The value of increased neopterin levels in reducing transfusion-transmitted virus infections: detection of a donation from a HBsAg positive chronic carrier by screening of neopterin in Turkish blood donors

Serum Neopterin Is Not Influenced by Age and Blood Group of Transfusion-Transmitted Infection Negative Blood Donors

Objectives

To measure serum neopterin levels in blood donors of the local population and to study its relationship with age and blood group of transfusion-transmitted infection (TTI) negative blood donors.

Methodology

This cross-sectional study was carried out in the Department of Physiology at Liaquat National Hospital and Medical College (LNMC), Karachi, Pakistan, in collaboration with the Basic Medical Sciences Institute and Jinnah Post Graduate Medical Centre (JPMC). Data were collected from January 2018 to July 2018. A total of 174 blood donors participated in the study, who were selected by using a random sampling technique. They were screened through the standard procedures used for screening at the JPMC blood bank for TTIs as per the World Health Organization recommendations. Serum neopterin was estimated using enzyme-linked immunosorbent assay (ELISA) kits. Data analysis was performed using Statistical Package for Social Sciences (SPSS) version 23 (IBM Corp., Armonk, NY, USA). Chi-square and ANOVA (analysis of variance) were applied, and tests of significance were kept as P < 0.05.

Results

Neopterin level in the serum of TTI-positive blood donors was 15.1 ± 4.59 nmol/L, which was above the normal range and cutoff value of 10 nmol/L, whereas the neopterin level in the serum of TTI-negative blood donors was 6.1 ± 1.82 nmol/L (P = 0.001). In TTI-negative blood donors, the neopterin levels were within normal limits and were not influenced by age and blood groups (P > 0.05).

Conclusions

Serum neopterin levels did not report any significant difference in terms of age and blood group of TTI-negative blood donors and were seen to be within normal limits.

Neopterin and Soluble CD14 Levels as Indicators of Immune Activation in Cases with Indeterminate Pattern and True Positive HIV-1 Infection

Background

We aimed to evaluate the roles of the plasma immune activation biomarkers neopterin and soluble CD14 (sCD14) in the indirect assessment of the immune activation status of patients with the indeterminate HIV-1 (IHIV-1) pattern and a true HIV-1-positive infection (PCG).

Methods

This cross-sectional and descriptive study included eighty-eight patients with the IHIV-1 pattern, 100 patients in the PCG, and 100 people in a healthy control group (HCG). Neopterin and sCD14 levels were determined by competitive and sandwich ELISA methods, respectively.

Results

Mean neopterin and sCD14 levels among those with the IHIV-1 pattern were significantly lower than among the PCG (p < 0.001 and p = 0.001, respectively), but they were similiar to those in the HCG (p = 0.57 and p = 0.66, respectively. Mean neopterin and sCD14 levels among the PCG were found to be significantly higher than among those with the IHIV-1 pattern (p < 0.001 and p = 0.001, respectively) and among those in the HCG (p = 0.001, p < 0.001, respectively). Neopterin did not have adequate predictive value for identifying those in the PCG (area under the curve [AUC] = 0.534; 95% CI, 0.463–0.605; p = 0.4256); sCD14 also had poor predictive value but high specificity (100%) for identifying those in the PCG (AUC = 0.627; 95% CI, 0.556–0.694; p = 0.0036).

Conclusions

While low levels of these two biomarkers were detected among those with the IHIV-1 pattern, they were found in high levels among those in the PCG. These two markers obviously cannot be used as a sceening test because they have low sensitivies. Taken together, we suggest that neopterin and sCD14 may be helpful because they both have high specificity (92%-100%) as indirect non-specific markers for predicting the immune activation status of individuals, whether or not they have true positive HIV-1.