beta(2)-microglobulin and immunoglobulins are more useful markers of disease progression in HIV than neopterin and adenosine deaminase

Reference change values of six biochemical quantities (beta(2)-microglobuli n, neopterin, adenosine deaminase and immunoglobulins IgA, IgG and IgM) hav e been established in asymptomatic human immunodeficiency virus (HIV)-infec ted patients following the method described by Harris and Yasaka in 1983. P atients included in the evaluation were classified as A1, A2 or A3 accordin g to the classification of the Centers for Disease Control (CDC) (January 1 993). All patients were followed-up quarterly, with a minimum of four sampl es each available for statistical analysis. The main objective of this pape r was to study whether differences found to be greater than calculated refe rence change values could predict clinical or immunological worsening in pa tients' status. Retrospective analysis was made in asymptomatic patients (n = 256) included in an HIV infection protocol carried out in our hospital. Of these patients, 179 showed clinical or immunological worsening during th e study period and 77 maintained their clinical and immunological status. C hanges in beta(2)-microglobulin showed the greatest sensitivity to detect c linical or immunological worsening (43.0%), whereas changes in adenosine de aminase showed the lowest (21.8%). Clinical or immunological worsening in 1 69 of the 179 patients was detected by one of the six biochemical quantitie s evaluated. Ten patients showed clinical or immunological worsening, altho ugh differences between measurements were lower than the reference change v alues calculated. Of 77 patients whose clinical state did not deteriorate, there was a change in biochemical. analytes greater than the reference valu e calculated in 29 patients (a period of 12 months had elapsed since detect ion). In 48 patients, no increases greater than calculated reference change values were detected. The sensitivity obtained using the six analytes was 94.4% and the specificity was 62.3%.