Neopterin as a predictive marker for disease progression in human immunodeficiency virus type 1 infection.
We assessed the value of urinary neopterin concentrations for prognosis of disease progression in HIV-1-infected patients. Sixty-eight anti-HIV-1 seropositive homosexuals with lymphadenopathy syndrome were tested for urinary neopterin and T-cell subset counts in 1982-83, and the incidence rate at which they developed acquired immunodeficiency syndrome (AIDS) between then and May 1988 was evaluated. Overall, 21 of 68 (30.9%) cases progressed to AIDS, with a yearly progression rate of 4-9%. The predictive value of urinary neopterin concentrations was higher (P = 0.0042) than that of CD4+ T-cell counts (P = 0.015) or the CD4+/CD8+ T-cell ratio (P = 0.022). Counts of CD8+ T-cells failed to show predictive significance (P = 0.29). Similarly, multivariate-regression analysis indicated that neopterin concentrations and CD4+ T-cell numbers were significant copredictors. Produced by human macrophages activated by interferon gamma, neopterin is thus a marker of macrophage activation via T cells. We conclude that these data demonstrate a correlation between the amount of T-cell-macrophage activation, as measured by urinary neopterin concentrations, and the progression of the disease.
Fuchs
D
D
Institute of Medical Chemistry and Biochemistry, University of Innsbruck, Austria.
Spira
T J
TJ
Hausen
A
A
Reibnegger
G
G
Werner
E R
ER
Felmayer
G W
GW
Wachter
H
H
D000386:AIDS-Related Complex / Q000652:urine*; D000163:Acquired Immunodeficiency Syndrome / Q000652:urine; D015415:Biomarkers / Q000652:urine; D001708:Biopterins / Q000031:analogs & derivatives* / Q000652:urine; D002851:Chromatography, High Pressure Liquid; D015497:HIV-1; D006716:Homosexuality; D006801:Humans; D008297:Male; D019798:Neopterin; D011379:Prognosis; D013601:T-Lymphocytes / Q000276:immunology
D015415:Biomarkers; D001708:Biopterins; D019798:Neopterin