CIRCULATING LEVELS OF NEOPTERIN AND INDICATORS OF NUTRITIONAL-STATUS IN HEMOPHILIAC PATIENTS WITH AND WITHOUT HIV-INFECTION

Neopterin, a product of activated macrophages/monocytes, was studied i n 20 HIV(+) and 20 HIV(-) hemophiliac patients aged 3-31 years. None o f the HIV(+) patients had clinical symptoms of AIDS, and most were asy mptomatic in CDC stage II. In the overall population and age matched p atients, neopterin levels were significantly higher in HIV(+) than in HIV(-) patients and they increased during the 10 months of median foll ow-up time. As expected, the mean levels of CD4 cells, CD4/CD8 cell ra tio, 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 o f HIV(+) patients (16% and 75%) than HIV(-) patients (0 and 20%) had n eopterin levels above normal (10 nmol/L). While 80% of HIV(+) less tha n 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 H IV(-) had prealbumin and neopterin levels in the abnormal range. Durin g follow-up, neither indicators of nutritional status nor CD4 number o r CD4/CD8 cell ratio changed as much as did neopterin levels. While ne opterin levels correlated negatively with CD4 cell number (r = -0.26), CD4/CD8 cell ratio (r = -0.39), platelets (r = -0.47, p < 0.05), prea lbumin (r = -0.47, p < 0.05) and albumin (r = -0.31), it positively co rrelated with CD8 number (r = 0.24), and neutrophils (r = 0.40). We co nclude that in the follow-up of HIV (+) hemophiliac young patients, me asurement of plasma neopterin and prealbumin may be very useful and pr obably more sensitive than other indices such as CD4 cell numbers and CD4/CD8 ratios. (C) 1998 Elsevier Science Inc.