Urinary NeopterinConcentrationsvs Total Neopterinsfor Clinical Utility

Neopterin measurements are especially useful as an early marker in (e.g.) allograft rejections and in patients infected with human immunodeficiency virus type 1 (H1V-1). An increased concentration of total neopterins (neoptenn + dihydroneopterin) is also a significant marker in patients with H1V-1infection,in thisstudywe comparedconcentrations of neopterin and total neopterins in urine samples from 77 homosexual men with and 73 without established H1V-1 infection. H1V-1-seropositivehomosexualmen had higher concentrationsof neopterin and total neopterins (and 7,8dihydroneopterin)in their urine than did those who were HIV-1-seronegative,and there was a close correlationbetween neopterinand total neopterins.Both neopterinvanablescorrelatedinverselywithCD4 T-cellcountsand CD4/ CD8 T-cellratiosbutnotwithCD8 T-celI countsinthe H1V-1-seropositivemen. Our data indicate that measurements of neopterinand total neopterinsare of almostequal potential for clinical diagnosis. However, when measuring total neopterins, which includes oxidation of 7,8-dihydroneoptenn toneopterin, more strict requirementsof sample collectionand handlingare necessaryto avoid degradation of the 7,8-dihydro derivative.

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