title: Serum Adenosine Deaminase (ADA) Activity: A Novel Screening Test to Differentiate HIV Monoinfection From HIV-HBV and HIV-HCV Coinfections.
abstract: BACKGROUND
  CD4(+) cell count, the common HIV infection screening test, is costly and unable to differentiate HIV monoinfection from its concurrent infection with hepatitis B or C virus. We aimed to ascertain diagnostic value of serum adenosine deaminase (ADA) activity as a useful tool to differentiate HIV mono- and co-infection.
  
  
  METHODS
  Blood samples were collected from 30 HIV-HBV and 30 HIV-HCV coinfected patients, 33 HIV positive subjects, and 72 controls. CD4(+) cell count, serum total ADA (tADA), and ADA1, and ADA2 isoenzyme activities were determined and their sensitivity and specificity were computed.
  
  
  RESULTS
  tADA and ADA2 activities were significantly higher and CD4(+) counts were markedly lower in all patients compared with controls. Strong inverse agreements between CD4(+) cell counts and both tADA and ADA2 activities were observed. Serum tADA and ADA1 activities showed the highest specificity and the highest sensitivity, respectively, for differentiating HIV monoinfection from HIV-HBV and HIV-HCV coinfections.
  
  
  CONCLUSIONS
  We showed strong agreement and correlation between CD4(+) cell count and ADA enzyme activity. Based on high ADA sensitivity and specificity, it is concluded that determination of ADA activity might be a novel diagnostic tool to distinguish of HIV monoinfection from its coinfection with HBV or HCV.
authors.affiliation: Cellular and Molecular Research Center, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.|Department of Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Kurdistan, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Abdi
authors.affiliation: Department of Pathology and Medical Laboratory Sciences, Faculty of Para Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
authors.forename: Rizgar
authors.initials: R
authors.lastname: Rahbari
authors.affiliation: Department of Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Kurdistan, Iran.
authors.forename: Zahed
authors.initials: Z
authors.lastname: Khatooni
authors.affiliation: Clinical Laboratory of Be'sat Hospital, Sanandaj, Iran.
authors.forename: Nima
authors.initials: N
authors.lastname: Naseri
authors.affiliation: Department of Microbiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Adel
authors.initials: A
authors.lastname: Najafi
authors.affiliation: Department of Biochemistry and Nutrition, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
authors.forename: Iraj
authors.initials: I
authors.lastname: Khodadadi
mesh_terms: D000243:Adenosine Deaminase / Q000097:blood*; D000328:Adult; D060085:Coinfection / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000175:diagnosis* / Q000201:enzymology; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D006526:Hepatitis C / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D000243:Adenosine Deaminase
keywords: adenosine deaminase; coinfection; diagnosis; hepatitis B virus; hepatitis C virus; human immunodeficiency virus