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1994-10-25
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Document 3096
DOCN M94A3096
TI Urinary neopterin as a prognostic index of survival time in HIV-1
infection.
DT 9412
AU Rogstad KE; Morgan L; Hughes J; Bignell CJ; Department of Genitourinary
Medicine, City Hospital, Nottingham,; UK.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):154 (abstract no. PB0044). Unique
Identifier : AIDSLINE ICA10/94369479
AB OBJECTIVE: To assess the value of urinary neopterin as a predictor of
survival time in patients infected with HIV-1. METHOD: This was a
semi-longitudinal study of 67 patients (63 male, 4 female) seropositive
for HIV-1 attending a genitourinary clinic and included those with
homosexually and heterosexually acquired infection, intravenous drug
abusers and haemophiliacs. Neopterin was measured on random urine
samples by HPLC. Results were expressed as mumol neopterin per mol
creatinine (reference range 40 to 210). Follow up was for a minimum of
13 months (median 34 months; range 13 to 38 months). Kaplan-Meier
survival curves were calculated using time to death or months of follow
up from the first recorded neopterin value exceeding arbitary thresholds
of 300, 400, 500, 600 and 700 mumol/mol. RESULTS: The number of
measurements from each patient ranged from 1 to 10, median 2. A trend
for values to increase with clinical progression of the disease was seen
in those subjects (n = 31) with 3 or more observations. 17 patients (16
male, 1 female) died during the course of the study; overall survival at
1 and 2 years was 94% (SE 3%) and 77% (SE 6%) respectively. There was a
clear inverse relationship between urinary neopterin levels and 1 and 2
year survival. This was highly significant at 2 years (P < .001), with
survival ranging from 76% (SE 6%) in patients with neopterin results
exceeding 300 mumol/mol to 20% (SE 10%) in those with neopterin results
greater than 700 mumol/mol. CONCLUSION: Sequential urinary neopterin
measurements may be valuable in predicting survival times in HIV-1
infected patients. We are currently accumulating a larger data set, and
results will be presented comparing the value of urinary neopterin with
CD4 lymphocyte counts as prognostic indices.
DE Acquired Immunodeficiency Syndrome/*MORTALITY/TRANSMISSION/*URINE
Biological Markers/URINE Biopterin/*ANALOGS & DERIVATIVES/URINE
Comparative Study Female Human HIV
Seropositivity/*MORTALITY/TRANSMISSION/*URINE *HIV-1 Male Predictive
Value of Tests Prognosis Risk Factors Survival Rate Time Factors
MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).