NEOPTERIN, BETA(2)-MICROGLOBULIN, AND ACUTE-PHASE PROTEINS IN HIV-1-SEROPOSITIVE AND HIV-1-SERONEGATIVE ZAMBIAN PATIENTS WITH TUBERCULOSIS

Neopterin is a biochemical marker for the activation of the cell-media ted immune system. We measured neopterin, beta(2)-microglobulin, and a cute phase proteins in 31 HIV-seropositive and -seronegative Zambian p atients with tuberculosis, using stored sera that had been obtained at the beginning and at end of antituberculosis treatment. In both HIV-s eropositive and -seronegative patients neopterin and acute phase prote ins were elevated when tuberculosis was initially diagnosed and fell d uring treatment. In contrast, the mean beta(2)-microglobulin level inc reased during antituberculous therapy in the HIV-seropositive group. S erum neopterin levels at diagnosis were correlated with other paramete rs of disease activity (fever, anemia, and weight loss), In both group s, patients with persistently elevated neopterin levels at the end of treatment were more likely to suffer relapse of tuberculosis or other adverse health events in the subsequent follow-up period. Neopterin ca n be used to monitor the response to antituberculous therapy in both H IV-seropositive and -seronegative patients and may have a prognostic v alue for the patients' wellbeing in the follow-up period.