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Neopterin and Biochemical Parameters as Indicators of Predicting HIV Disease Progression and Treatment Response: A Cross-sectional Study in Ghana

Background: Surrogate markers have been identified to play significant role in the pathogenesis and prognosis of HIV infection. However, there is limited data on the utility of neopterin estimation in HIV infection. Therefore, the study sought to measure and ascertains the trends of serum neopterin and other biochemical parameters as indicators of predicting HIV disease progression and treatment response among HIV seropositive individuals. 
Methods: A cross-sectional study with 298 HIV seropositive individuals consisting of 165 HIV on highly active antiretroviral treatment and 136 naïve highly active antiretroviral patients. Venous blood was drawn for the assay of neopterin and the other biochemical parameters. 
Results: Neopterin was significantly lower (P<0.0001) in patients in the highly active antiretroviral therapy than those in the naïve highly active antiretroviral therapy group. Serum neopterin increased as the disease progresses and decreased as the duration of the therapy treatment increased (p=0.0001). At a cut of point of 54.5 nmol/L, neopterin gave a sensitivity of 97.5%, specificity of 95.9% and an area under the curve of 0.99. 
Conclusion: Neopterin has shown to be to be good marker in predicting HIV disease progression especially in patients with CD4 counts less than 200mm-3 and a useful indicator of patient’s response to therapy treatment.