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Utility of Serum Neopterin and Serum IL-2 Receptor Levels to Predict Absolute CD4 T Lymphocyte Count in HIV Infected Cases

DOI: 10.1155/2013/143648

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Abstract:

A prospective study was carried out to evaluate the efficacy of serum neopterin and soluble IL-2 receptor (sIL-2R) concentrations in comparison to CD4 count to study the progression of HIV disease and monitor response to ART in HIV cases. One hundred newly diagnosed HIV seropositive subjects were recruited. CD4 counts were determined by FACS system. Serum neopterin and sIL-2R levels were measured using enzyme immunoassay. In our study, levels of neopterin and sIL-2R were significantly higher in subjects with CD4 200 cells/μL (with S. neopterin levels of 25.1?nmol/L and sIL-2R levels of 47.1?pM as cutoff values for CD4 200 cells/μL) compared to those in subjects with CD4 200 cells/μL at baseline which indicate that these markers can be utilized for initiation of ART in HIV cases. The levels of these markers decreased significantly after initiation of ART. In patients with CD4 200 cells/μL, these markers are helpful in predicting disease progression. 1. Introduction HIV/AIDS continues to exact an enormous toll throughout the world, in both human and economic terms, posing a serious impediment to the growth and economic stability of many developing countries [1]. Infection with HIV-1 produces a prolonged, gradually progressive disease which leads to opportunistic infections and eventually death. The likelihood and timing of development of clinical AIDS following seroconversion, for any particular individual, are not readily predictable; the use of nonclinical markers has become critically important to patient management. The various phases of HIV infection, including the early asymptomatic phase, are associated with quantifiable laboratory findings. Laboratory surrogate markers of HIV infection, are by definition, measurable traits that correlate with the development of clinical AIDS [2, 3]. The cost of antiretroviral therapy has dramatically reduced and this has led to the increased use of antiretroviral therapy (ART) in developing countries. In view of that, inexpensive laboratory tests are also needed to monitor disease progression and treatment response in HIV infected individuals, living in resource-limited environments most heavily impacted by the epidemic. Currently the standard methods used to monitor HIV infection are clinical assessment, flow cytometry based CD4 T lymphocyte count (CD4 counts) measurement, and molecular assays to quantify plasma viral load (PVL). Though clinical assessment remains the most feasible approach, it lacks sensitivity in determining disease stage, progression, and therapy response; therefore, it is to be used in

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