Abstract
BackgroundWe aimed to evaluate the roles of the plasma immune activation biomarkers neopterin and soluble CD14 (sCD14) in the indirect assessment of the immune activation status of patients with the indeterminate HIV-1 (IHIV-1) pattern and a true HIV-1-positive infection (PCG).MethodsThis cross-sectional and descriptive study included eighty-eight patients with the IHIV-1 pattern, 100 patients in the PCG, and 100 people in a healthy control group (HCG). Neopterin and sCD14 levels were determined by competitive and sandwich ELISA methods, respectively.ResultsMean neopterin and sCD14 levels among those with the IHIV-1 pattern were significantly lower than among the PCG (p < 0.001 and p = 0.001, respectively), but they were similiar to those in the HCG (p = 0.57 and p = 0.66, respectively. Mean neopterin and sCD14 levels among the PCG were found to be significantly higher than among those with the IHIV-1 pattern (p < 0.001 and p = 0.001, respectively) and among those in the HCG (p = 0.001, p < 0.001, respectively). Neopterin did not have adequate predictive value for identifying those in the PCG (area under the curve [AUC] = 0.534; 95% CI, 0.463–0.605; p = 0.4256); sCD14 also had poor predictive value but high specificity (100%) for identifying those in the PCG (AUC = 0.627; 95% CI, 0.556–0.694; p = 0.0036).ConclusionsWhile low levels of these two biomarkers were detected among those with the IHIV-1 pattern, they were found in high levels among those in the PCG. These two markers obviously cannot be used as a sceening test because they have low sensitivies. Taken together, we suggest that neopterin and sCD14 may be helpful because they both have high specificity (92%-100%) as indirect non-specific markers for predicting the immune activation status of individuals, whether or not they have true positive HIV-1.
Highlights
Neopterin is a purine nucleotide which forms as results of the guanosine triphosphate (GTP) catabolism
Neopterin did not have adequate predictive value for identifying those in the positive control group (PCG); soluble CD14 (sCD14)
Neopterin and sCD14 in HIV-1 Infections had poor predictive value but high specificity (100%) for identifying those in the PCG (AUC = 0.627; 95% CI, 0.556–0.694; p = 0.0036)
Summary
Neopterin is a purine nucleotide which forms as results of the guanosine triphosphate (GTP) catabolism. Levels increase in pathologies and with activated cellular immune mechanisms It is released from monocytes, macrophages, dendritic cells, and endothelial cells activated by interferon gamma (IFN-γ) secreted by Th1 lymphocytes [1,2]. Soluble CD14 (sCD14) is a glycosyl phosphatidyl inositolse (GPI) linked protein that is expressed as a receptor on the surface of cells such as monocyte/macrophages (M/Ms), polymorphonuclear leukocytes (PNLs), and dendritic cells involved in natural immune responses. We aimed to evaluate the roles of the plasma immune activation biomarkers neopterin and soluble CD14 (sCD14) in the indirect assessment of the immune activation status of patients with the indeterminate HIV-1 (IHIV-1) pattern and a true HIV-1-positive infection (PCG)
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