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)
Melmed
R N
RN
Department of Microbiology and Immunology, Jonsson Comprehensive Cancer Center, UCLA School of Medicine 90024-1747.
Taylor
J M
JM
Detels
R
R
Bozorgmehri
M
M
Fahey
J L
JL
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