Neopterin concentration in cerebrospinal fluid in HIV-positive patients with central nervous system complications

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BACKGROUND

The composition of cerebrospinal fluid (CSF) analysis has its own diagnostic value.

AIM

To measure the neopterin concentration in the CSF and blood serum of patients with central nervous system (CNS) damage in HIV-infected patients in the AIDS stage.

MATERIAL AND METHODS

All included patients were divided into three group. The main group (group 1) consisted of HIV-infected patients with cerebral toxoplasmosis (n=22), the comparison group (group 2) consisted of HIV-infected patients with fungal lesions of the central nervous system (CNS cryptococcosis) (n=15). The «control» group (group 3, without an opportunistic infectious agent) was represented by 7 patients hospitalized with symptoms of HIV-associated encephalopathy. The concentration of neopterin (nmol/L) was determined by the ELISA method using the kit of the company «IBL» (Germany)-Neopterin ELISA.

RESULTS

The average concentration of neopterin in all the studied liquor samples was 7.53 times higher than its average serum level (p<0.000001) and did not correlate with its serum concentration (R=0.234117). Differences in the concentration of neopterin between the samples of liquor were established (p=0.0185). The highest level of neopterin (Me; Q1—Q3) was found in the CSF of HIV-infected patients with fungal lesions (94.46; 60.36—108.55 nmol/L), the lowest — in HIV-infected patients hospitalized with encephalopathy (31.65; 18.23—74.46 nmol/L). In patients with toxoplasmosis, intermediate concentration values of neopterin in the cerebrospinal fluid were obtained (65.35; 29.13-90.96 nmol/l). There were no differences in the concentration of neopterin in the blood serum between the groups (p=0.19993).

CONCLUSIONS

The neopterin concentration in CSF is determined by its production by CNS cells, and not by passive penetration from the blood serum. Differences in the concentration of neopterin in the CSF of patients with HIV-associated CNS damage in the AIDS stage may be due to an etiological factor.

Keywords:

liquor

cerebrospinal fluid

neopterin

HIV infection

aids

toxoplasmosis

cryptococcosis

Authors:

Karakulova Yu.V.

Wagner Perm State Medical University

SPIN RSCI: 5066-6556
Scopus AuthorID: 12647536000
ResearcherID: D-2553-2018
ORCID: 0000-0002-7536-2060

Seksyaev N.E.

E.A. Wagner Perm State Medical University

Sosnin D.Yu.

E.A. Vagner Perm State Medical University

ORCID: 0000-0002-1232-8826

Received:

06.07.2021

Accepted:

23.08.2021

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