Circulating levels of neopterin and indicators of nutritional status in hemophiliac patients with and without HIV infection
1998
Kuvibidila, S. | Sharma, R. | Warrier, R.P. | Andes, W.A.
Neopterin, a product of activated macrophages/monocytes, was studied in 20 HIV(+) and 20 HIV(-) hemophiliac patients aged 3-31 years. None of the HIV(+) patients had clinical symptoms of AIDS, and most were asymptomatic in CDC stage II. In the overall population and age matched patients, neopterin levels were significantly higher in HIV(+) than in HIV(-) patients and they increased during the 10 months of median follow-up time. As expected, the mean levels of CD4 cells, CD4/CD8 cell ratio, absolute lymphocyte counts, and indicators of nutritional status (albumin, prealbumin) were significantly lower (p < 0.005-0.05) in HIV(+) than HIV(-) patients. In both blood samples, a higher percentage of HIV(+) patients (16% and 75%) than HIV(-) patients (0 and 20%) had neopterin levels above normal (10 nmol/L). While 80% of HIV(+) less than or equal to 13 years old and 50% of age-matched HIV(-) patients had prealbumin levels below normal (< 160 mg/L), 60% of HIV(+) and 5% of HIV(-) had prealbumin and neopterin levels in the abnormal range. During follow-up, neither indicators of nutritional status nor CD4 number or CD4/CD8 cell ratio changed as much as did neopterin levels. While neopterin levels correlated negatively with CD4 cell number (r=-0.26), CD4/CD8 cell ratio (r=-0.39), platelets (r=-0.47, p<0.05), prealbumin (r=-0.47, p<0.05) and albumin (r=-0.31), it positively correlated with CD8 number (r=0.24), and neutrophils (r=0.40). We conclude that in the follow-up of HIV(+) hemophiliac young patients, measurement of plasma neopterin and prealbumin may be very useful and probably more sensitive than other indices such as CD4 cell numbers and CD4/CD8 ratios.
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