PROGNOSTIC VALUE OF ADENOSINE-DEAMINASE COMPARED TO OTHER MARKERS FORPROGRESSION TO ACQUIRED-IMMUNODEFICIENCY-SYNDROME AMONG INTRAVENOUS-DRUG-USERS

This study was designed to determine the prognostic value of erythrocy te adenosine deaminase (ADA) as a possible indicator of progression to AIDS, and compare this with other known cellular and serological mark ers. At tile end of a 3-year study, a cohort of 114 human immunodefici ency virus-1 (HIV-1) seropositive intravenous drug users (IVDUs) from the five different Center for Disease Control (CDC) groups was examine d in order to estimate the prognostic relevance with respect to the pr ogression to acquired immunodeficiency syndrome (AIDS) of each of the following markers at baseline value: number and percentage of CD4(+) T cells, number of CD8(+) T cells, CD4(+)/CD8(+) ratio, IgA and beta(2) microglobulin and ADA levels, and the presence of HIV antigens. Moreo ver, 57 IVDUs belonging to II and III CDC groups were analyzed in a fo llow-up study at 6-month intervals, in order to evaluate and compare t he behavior of each marker over time. The prognostic significance of e ach marker was assessed by computing the survival distribution and the Cox analysis in a multivariate model providing the set of markers wit h greatest predictive value. The revels of ADA and the CD4(+)/CD8(+) r atio showed a linear association with disease staging, whereas beta(2) microglobulin and CD4(+)/ CD8(+) ratio were the best predictors for A IDS progression. A highly significant increase in ADA and beta(2) micr oglobulin was observed during follow-up. The results obtained among HI V-positive IVDUs clearly indicate that the erythrocyte ADA may be cons idered a reliable marker of the development of HIV infection from the intermediate stages of the disease onwards. The measurement of beta(2) microglobulin should be regarded as a particularly useful parameter i n the assessment of HIV infection in drug users. (C) 1995 Wiley-Liss, Inc.