Is Neopterin Helpful in Distinguishing between Different Disease Patterns in AIDS?

Previous studies of the role of cellular and serologic markers in patients infected with the human immunodeficiency virus type 1 (H IV -1) have focussed mainly on the predictivity for the transition from asymptomatic HIV-1 seropositive status to ATDSrelated complex or to AIDS itself (1. 2). The CDC definition of AIDS was not intended for clinical prognostic use and therefore its use as the endpoint in prognostic studies has some shortcomings. For example, it has become clear that the prognosis of AIDS patients when only Kaposi ' s sarcoma is present differs markedly from that observed when opportunistic infection is involved (3) . To better understand the natural history of HIV-l infection it would be more accurate to elucidate markers for the different diseases which define AIDS. It has been shown that pneumocystis carinii pneumonia is unlikely to develop in HIV infected patients unless their CD4+ T cells are depleted to < 200/mm' or the patients are symptomatic (4). Therefore. prophylaxis should be reserved for these patients . The aim of this study was to analyse the cellular and serologic characteristics associated with certain indicator diseases of AIDS . We evaluated the relationship of the number of total lymphocytes, the number of CD4 + T cells. serum ~2 microglobulin and urinary neopterin to these AIDS defining opportunistic infections at the time of the initial diagnosis.