsets

aP=N.S.；bP=0.006；cP=0.031；dP=0.046；ep=0.037.
N，number of patients；N.S.，not significant.Normal ranges：CD4+T-cells，400—1，800/μl；CD8+T-cells，300—1，200/μl；CD8+CD57+T-cells，80—200/μl；CD56+natural killer cells，150—400/μl.SEM，standard error of the mean.

Quantitation of serum HIV RNA in 11 subjects during DNCB use is shown in Table 3.In the two patients who discontinued DNCB application，the mean HIV RNA level increased from 2，650 copies/ml to 8，800 copies/ml.In contrast，the nine patients who continued to use DNCB showed a significant decrease in HIV RNA levels，from 42，911 copies/ml to 16，111 copies/ml（P=0.02）.Patients on AZT had a slight increase in HIV RNA copies，while patients not taking AZT showed a threefold decrease in HIV RA copy numbers（P=0.017）.Subjects with initial HIV RNA copy numbers＞10，000/ml showed a greater response to DNCB than subjects with initial HIV RNA copy numbers＜10，000/ml（see Table 3）.

Table 3　Effect of topical DNCB application on HIV RNA levels in serum

aNot on AZT；bP=N/A；cP=0.02；dP=0.017；eP=0.014.
N，number of patients；N/A，not applicable due to small sample size.SEM，standard error of the mean.