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Neopterin to Predict Disease Progression in Intravenous Drug Users Infected with HIV-1

  • R. Zangerle
  • D. Fuchs
  • G. Reibnegger
  • P. Fritsch
  • H. Wachter
Conference paper

Abstract

Most of our knowledge about the natural history of HIV infection comes from cohorts of homosexual men and men with hemophilia. The natural history of Human Immunodeficiency Virus (HIV) infection in intravenous drug users (IVDUs) is different from other people at risk in as far as some diseases, such as bacterial pneumonia or endocarditis, contribute to morbidity and mortality (Moss 1989); however, these diseases related to drug intake are not listed in the existing HIV staging classifications nor in the AIDS definition. A staging system for HIV infection should be easily capable of determining individual prognosis for all people at risk, but such a system is still lacking (Chaisson 1990). Therefore, the identification of factors correlated with and possibly contributing to the outcome of infection with HIV is important for our understanding of the pathogenesis and natural history of HIV infection and in designing therapeutic trials. Many reports address the possibility of early prediction of HIV-1 related disease progression. Low numbers of CD4+ T cells and low ratios of CD4+/CD8+ T cells were shown to be associated with a more unfavourable disease course (Polk 1987, Moss 1988, Eyster 1989, Fahey 1990, Fernandez-Cruz 1990). Additionally, HIV-1 p 24 antigenaemia (de Wolf 1988), increased concentrations of ß2-microglobulin in serum (Moss 1988, Anderson 1990) and increased urinary and/or serum concentrations of neopterin (Fahey 1990, Fuchs 1988, Fuchs 1989) indicated more rapid progression of the disease. However, the question remains whether these data, which were raised mainly from cohorts of homosexual men and men with haemophilia, also are valid for people with intravenous drug use. The aim of our study was to investigate the power of urinary neopterin to predict the development of AIDS or Walter Reed stage 5 (oral candidiasis in combination with a CD4 T cell count below 400 × 10−6/liter).

Keywords

Human Immunodeficiency Virus Human Immunodeficiency Virus Type Human Immunodeficiency Virus Infection Human Immunodeficiency Virus Disease Intravenous Drug User 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. ANDERSON RE, LANG W, SHIBOSKI S, ROYCE R, JEWELL N, WINKELSTEIN W Jr (1990) Use of beta 2-microglobulin level and CD4 lymphocyte count to predict development of acquired immunodeficiency syndrome in persons with human immunodeficiency virus infection. Arch Intern Med 150: 73–77.PubMedCrossRefGoogle Scholar
  2. CHAISSON RE, VOLBERDING PA (1990) Clinical manifestations of HIV infection In Principles and Practice of Infectious Diseases, 3rd Edition edited by Mandell GL, Douglas RG Jr, Bennett JE. New York: Churchill Livingstone pp 1059–1092.Google Scholar
  3. DES-JARLAIS DC, FRIEDMAN SR, MARMOR M et al (1987) Development of AIDS, HIV seroconversion, and potential cofactors for T4 cell loss in a cohort of intravenous drug users. AIDS 1: 105–111.PubMedGoogle Scholar
  4. DE WOLF F, LANGE JMA, HOUWELING JTM et al (1988) Numbers of CD4+ cells and the levels of core antigens of an antibodies to the human immunodeficiency virus as predictors of AIDS among seropositive homosexual men. J Infect Dis 158: 615–621.PubMedCrossRefGoogle Scholar
  5. EYSTER ME, BALLARD JO, GAIL MH, DRUMMOND JE, GOEDERT JJ (1989) Predictive markers for the acquired immunodeficiency syndrome (AIDS) in hemophiliacs: persistence of p24 antigen and low T4 cell count. Ann Intern Med 110: 963–969.PubMedGoogle Scholar
  6. FAHEY JL, TAYLOR JM, DETELS R et al (1990) The prognostic value of cellular and serologic markers in infection with human immunodeficiency virus type 1. N Engl J Med 322: 166–172.PubMedCrossRefGoogle Scholar
  7. FERNANDEZ-CRUZ E, DESCO M, MONTES MG, LONGO N, GONZALEZ B, ZABAY JM (1990) Immunological and serological markers predictive of progression to AIDS in a cohort of HIV-infected drug users. AIDS 4: 987–994.CrossRefGoogle Scholar
  8. FUCHS D, HAUSEN A, REIBNEGGER G, WERNER ER, DIERICH MP, WACHTER H (1988) Neopterin as a marker for activated cell-mediated immunity: application in HIV infection. Immunol Today 9: 150–155.PubMedCrossRefGoogle Scholar
  9. FUCHS D, SPIRA TJ, HAUSEN A et al (1989) Neopterin as a predictive marker for disease progression in human immunodeficiency virus type 1 infection. Clin Chem 35: 1746–1749.PubMedGoogle Scholar
  10. FUCHS D, HAUSEN A, REIBNEGGER G et al (1989) Interferon-gamm concentrations are increased in sera from individuals with human immunodeficiency virus type 1. J Acquir Immune Defic Syndr 2: 158–162PubMedGoogle Scholar
  11. GAIL MH, ROSENBERG PS, GOEDERT JJ (1990) Therapy may explain recent deficits in AIDS incidence. J Acquir Immune Defic Syndr 3: 296–306.PubMedGoogle Scholar
  12. GORTER RW, VRANIZIAN K; MOSS AR, BRODIE B, WOLFE H (1990) Progression of HIV disease in intravenous drug users. Sixth International Conference on AIDS, San Francisco, June 22–24, Th. C. 644Google Scholar
  13. HUBER C, BATCHELOR JR, FUCHS D et al (1984) Immune response associated production of neopterin release from macrophages primarily under control of interferon-gamma. J Exp Med 160: 310–316.PubMedCrossRefGoogle Scholar
  14. MACDONALD KB, CHMIEL JS, GOLDSMITH J et al (1988) Prognostic usefulness of the Walter Reed Staging Classification for HIV infection. J Acquir Immune Defic Syndr 1: 367–374.Google Scholar
  15. MELMED RN, TAYLOR JM, DETELS R, BOZORGMEHRI M, FAHEY JL (1989) Serum neopterin changes in HIV-infected subjects: indicator of significant pathology, CD4 T cell changes, and the development of AIDS. J Acquir Immune Defic Sndr 2: 70–76.Google Scholar
  16. MOSS AR, BACCHETTI P, Osmond D et al (1988) Seropostivity for HIV and the development of AIDS or AIDS related condition: three year follow up of the San Francisco General Hospital cohort. Br Med J 296: 745–750.CrossRefGoogle Scholar
  17. MOSS AR, BACCHETTI P (1989) Natural history of HIV infection. AIDS 3: 55–61.PubMedCrossRefGoogle Scholar
  18. POLK BF, FOX R, KANCHANARAKSA S et al (1987) Predictors of the acquired immunodeficiency syndrome developing in a cohort of seropositive homosexual men. N Engl J Med 316: 61–66.PubMedCrossRefGoogle Scholar
  19. SONNERBORG AB, VON STEDINGK LV, HANNSON LO, STRANNEGARD OO (1989) Elevated neopterin and beta 2-microglobulin levels in blood and cerebrospinal fluid occur early in HIV-1 infection. AIDS 3: 277–283.PubMedCrossRefGoogle Scholar
  20. WACHTER H, FUCHS D, HAUSEN A, REIBNEGGER G, WERNER ER (1989) Neopterin as a marker for activation of cellular immunity: immunologic basis and clinical application. Adv Clin Chem 27: 81–141.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag/Wien 1991

Authors and Affiliations

  • R. Zangerle
    • 1
  • D. Fuchs
    • 2
  • G. Reibnegger
    • 3
  • P. Fritsch
    • 3
  • H. Wachter
    • 2
  1. 1.Department of Dermatology and VenereologyThe AIDS UnitInnsbruckAustria
  2. 2.Institute of Medical Chemistry and BiochemistryUniversity of InnsbruckInnsbruckAustria
  3. 3.Ludwig Boltzmann Institute of AIDS ResearchInnsbruckAustria

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