ArticlePloS one2015
Plasma Levels of Neopterin and C-Reactive Protein (CRP) in Tuberculosis (TB) with and without HIV Coinfection in Relation to CD4 Cell Count.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
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Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Screening performance of C-reactive protein for active pulmonary tuberculosis in HIV-positive patients: A systematic review with a meta-analysis.Frontiers in immunology · 2022Pooled it
- Macrophage Activation Marker Neopterin: A Candidate Biomarker for Treatment Response and Relapse in Visceral Leishmaniasis.Frontiers in cellular and infection microbiology · 2018Trial
- The accuracy of point-of-care C-Reactive Protein as a screening test for tuberculosis in children.PLOS global public health · 2024Article
- The Role of C-Reactive Protein as a Triage Tool for Pulmonary Tuberculosis in Children.Journal of the Pediatric Infectious Diseases Society · 2022Article
- Advancing mRNA technologies for therapies and vaccines: An African context.Frontiers in immunology · 2022Review
- Evaluation of Host Serum Protein Biomarkers of Tuberculosis in sub-Saharan Africa.Frontiers in immunology · 2021Article
- Effect of Inflammatory Cytokines/Chemokines on Pulmonary Tuberculosis Culture Conversion and Disease Severity in HIV-Infected and -Uninfected Individuals From South Africa.Frontiers in immunology · 2021Article
- Expression of MicroRNAs Is Dysregulated by HIV WhileFrontiers in microbiology · 2021Article
- Plasma levels of CRP, neopterin and IP-10 in HIV-infected individuals with and without pulmonary tuberculosis.Journal of clinical tuberculosis and other mycobacterial diseases · 2019Article
- Plasma Profiles of Inflammatory Markers Associated With Active Tuberculosis in Antiretroviral Therapy-Naive Human Immunodeficiency Virus-Positive Individuals.Open forum infectious diseases · 2019Article
- Elevated serum neopterin levels in children with functional constipation: association with systemic proinflammatory cytokines.World journal of pediatrics : WJP · 2018Article
- Inflammation responses in patients with pulmonary tuberculosis in an intensive care unit.Experimental and therapeutic medicine · 2018Article
- Serum Levels of Soluble CD40 Ligand and Neopterin in HIV Coinfected Asymptomatic and Symptomatic Visceral Leishmaniasis Patients.Frontiers in cellular and infection microbiology · 2018Article
- Barriers to HIV remission research in low- and middle-income countries.Journal of the International AIDS Society · 2017Review
- Metabolomics Identifies Multiple Candidate Biomarkers to Diagnose and Stage Human African Trypanosomiasis.PLoS neglected tropical diseases · 2016Article
- Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWhile the risk of TB is elevated in HIV-positive subjects with low CD4 cell counts, TB may in itself be associated with CD4 lymphocytopenia. We investigated markers of immune activation (neopterin) and inflammation (CRP) in TB patients with and without HIV coinfection and their association with CD4 cell levels, and determined their predictive capacity as alternative markers of advanced immunosuppression.
methodsParticipants selected from a cohort of adults with TB at Ethiopian health centers (195 HIV+/TB+, 170 HIV-/TB+) and 31 controls were tested for plasma levels of neopterin and CRP. Baseline levels of neopterin and CRP were correlated to CD4 cell count before and after anti-TB treatment (ATT). The performance to predict CD4 cell strata for both markers were investigated using receiver operating curves.
resultsLevels of both biomarkers were elevated in TB patients (neopterin: HIV+/TB+ 54 nmol/l, HIV-/TB+ 23 nmol/l, controls 3.8 nmol/l; CRP: HIV+/TB+ 36 μg/ml, HIV-/TB+ 33 μg/ml, controls 0.5 μg/ml). Neopterin levels were inversely correlated (-0.53, p<0.001) to CD4 cell count, whereas this correlation was weaker for CRP (-0.25, p<0.001). Neither of the markers had adequate predictive value for identification of subjects with CD4 cell count <100 cells/mm3 (area under the curve [AUC] 0.64 for neopterin, AUC 0.59 for CRP).
conclusionNeopterin levels were high in adults with TB, both with and without HIV coinfection, with inverse correlation to CD4 cell count. This suggests that immune activation may be involved in TB-related CD4 lymphocytopenia. However, neither neopterin nor CRP showed promise as alternative tests for immunosuppression in patients coinfected with HIV and TB.
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