Original Research

Levels of procalcitonin, C-reactive protein and neopterin in patients with advanced HIV-1 infection

P Bipath, M Viljoen, Peter F Levay
Southern African Journal of HIV Medicine | Vol 13, No 2 | a143 | DOI: https://doi.org/10.4102/sajhivmed.v13i2.143 | © 2012 P Bipath, M Viljoen, Peter F Levay | This work is licensed under CC Attribution 4.0
Submitted: 15 December 2012 | Published: 07 June 2012

About the author(s)

P Bipath, Department of Physiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa
M Viljoen,
Peter F Levay, Department of Internal Medicine, Kalafong Hospital and School of Medicine, Faculty of Health Sciences, University of Pretoria


Objectives. 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.

Design. 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.

Setting. Secondary general hospital in Pretoria.

Results. 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 (p<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 (p<0.05) in the ART- naïve group. Negative correlations were found between neopterin and CD4 counts for the total patient group (r=-0.482; p<0.001). Neopterin was significantly (p<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.

Conclusions. 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.

S Afr J HIV Med 2012;13(2):78-82.


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