title: Neopterin and Soluble CD14 Levels as Indicators of Immune Activation in Cases with Indeterminate Pattern and True Positive HIV-1 Infection.
abstract: BACKGROUND
  We aimed to evaluate the roles of the plasma immune activation biomarkers neopterin and soluble CD14 (sCD14) in the indirect assessment of the immune activation status of patients with the indeterminate HIV-1 (IHIV-1) pattern and a true HIV-1-positive infection (PCG).
  
  
  METHODS
  This cross-sectional and descriptive study included eighty-eight patients with the IHIV-1 pattern, 100 patients in the PCG, and 100 people in a healthy control group (HCG). Neopterin and sCD14 levels were determined by competitive and sandwich ELISA methods, respectively.
  
  
  RESULTS
  Mean neopterin and sCD14 levels among those with the IHIV-1 pattern were significantly lower than among the PCG (p < 0.001 and p = 0.001, respectively), but they were similiar to those in the HCG (p = 0.57 and p = 0.66, respectively. Mean neopterin and sCD14 levels among the PCG were found to be significantly higher than among those with the IHIV-1 pattern (p < 0.001 and p = 0.001, respectively) and among those in the HCG (p = 0.001, p < 0.001, respectively). Neopterin did not have adequate predictive value for identifying those in the PCG (area under the curve [AUC] = 0.534; 95% CI, 0.463-0.605; p = 0.4256); sCD14 also had poor predictive value but high specificity (100%) for identifying those in the PCG (AUC = 0.627; 95% CI, 0.556-0.694; p = 0.0036).
  
  
  CONCLUSIONS
  While low levels of these two biomarkers were detected among those with the IHIV-1 pattern, they were found in high levels among those in the PCG. These two markers obviously cannot be used as a sceening test because they have low sensitivies. Taken together, we suggest that neopterin and sCD14 may be helpful because they both have high specificity (92%-100%) as indirect non-specific markers for predicting the immune activation status of individuals, whether or not they have true positive HIV-1.
authors.affiliation: Department of Medical Microbiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Hayriye Kırkoyun
authors.initials: HK
authors.lastname: Uysal
authors.affiliation: Istanbul Public Health Laboratory, Istanbul, Turkey.
authors.forename: Pari
authors.initials: P
authors.lastname: Sohrabi
authors.affiliation: Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Habip
authors.affiliation: Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Suat
authors.initials: S
authors.lastname: Saribas
authors.affiliation: Medical Faculty of Marmara University, Istanbul, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Kocazeybek
authors.affiliation: Istanbul Leprosy Dermatology and Venereology Hospital, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Seyhan
authors.affiliation: Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Reyhan
authors.initials: R
authors.lastname: Calışkan
authors.affiliation: Istanbul Aydın University - Health Services Vocational School Of Higher Education, Istanbul, Turkey.
authors.forename: Esad
authors.initials: E
authors.lastname: Bonabi
authors.affiliation: Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Pelin
authors.initials: P
authors.lastname: Yuksel
authors.affiliation: Turkish Red Crescent, Istanbul, Turkey.
authors.forename: Ilhan
authors.initials: I
authors.lastname: Birinci
authors.affiliation: Deparment of Biostatistics, Medical School of Bezmialem Vakif University, Istanbul, Turkey.
authors.forename: Omer
authors.initials: O
authors.lastname: Uysal
authors.affiliation: Department of Medical Microbiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Bekir
authors.initials: B
authors.lastname: Kocazeybek
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000175:diagnosis* / Q000276:immunology; D015497:HIV-1 / Q000276:immunology / Q000302:isolation & purification*; D006801:Humans; D055633:Immune System Phenomena; D018950:Lipopolysaccharide Receptors / Q000097:blood* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood* / Q000276:immunology; D055815:Young Adult
chemical_list: D015415:Biomarkers; D018950:Lipopolysaccharide Receptors; D019798:Neopterin