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Neopterin and β2-microglobulin as prognostic indices in human immunodeficiency virus type 1 infection

Neopterin und β2-Mikroglobulin als Prognoseindices bei Infektionen mit dem humanen Immunschwächevirus Typ 1 (HIV-1)

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Summary

The great majority of individuals with human immunodeficiency virus type 1 (HIV-1) infection presents with no signs or symptoms, or only lymphadenopathy. To initiate prophylactic measures in time it is necessary to establish risk criteria. CD4+ cell counts are significant predictors. Supplementary methods to improve the predictive information of CD4+ cell counts are still required. In addition, CD4+ cell counting is laborious, expensive, and restricted to specialized laboratories. Thus, there is also a place for more easily performed laboratory tests with similar predictive value as CD4+ cell counts. Neopterin and β2-microglobulin levels proved to be significant predictors of AIDS risk in HIV-1 seropositives. The predictive value of both parameters is equal to CD4+ cell counts and both markers are significant joint predictors in addition to CD4+ cell counts. Measurement of the parameters is done in serum (neopterin and β2-microglobulin) or urine (neopterin) specimens which reduces the risk of HIV-1 transmission compared to handling of whole-blood samples as it is required for cell counting. Although more studies are needed, especially in developing countries and in persons receiving zidovudine, it can be recommended to use neopterin and β2-microglobulin as additional marker to estimate AIDS risk in HIV-1 seropositive individuals. Moreover, both markers may be useful for this purpose without CD4+ cell counts if cell counting is not available.

Zusammenfassung

Die Mehrheit der mit dem humanen Immundefizienzvirus Typ 1 (HIV-1) infizierten Personen ist frei von Symptomen oder weist nur persistierende Lymphadenopathie auf. Es ist notwendig, Risikokriterien für das Fortschreiten der Erkrankung zu erstellen, um zeitgerecht prophylaktische Maßnahmen einleiten zu können. Die Zahl der CD4-positiven Zellen ist ein geeigneter Prognoseparameter. Die Zellzählung ist jedoch aufwendig, teuer und Speziallabors vorbehalten, sodaß zusätzliche einfache Untersuchungen erwünscht sind, um die Risikoabschätzung weiter zu verbessern. Wissenschaftliche Untersuchungen ergaben, daß Neopterin und ß2- Mikroglobulin bei der HIV-1 Infektion gleich gute Prognoseparameter sind wie die Zahl der CD4-positiven Zellen; beide Parameter liefern darüber hinaus zusätzliche Infromation. Die Bestimmung der Meßgrößen erfolgt aus Serum (Neopterin und ß2-Mikroglobulin) oder Urin (Neopterin), wodurch das Risiko einer eventuellen HIV-1 Übertragung bei der Testdurchführung im Vergleich zur Bearbeitung von Vollblut, wie es zur Zellzählung benötigt wird, verringert wird. Auch wenn noch weitere Untersuchungen vor allem in Entwicklungsländern und in mit Zidovudin behandelten HIV-1 Infizierten notwendig sind, können Neopterin und β2-Mikroglobulin als zusätzliche Parameter zur Abschätzung des AIDS-Risikos bei HIV-1 Infizierten empfohlen werden. Beide Meßgrößen sind auch dazu geeignet, die Bestimmung von CD4- positiven Zellen zu ersetzen, wenn die Möglichkeiten der Zellquantifizierung nicht gegeben sind.

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Authors and Affiliations

  1. Institut für Medizinische Chemie und Biochemie, Universität Innsbruck, und Ludwig Boltzmann Institut für AIDS-Forschung, A-6020, Innsbruck, Austria

    D. Fuchs,  G. Reibnegger, E. R. Werner D. Sc. &  H. Wachter

  2. Institut für Medizinische Biometrie, Universität Tübingen, W-7400, Tübingen, Germany

    A. Krämer M. D.

  3. Institut für Hygiene, Universität Innsbruck, und Ludwig Boltzmann Institut für AIDS-Forschung, A-6020, Innsbruck, Austria

    M. P. Dierich

  4. Epidemiology and Biostatistics Program, National Cancer Institute, 20892, Bethesda, MD, USA

    J. J. Goedert M. D.

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  1. D. Fuchs
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  4. E. R. Werner D. Sc.
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Fuchs, D., Krämer, A., Reibnegger, G. et al. Neopterin and β2-microglobulin as prognostic indices in human immunodeficiency virus type 1 infection. Infection 19 (Suppl 2), S98–S102 (1991). https://doi.org/10.1007/BF01644476

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