Association Between Neopterin Levels and Outcome in 30 Day HIV/AIDS Naive Patients

Abstract

Introduction: HIV/AIDS is still a major problem throughout the world even in Indonesia. Some markers can provide information regarding the description of immune activity in HIV/AIDS. Neopterin produced by macrophages as a catabolic result of Guanosine Triphosphate (GTP) is one of them. Neopterin has been widely studied as a prognostic indicator of the course in HIV/AIDS. Until now there have been no studies examine the association between neopterin levels and outcomes in 30 days of HIV/AIDS patients.Methods: A prospective longitudinal analytic study involved 56 samples of HIV/AIDS naive patients from January to April 2019. Serum neopterin levels were measured by the Enzyme Linked Immunosorbent Assay (ELISA) method. Outcome is a living condition or death within the first 30 days of the patient being treated. Discriminant function analysis was used to determine the association between variable and controlling confounding factors using the "R" program. Outputs of p value was significant if <0.05.Results: The average age of the study subjects was 39.7 ± 11 years old with predominantly male gender (71.4%). The median serum neopterin level of the study subjects was 168.13 nmol/L with the lowest levels of 11.78 nmol/L and the highest level of 196.95 nmol/L. Outcomes were grouped live and died, each group at 50%. There was a significant positive association between serum neopterin levels and outcomes in 30 days (p=0.02)Conclusion: Role of neopterin levels still need to be proven as a prognostic factor by evaluating other factors that influence the outcome of HIV/AIDS patients.

Secondary syphilis mimicking mid-borderline leprosy in HIV-positive patient

“…10 The ARV is initiated in HIV patients without tuberculosis infection regardless of CD4 count. 13 First-line ARVs are given in combination of two nucleoside reverse-transcriptase inhibitors (NRTI), added with a nonnucleoside reverse-transcriptase inhibitor (NNRTI) or protease inhibitor (PI). 11 The treatment of FDC once a day consisting of tenofovir disoproxil fumarate, lamivudine and efavirenz is a combination that shows good therapeutic and virological response, rarely causes severe side effects and is the main choice of ARV in Indonesia.…”

“…In addition, several studies have shown that prophylactic administration of cotrimoxazole (TMP-SMX) in patients with low CD4 count can reduce the risk of opportunistic infections and mortality. 10, 13 In this case, the patient was diagnosed with HIV stage III due to weight loss of 15 kg (>10%) in 3 months, oral candidiasis in the last one month, history of sexual intercourse with men, chronic respiratory and mucocutaneous infections, reactive results of the three methods of examination, had a CD4 count of 14 cells/ µL and a viral load of 1,582,851 copies/mL. Fixed dose combination of ARV therapy (tenofovir disoproxil fumarate, lamivudine and efavirenz) was given because there was no pulmonary tuberculosis comorbidity (GeneXpert negative) and other laboratory results were normal.…”