β₂-Microglobulin and Immunoglobulins are More Useful Markers of Disease Progression in HIV than Neopterin and Adenosine Deaminase

Abstract

Reference change values of six biochemical quantities (beta 2-microglobulin, neopterin, adenosine deaminase and immunoglobulins IgA, IgG and IgM) have been established in asymptomatic human immunodeficiency virus (HIV)-infected patients following the method described by Harris and Yasaka in 1983. Patients included in the evaluation were classified as A1, A2 or A3 according to the classification of the Centers for Disease Control (CDC) (January 1993). All patients were followed-up quarterly, with a minimum of four samples each available for statistical analysis. The main objective of this paper was to study whether differences found to be greater than calculated reference change values could predict clinical or immunological worsening in patients' status. Retrospective analysis was made in asymptomatic patients (n = 256) included in an HIV infection protocol carried out in our hospital. Of these patients, 179 showed clinical or immunological worsening during the study period and 77 maintained their clinical and immunological status. Changes in beta 2-microglobulin showed the greatest sensitivity to detect clinical or immunological worsening (43.0%), whereas changes in adenosine deaminase showed the lowest (21.8%). Clinical or immunological worsening in 169 of the 179 patients was detected by one of the six biochemical quantities evaluated. Ten patients showed clinical or immunological worsening, although differences between measurements were lower than the reference change values calculated. Of 77 patients whose clinical state did not deteriorate, there was a change in biochemical analytes greater than the reference value calculated in 29 patients (a period of 12 months had elapsed since detection). In 48 patients, no increases greater than calculated reference change values were detected. The sensitivity obtained using the six analytes was 94.4% and the specificity was 62.3%.

Measurement of renal function in kidney donors using serum cystatin C and β2-microglobulin

“…However, an increase in B2M is not speci¢c to a fall in GFR since it is elevated in viral infections, including HIV, re£ecting lymphocyte turnover. 7 Furthermore, it has been shown that serum B2M re£ects changes in lymphocyte activation in post-transplant patients. 8 Even though this test is available in our laboratory it has been ruled out for the detection of a reduction in GFR.…”

Neopterin in Diagnosis and Monitoring of Infectious Diseases

“…A retrospective study compared β 2 microglobulin, immunoglobulin A, G, and M, adenosine deaminase, and neopterin levels above normal range as predictors of clinical or immunological deterioration in 256 patients with HIV infection. Changes in β 2 microglobulin levels showed the greatest sensitivity to detect worsening (43%) with neopterin slightly less sensitive (41.9%) followed by immunoglobulin levels (26.8–35.2%) and adenosine deaminase levels with 21.8% having the lowest sensitivity [ 28 ].…”

Saliva and inhibition of HIV‐1 infection: molecular mechanisms

“…The constitutively expressed subunit is a sensitive but nonspecific parameter of inflammation and infection (Fuchs et al, 1991). β-2 M concentrations in OMT have shown good correlation with serum levels (Nishanian et al, 1998) and may show greater sensitivity than neopterin in detecting clinical or immunological deterioration (Martinez-Bru et al, 1999).…”