Elevated adenosine deaminase activity in patients with HIV and tuberculousperitonitis

Objective To evaluate the diagnostic potential of the ADA(T), ADA isoenzyme s (ADA(1) and ADA(2)) and the interferon-gamma (IFN-gamma) test in HIV-sero positive patients with tuberculous peritonitis. Methods Ascitic ADA(T), ADA(1), ADA(2) and IFN-gamma were prospectively eva luated in HIV-seronegative patients with tuberculous peritonitis (n =17), H IV-seropositive patients with tuberculous peritonitis (n = 6) and in patien ts with cirrhosis (n = 22) and malignancy (n = 5). Results ADA(T) and ADA(2) isoenzyme activities of HIV-seronegative (ADA(T) = 109 U/I; ADA(2) = 94 U/I) and HIV-seropositive (ADA(T) =109.5 U/I; ADA(2) = 95.5 U/I) patients with tuberculous peritonitis, respectively, were sign ificantly different (P < 0.001) from patients with cirrhosis (ADA(T) = 10.5 U/I; ADA(2) = 8 U/I) and malignancy (ADA(T) = 13 U/I; ADA(2) = 11 U/I). Th ere was no significant difference in ADA(T) and ADA(2) activities between H IV-seropositive and seronegative patients with tuberculous peritonitis, The re was no significant correlation between ADA, its isoenzymes and IFN-gamma . Conclusions The diagnosis of tuberculous peritonitis can be made by a sensi tive, relatively non-invasive procedure in both HIV-seronegative and seropo sitive patients with minimal risk to the patient and the investigator, The diagnostic value of ADA(T) is not enhanced by measuring ADA isoenzymes or I FN-gamma. Eur J Gastroenterol Hepatol 11:337-341 (C) 1999 Lippincott Willia ms & Wilkins.