title: A non-specific biomarker of disease activity in HIV/AIDS patients from resource-limited environments.
abstract: BACKGROUND
  A general non-specific marker of disease activity that could alert the clinician and prompt further investigation would be of value in patients with HIV/AIDS, especially in resource limited environments.
  
  
  OBJECTIVE
  To investigate the potential of neopterin as non-specific biomarker in patients with advanced HIV/AIDS.
  
  
  METHODS
  Cross-sectional study in 105 HIV positive patients (75 on highly active antiretroviral treatment (HAART). Neopterin was assessed by enzyme linked immune-absorbent assay and cytokines by flow cytometry.
  
  
  RESULTS
  Neopterin levels were significantly higher (p<0.001) for the total patient than for the control group. Significant correlations between neopterin and plasma indicators of inflammation showed neopterin to be a good indicator of active inflammatory status and of the effect of HAART on the immune system. Neopterin was superior to C-reactive protein and to individual cytokines as indicator of immune deficiency. Increased neopterin levels were associated with a decline in albumin, haemoglobin and the albumin/globulin ratio, and with increases in red cell distribution width.
  
  
  CONCLUSIONS
  Plasma neopterin is a good non-specific biomarker of disease activity in HIV/AIDS patients. It is a good indicator of inflammatory activity, perpetuation of inflammation-associated co-morbidities, degree of immune deficiency and has predictive value for underlying disease, and for monitoring the HAART response.
authors.affiliation: Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa.
authors.forename: Priyesh
authors.initials: P
authors.lastname: Bipath
authors.affiliation: Department of Internal Medicine (Kalafong Hospital), School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa.
authors.forename: Peter
authors.initials: P
authors.lastname: Levay
authors.affiliation: Biostatistics Unit at Pretoria, Medical Research Council of South Africa.
authors.forename: Steve
authors.initials: S
authors.lastname: Olorunju
authors.affiliation: Department of Psychiatry, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa.
authors.forename: Margaretha
authors.initials: M
authors.lastname: Viljoen
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D023241:Antiretroviral Therapy, Highly Active; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D016207:Cytokines / Q000097:blood*; D017248:Enzyme Multiplied Immunoassay Technique; D005260:Female; D005434:Flow Cytometry; D015658:HIV Infections / Q000097:blood* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007107:Immune System / Q000187:drug effects*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood*; D011237:Predictive Value of Tests; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D016207:Cytokines; D019798:Neopterin
keywords: HIV/AIDS; biomarkers; immune activation; neopterin