Elevated adenosine deaminase activity in patients with HIV and tuberculous peritonitis.
OBJECTIVE
To evaluate the diagnostic potential of the ADA(T), ADA isoenzymes (ADA1 and ADA2) and the interferon-gamma (IFN-gamma) test in HIV-seropositive patients with tuberculous peritonitis.


METHODS
Ascitic ADA(T), ADA1, ADA2 and IFN-gamma were prospectively evaluated in HIV-seronegative patients with tuberculous peritonitis (n = 17), HIV-seropositive patients with tuberculous peritonitis (n = 6) and in patients with cirrhosis (n = 22) and malignancy (n = 5).


RESULTS
ADA(T) and ADA2 isoenzyme activities of HIV-seronegative (ADA(T) = 109 U/l; ADA2 = 94 U/l) and HIV-seropositive (ADA(T) = 109.5 U/l; ADA2 = 95.5 U/l) patients with tuberculous peritonitis, respectively, were significantly different (P < 0.001) from patients with cirrhosis (ADA(T) = 10.5 U/l; ADA2 = 8 U/l) and malignancy (ADA(T) = 13 U/l; ADA2 = 11 U/l). There was no significant difference in ADA(T) and ADA2 activities between HIV-seropositive and seronegative patients with tuberculous peritonitis. There was no significant correlation between ADA, its isoenzymes and IFN-gamma.


CONCLUSIONS
The diagnosis of tuberculous peritonitis can be made by a sensitive, relatively non-invasive procedure in both HIV-seronegative and seropositive patients with minimal risk to the patient and the investigator. The diagnostic value of ADA(T) is not enhanced by measuring ADA isoenzymes or IFN-gamma.
Sathar
M A
MA
Department of Medicine, University of Natal/King Edward VIII Hospital, Durban, South Africa.
Ungerer
J P
JP
Lockhat
F
F
Simjee
A E
AE
Gouws
E
E
D017088:AIDS-Related Opportunistic Infections / Q000201:enzymology*; D000243:Adenosine Deaminase / Q000032:analysis*; D000328:Adult; D000368:Aged; D001201:Ascites / Q000201:enzymology; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000201:enzymology*; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis; D007527:Isoenzymes / Q000032:analysis; D008103:Liver Cirrhosis / Q000201:enzymology; D008113:Liver Neoplasms / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000201:enzymology; D014395:Peritonitis, Tuberculous / Q000201:enzymology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
D007527:Isoenzymes; D007371:Interferon-gamma; D000243:Adenosine Deaminase