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

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