n Southern African Journal of HIV Medicine - Levels of procalcitonin, C-reactive protein and neopterin in patients with advanced HIV-1 infection : original article

Volume 13, Issue 2
  • ISSN : 1608-9693
  • E-ISSN: 2078-6751



To compare the value of procalcitonin, C-reactive protein (CRP) and neopterin as indicators of immune deficiency, co-infection, efficacy of treatment, and disease progression, in patients with advanced HIV-1 infection.

Cross-sectional, investigating baseline blood measurements and clinical observations in 82 HIV-positive patients divided into an antiretroviral treatment (ART) group and an ART-naïve group.
Secondary general hospital in Pretoria.
Procalcitonin and CRP levels showed no significant differences between the ART and ART-naïve groups, and no correlations with CD4 counts or viral loads. CRP levels were significantly higher with TB co-infection (<0.05). Neopterin levels were raised above normal in 92% of the ART-naïve group and in 75% of the ART group. The levels were significantly higher (<0.05) in the ART-naïve group. Negative correlations were found between neopterin and CD4 counts for the total patient group (=-0.482; <0.001). Neopterin was significantly (<0.05) higher in the HIV/TB co-infection group than in those without TB. Higher neopterin levels at baseline were associated with a decline in CD4 counts over the ensuing 6-month period, and patients with higher baseline neopterin levels developed more complications over the 6-month period.
Compared with procalcitonin and CRP, neopterin appears to be associated with the degree of immunodeficiency and of co-infection with TB. Neopterin levels may be investigated further as a measure of disease progression or treatment response.

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