Serum neopterin changes in HIV-infected subjects: indicator of significant pathology, CD4 T cell changes, and the development of AIDS.
Serum neopterin is a metabolite of dihydroneopterin triphosphate, which is produced from GTP during immune activation. A study was undertaken in homosexual male subjects followed at 6 month intervals for 3 or more years to determine the value of serum neopterin changes induced by HIV infection. The significance of serum neopterin levels in evaluating prognosis of HIV-infected individuals was also assessed. Serum neopterin was found to be a useful indicator of the presence of HIV infection. Stratification of 29 HIV seroconverters showed a strong inverse correlation between the serum neopterin rise and the blood CD4 T cell fall in the first year following HIV infection. Thus, a small increase in neopterin (less than 5 nmol/L) at the time of HIV seroconversion was associated with minimal CD4 T cell reduction and a large increase (greater than 12 nmol/L) was associated with a much greater CD4 T cell fall. Neopterin levels were markedly different (lower) in individuals with little or no CD4 T cell fall when compared with those with moderate or marked rates of T cell fall. This relationship between serum neopterin and the CD4 T cell level was further confirmed by an evaluation of both parameters in a group of 799 seropositive homosexual men. In this analysis, serum neopterin was shown to have a significant predictive value for the development of AIDS within 3 years. Furthermore, when serum neopterin and CD4 T cell measurements were considered together, the prognostic value of the combination was significantly greater than either alone.(ABSTRACT TRUNCATED AT 250 WORDS)
Department of Microbiology and Immunology, Jonsson Comprehensive Cancer Center, UCLA School of Medicine 90024-1747.
R N
RN
Melmed
J M
JM
Taylor
R
R
Detels
M
M
Bozorgmehri
J L
JL
Fahey
D000163:Acquired Immunodeficiency Syndrome / Q000097:blood* / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D000945:Antigens, Differentiation, T-Lymphocyte / Q000032:analysis*; D001708:Biopterins / Q000031:analogs & derivatives* / Q000097:blood; D006679:HIV Seropositivity / Q000097:blood / Q000276:immunology; D006716:Homosexuality; D006801:Humans; D008297:Male; D019798:Neopterin; D013601:T-Lymphocytes / Q000145:classification* / Q000276:immunology
D000945:Antigens, Differentiation, T-Lymphocyte; D001708:Biopterins; D019798:Neopterin